Unum Policyholder Sues for Long-Term Disability Benefits

By TopClassActions | November 22, 2013

Category: Labor & Employment

By Robert J. Boumis

Vivan Vachon has filed a disability insurance lawsuit against insurance giant Unum Life Insurance Company of America, alleging that the company wrongfully denied her legitimate long-term disability (LTD) claim.

Vachon was employed by Wentworth-Douglas Hospital, and had an LTD insurance policy through Unum at the time. Prior to September 2011, Vachon worked as a phlebotomist for the hospital, a type of medical technician who specializes in drawing blood. The lawsuit states that, in September 2011, Vachon became disabled due to a combination of several serious physical disorders, including fibromyalgia, irritable bowl syndrome (IBS), migraines, chronic back pain, hypertension, hypothyroidism and clinical depression.

The disability insurance lawsuit asserts that the combination of these disorders more than satisfies the definition of “disabled” established in the insurance policy. Despite these physical conditions, Vachon briefly attempted to return to work in October of that year, but after a week, it was obvious that she could no longer perform her job functions.

Unum initially approved Vachon for short-term disability insurance, which can run for up to 26 weeks. However, a month before the short-term disability benefits were set to expire, Unum sent Vachon a letter denying her long-term disability payments. According to the Unum lawsuit, the insurance company asserted that Vachon could continue to work, despite her conditions.

Vachon began the appeals process through Unum. Many of the laws regulating pensions and long-term disability insurance, including the Employee Retirement Income Security Act (ERISA), require a policyholder to exhaust any internal appeals process prior to taking civil action like a lawsuit. Vachon’s physician submitted documentation about her illness, including a letter that detailed her medical history, asserting Vachon was disabled and could not work. Unum upheld its denial in January 2013 with a letter that claimed Vachon could perform “light physical occupational activities.”

Vachon’s Unum lawsuit asserts that per the terms of the LTD plan, Vachon is disabled and cannot work. The disability insurance lawsuit seeks to enforce the terms of the LTD policy, to get Unum to pay out any back-owed LTD benefits and make future payments. The lawsuit also seeks legal fees and interest on the allegedly back-owed amounts.

The Unum disability insurance lawsuit is Vivan Vachon, v. Unum Life Insurance Company of America, Case No. 4:13-cv-40122-TSH, in the U.S. District Court for the District of Massachusetts.

If you or someone you care about had a legitimate long-term disability insurance claim denied, you may have legal recourse. While large companies like Unum have a way of making their word seem final, the legal system is designed to protect everyone’s rights, regardless of the parties involved. You can start to explore your options by visiting the Unum/UnumProvident Disability Insurance Claim Denial Class Action Lawsuit Investigation. Here, you can enter information about your situation for a legal review by a trained expert with a background in this type of litigation. The initial consultation is completely free of charge and from here, you can receive additional guidance on the best steps to take in your exact situation.