Amanda Antell  |  July 16, 2014

Category: Consumer News

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Unum disabiliy insurance problemsA Unum disability benefits lawsuit was filed against Unum Life Insurance Company for allegedly wrongfully reducing the long-term disability benefits paid to a California man.

Plaintiff Michael C. Kaplan became disabled in 2003. He was first insured through his employer, the County of Monterey. His Unum lawsuit indicates that he had paid all premiums through payroll deductions, and followed all requirements as expected by the defendant.

Unum is the oldest disability insurance company in America, and the largest disability insurance provider in the world. For years, people have filed Unum claim denial lawsuits over for various alleged unethical claim denial tactics to keep profits high.

Overview of the Insurance Policy Deductible

After Kaplan filed for long-term disability benefits, Unum approved his claim and started sending monthly payments. He reportedly received the payments in varying amounts every month until  he was also approved to receive Social Security Disability Insurance (SSDI) benefits.

That month Unum reduced the amount of Kaplan’s monthly long-term disability benefits in the amount of the SSDI monthly checks, according to his Unum lawsuit. After Kaplan noticed the payment deduction, he sent Unum a copy of his policy and advisement letter, stating that his policy did not provide for an offset of this nature.

According to Kaplan’s Unum lawsuit, Unum acknowledged his benefits should not have been reduced. Shortly thereafter, Unum paid the him the amount that had been deducted from his long-term disability benefits, and then had his regular payment continue until June 1, 2008.

A week earlier, according to the Unum lawsuit, Unum revised the Kaplan’s policy to state that they could reduce payments in the amount of the Social Security payments. Kaplan appealed this decision and was denied. Several months later, Kaplan once again attempted to appeal the decision, and requested that Unum get an independent legal opinion on the matter. Unum’s claim examiner for the plaintiff had replied back in a letter, stating “this is not going to happen,” the disability insurance lawsuit says.

The disability insurance lawsuit alleged that Unum initially concealed a record of the earlier letter that acknowledged the Social Security benefits should not be deducted, but admitted it when the plaintiff produced his own copy. Despite the discovery, Unum has yet to pay back any of the deducted payments since June 2008, the Unum lawsuit says.

The Unum Disability Insurance Lawsuit is Michael C. Kaplan v. Unum Life Insurance Company, Case No. 5:14-cv-02210-RMW, in the U.S. District Court for the Northern District of California.

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

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