Unum Life Insurance Company of America is facing a new claim denial lawsuit, alleging the insurance company had wrongfully denied long term disability insurance to the claimant.

The claim denial lawsuit was filed by a woman from Georgia who needed long term disability insurance coverage for her serious medical conditions, which have left her unable to work.

Plaintiff Martina S. says she previously worked for Enterprise Holdings Inc. on a full time basis as a Reservation Sales Agent and was supposed to be provided long term disability insurance coverage should she ever need it.

This became relevant on Dec. 7, 2015, when Martina reportedly had to cease working due to severe back pain caused by intervertebral disc placement, intervertebral disc degeneration, and lumbago with sciatica.

When she filed for long term disability insurance, Martina says she filed all relevant medical evidence from her physician and other expert opinions that proved Martina would be unable to work in a similar occupation.

Overview of Claim Denial Lawsuit

According to the claim denial lawsuit, Martina applied for long term disability insurance but was reportedly denied by Unum on June 8, 2016, stating there was insufficient evidence that proved she was unable to perform her occupational duties.

Unum reportedly based this decision on a review by an in-house doctor and vocational expert. The claim denial letter gave Martina 180 days to appeal.

Martina says she filed an appeal on Nov. 28, 2016 and submitted additional medical records that showed the severity of her medical condition. However, Unum reportedly already made its decision to uphold its claim denial on Martina months before the appeal was filed.

According to the claim denial lawsuit, Martina had repeatedly sent her medical records to Unum that showed the severity of her condition after receiving the claim denial decision.

Martina says she sent medical records to Unum four different times between Dec. 2, 2016 to Dec. 23, 2016, with Unum finally responding to Martina by stating it would not be reopening her file and would uphold its decision.

However, Martina did not give up. She says she sent her medical records two more times in the beginning in January 2017, with Unum repeating its first response. Martina allegedly sent her medical records three more times between Jan. 27, 2017 and April 18, 2017, with Unum still choosing not to reopen her case.

At this point in time, Martina says she has exhausted all administrative options and has been forced to file legal action. Martina alleges her claim denial was made in bad faith, alleging Unum ignored relevant medical records that proved she was unable to work.

Under her Unum long term disability insurance policy, she claims, policyholders become eligible for coverage when they become unable to work in a similar occupation, have gainful employment in another company, and lose at least 20 percent of their income due to their disability.

Unum is one of the largest disability providers in the United States. It has become infamous for allegedly systematically using bad faith insurance tactics to deny claims. Martina is seeking compensation for all missing long term disability insurance payments, along with any other damages related to bad faith insurance.

This Long Term Disability Lawsuit is Case No. 4:18-cv-00238-CDL, in the U.S. District Court of Middle Georgia, Columbus Division.

Do YOU have a legal claim? Fill out the form on this page now for a free, immediate, and confidential case evaluation. The bad faith insurance attorneys who work with Top Class Actions will contact you if you qualify to let you know if an individual lawsuit or Unum class action lawsuit is best for you. [In general, Unum bad faith lawsuits are filed individually by each plaintiff and are not class actions.] Hurry — statutes of limitations may apply.

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