Georgia plaintiff Mary L. Craft filed an insurance claim denial lawsuit against Unum Life Insurance Company for wrongfully denying her long-term disability benefits, as she contends with stage-three breast cancer.

Before Craft became disabled, she was fully employed as Manager and Director of Human Resources for Georgia Bankers Association, according to the Unum lawsuit. She was fully employed, but had needed to gather her long-term disability benefits before the first year had passed since she became eligible. Essentially, because she claimed to be disabled within the first twelve months of her coverage, Unum had been suspicious of her disability being a pre-existing condition.

Craft officially became disabled on Dec. 10, 2012 due Leptomeningeal Carcinomatosis, also known as breast cancer. However, the insurance policy that Craft had been provided did not go into effect until July 1, 2012, so Unum had investigated the claim to insure that the cancer had not been present previously. Due to a prescription for Ferma at an earlier date when her cancer was not as aggressive, Unum declared her condition pre-existing and denied her disability insurance coverage on July 3, 2013.

Craft appealed this decision on Jan. 8, 2014, submitting medical records to prove that she had a different, less aggressive form of breast cancer at the time. She submitted testimony from her doctor that indicated her condition was different at the time of her Ferma prescription as the drug was meant for therapy, and furthermore Craft would not be alive today without the medication.

The type of cancer the Georgia woman has now is aggressive, and could not have been a pre-existing condition, according to the Unum lawsuit. Lab results of her breast cancer were reportedly sent to Unum on July 11, 2012, at the time of her first claim submission. Despite all the medical evidence and administration cooperation, Unum still denied Craft her disability benefits based on the Ferma prescription, stating that the cancer had been a pre-existing condition.

Craft is sung Unum Life Insurance Company for practicing bad faith insurance and wrongfully denying her long-term disability benefits. She is seeking compensation for all missed payments, any additional interest, and legal fees.

Overview of Unum Claim Denial Policies

Under the federal act of ERISA, each full-time employee in the United States has the right to a comfortable retirement and pension plan, after working a certain amount of time at a place of employment. Despite federal regulation requirements, Unum has continually been found to be in violation of this act by wrongfully denying their policyholder’s benefits. Unum has been accused of using unfair claim denial tactics to dismiss the claims, to avoid paying out any benefits. Tactics Unum has been accused of illegally using include, but are not limited to:

• Making changes to the plan without the authorization of the policyholder
• Changing policies after the policyholder’s claims are filed
• Failing to notify the recipients about these changes
• Improperly and inappropriately investigating a claim
• Obtaining opinions from unqualified third parties
• Having contract medical examiners read over and misinterpret medical records
• Using these third-party medical examiners to deny a claim when the policyholder did not provide a medical exam, or giving the policyholder insufficient time to obtain a medical exam

This Unum lawsuit is Mary L. Craft v. Unum Life Insurance Company, Case No. 2:14-cv-00113-WCO, in the U.S. District Court for the Northern District of Georgia, Gainesville Division.