Jessica Tyner  |  January 31, 2014

Category: Consumer News

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Unum bad faith denial lawsuitPlaintiff Wanda Stup has joined the many other Unum policyholders who got her disability claim denied even after allegedly proving she had a very real and debilitating disease. She claims that the insurance giant “improperly denied her long-term disability benefits in violation of the Employee Retirement Income Security Act of 1974 (ERISA).”

According to claims raised in a bad faith denial lawsuit filed by Stup, Unum couldn’t deny she actually had Lupus, but the company allegedly has a number of tricks up their sleeve when it comes to denying claims or canceling payments for legitimate illnesses.

Unum says that it “acted reasonably” when it determined that even though Stup has Lupus, she could still work in a job that suited her training. Unum determined that Stup didn’t qualify for long-term disability coverage since her disease didn’t prevent her from working. However, as anyone familiar with Lupus knows, this can be a debilitating disease. Luckily for Stup, she took Unum to court in late 2004 and the court rejected Unum’s argument. It was found that Unum “abused its discretion in denying Stup LTD benefits.” This was 10 years ago, evidence that Unum bad faith denial allegations have been swirling for years.

As one of the biggest providers of long-term disabilty coverage in the country, the majority of people have coverage via Unum but may not even know it. Simply put, most people (fortunately) never have to file an LTD claim. They often have their policies via their employer and have been paying into it for years.

In Stups’ case, Lupus is defined as a “chronic inflammatory connective tissue disorder” and can impact the skin, lungs, joints, kidneys, heart and blood. There are varying degrees of Lupus, and it can render a person unable to perform even the most common of daily tasks, let alone work full-time. However, one of Unum’s favored tactics is using their own, hired doctors to make calls on how disabled a person is—usually without ever seeing the patient, according to some employees.

In Stups’ Unum bad faith lawsuit, she claimed that “Unum doctors were apparently uneducated in the Lupus diagnosis and had to be taught by the judge.” The judge in the case schooled the Unum doctors about just what Lupus is and the basics of medicine— something they were supposedly practicing for years. Since then, so many people have come forward with Unum complaints that multiple Unum class action lawsuits have been filed.

The basic premise of Unum bad faith lawsuits is that an investigation by CBS News uncovered a financial bonus system that rewarded Unum employees for closing or denying big cases.

A few years ago, CBS found a number of Unum employees and ex-employees who were willing to share what it’s really like working for the company. It was revealed that there were financial incentives, in writing, to reward employees who denied the biggest claims. Instead of caring for their customers and making the process as easy as possible, these employees said that it was a goal to make as much money as possible—and pay out as little as possible.

The sheer number of Unum horror stories back up this perspective of the nation’s biggest LTD provider. Many people just give up. Their health is failing, and it’s too much work and too much stress to battle such a giant. Others get frustrated in the appeals process. Joining an Unum class action lawsuit or filing an individual bad faith denial lawsuit is a last resort for many, but luckily it’s much more manageable than taking on Unum alone.

According to the Stups case, Unum attempted to rewrite the medical books on Lupus. There is countless research on Lupus and organizations dedicated to educating the public on the disease. Organizations like Lupus.org are always on hand to provide expert information on the ailment, but Stups says Unum chose to dismiss all of this information and research because, allegedly, it wasn’t profitable for them.

So-called Unum scandals are allegedly easy to find, with a number of victims willing to share their story. In some instances, the policyholder had paid into their Unum disability policy for decades. There are doctors, teachers, administrative professionals and construction workers alike all with Unum policies who, in the end, found out their coverage failed them the hard way.

People expect their LTD coverage to be there for them in the worst of times. Many times, these people easily get social security disability benefits (which isn’t easy to get), and yet Unum still denies their policy and says either they don’t qualify or are fit enough to work full-time. Even worse for these policyholders is that they’re denied coverage when they’re facing the biggest challenge of their life. Learning to deal with a disability, therapy and mounting medical bills are stress-inducing enough.

In general, Unum lawsuits are filed individually by each plaintiff and are not class actions.

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