Unum Insurance Company is now facing another ERISA disability lawsuit. Plaintiff Mary S., a physician, has initiated an ERISA disability lawsuit against Unum Life Insurance Company of America, alleging that the company violated ERISA protections.

The ERISA disability lawsuit explains that the plaintiff was a covered beneficiary through a group disability benefits policy issued by Unum Life Insurance Company. That policy became effective on Jan. 1, 2009.

The plaintiff says she was employed by Texas Health Resources and was able to receive the disability policy through that company. The ERISA disability lawsuit explains that the defendant administered the plan and had the sole authority to deny or grant benefits to applicants.

The ERISA disability benefits lawsuit says that the defendant has an inherent conflict of interest in their management of this plan because they fund the plan benefits and retain the sole authority to deny or grant benefits.

The ERISA disability benefits lawsuit says that the defendant’s decision to deny disability benefits is a critical factor that should be under review in the lawsuit because of the alleged conflict of interest.

The plaintiff in the disability benefits lawsuit argues that the plan fails to give the defendant appropriate discretion, as discretionary language is prohibited under the Texas Insurance Code and that the defendant maintains the fiduciary responsibility to administer the plan thoroughly and to furnish disability benefits according to the plan’s terms.

As explained in the ERISA disability benefits lawsuit, the plaintiff is a 65-year-old female, previously employed as an internal medicine physician with Texas Health Resources.

The plaintiff alleges in her ERISA disability benefits lawsuit that she experienced disabling conditions and ceased being able to actively work in July 2016 because of a major depressive disorder and a mild cognitive impairment. The plaintiff alleges that she developed this disability on July 18th, 2016 and initiated her short-term disability benefits application.

As explained in the ERISA disability benefits lawsuit, the short-term disability benefits were denied, leading the plaintiff to file for long term disability benefits. Those long-term disability benefits were denied on Oct. 26, 2016, she says.

The plaintiff says she pursued administrative remedies following the denial of benefits and submitted additional information such as her medical records to illustrate the severity of her disabling condition including her own review of the claim filed.

She says that internal consultants working with the defendant also reviewed the claim. But on May 19, 2017, the plaintiff says she was notified that the defendant had upheld their original decision to deny the plaintiff’s claim for long term disability benefits and informed the plaintiff at that time that she had exhausted her administrative remedies.

The plaintiff says that Unum has violated ERISA because of their management of this particular claim and in denying her benefits for a legitimate application. Unum has become the subject of numerous lawsuits brought by disability plan policyholders who allege that the company wrongfully denies benefits even when there is ample evidence of the underlying medical conditions.

The ERISA Disability Lawsuit is Case No.4:18-cv-04350 in the U.S. District Court for the Southern District of Texas, Houston Davison.

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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