Plaintiff Shawn Legare has filed an insurance claim lawsuit against Unum Life Insurance Company for allegedly denying him his benefits. According to the lawsuit, Legare was a full-time employee of Boston Scientific Corporation and was supposed to be covered for both short- and long-term disability under Unum.

Legare alleges in the bad faith insurance lawsuit that he has been permanently disabled since April 25, 2012, according to the terms of Unum’s long-term disability plan.  Due to his disability, Legare has been unable to perform to the full capacity of his job and has been under the medical supervision of a physician.  Shortly after becoming disabled, Legare submitted his insurance claims, together with his medical evidence, proof of loss, and all other required documentation.

Despite submitting all requirements, including evidence which proves his qualifications for insurance coverage, Unum sent a  letter on Dec. 7, 2012, denying him his benefits.  According to the letter, Unum had changed its long-term disability requirements on Aug. 21, 2012, and Legare no longer met the new standard.  Legare alleges he was not told of this policy change, and sent a timely appeal against Unum’s decision, which he claims was made in bad faith — a legal term used to describe an insurer breaking its contract to provide services.

Unum responded with another denial letter on March 6, 2013, and has reportedly not given any rightfully-owed benefits to the plaintiff.  Legare has exhausted all administrative options to claim his benefits, forcing him to take legal action against the insurance company.  Legare is seeking all missing insurance payments from the company, plus any additionally interest.

According to Unum’s requirements to receive long-term benefits, the plaintiff had to show that he would be permanently unable to work in his current position, as well as any similar field.  Additionally, they would lose over 20% of their net income, and would not be able to subsist on their current assets that would have been covered by the insurance.  At no point in time did the plaintiff deviate from the requirements of his insurance contract, meeting all requirements to receive long-term benefits.

Unum is being charged with bad faith insurance by unreasonably withholding the plaintiff’s benefits and without giving the claim a sufficient review.  Unum is not entitled to automatically dismiss a claim. According to its company procedures, a claim must be thoroughly looked over in a standard review.  Because Unum is the insurance provider for the employer, they ultimately decide whether or not a claim is viable for benefits or not.

Unum Litigation Movement

Though Legre’s case is unfortunate, it is not the first lawsuit to be filed against Unum.   Whether it’s using third-party testimony to discredit the claim, or simply changing the policy without the claimant’s knowledge, Unum has gained a reputation of allegedlyusing a variety of these tactics.

Under the Employee Retirement Income Security Act of 1974 (ERISA), any adult citizen who is found to be working full-time at a company for a certain number of years, has the right to a comfortable retirement.  Legare is bringing his lawsuit forward to claim his right to that long-awaited reward after working for so long.

The Unum bad faith insurance lawsuit is  Shawn Legare v. Unum Life Insurance of America, Case 0:14-cv-60159-JIC, in the United States District Court of Southern Florida.