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Unum Life Insurance Company of America is being hit with a claim denial lawsuit, from a Missouri woman who alleges she was wrongfully denied disability benefits.
Unum had been providing disability insurance to the woman’s former employer, and was expected to provide short term or long term disability coverage if the employee had met the company’s requirements.
Plaintiff Susan L. had been fully employed for a number of years, before becoming disabled on Dec. 10, 2014 and applying for disability benefits.
Unum initially approved the claim; the disability benefits were to last no later than March 17, 2015.
Soon after the benefits ended, Unum informed Susan that she no longer met the requirements to receive benefits.
According to her claim denial lawsuit, Susan is fully disabled as defined by the insurance company’s policy.
Susan has been diagnosed with a number of medical problems including fibromyalgia, chronic fatigue syndrome, sleep apnea, depression, and anxiety.
These conditions had interfered with Susan’s ability to work, which eventually forced her to cease working.
Since her employment ended, Susan has been unable to work in a similar occupation or earn sustainable income. She has lost a significant portion of indexed earnings, and has multiple medical documents proving her disabilities.
Even though she met all of Unum’s requirements, Susan was still denied disability coverage.
When Unum made this sudden announcement, the company stated that she lacked sufficient medical documentation to support her claims.
Overview of Unum Claim Denial Allegations
On Nov. 16, 2015, Susan filed an appeal against Unum’s decision to end the disability benefits. On Feb. 16, 2016, Unum responded to the appeal by upholding its decision to deny the disability benefits.
In addition, Susan’s claim denial lawsuit alleges that Unum failed to provide a complete and fair review of Susan’s disability claim and had allegedly mischaracterized her conditions.
More specifically, Unum had allegedly falsified medical records and opinions, and failed to come to a proper decision after reviewing all the pieces of medical evidence.
Furthermore, Unum allegedly denied Susan’s disability benefits for the company’s best interest rather than Susan.
Unum is the largest disability insurance provider in the country, serving millions of Americans across the country. However, Unum has gained a reputation for unfair claim denials, even for patients who meet all requirements and have serious medical conditions.
Susan is seeking compensation of all missed benefit payments from March 17, 2015, at $1953.94 per missed month.
She is also seeking additional damages and compensation for legal fees, after Unum allegedly failed to perform is obligation to serve Susan’s financial interests.
The Unum Claim Denial Lawsuit is Case No. 16-cv-6057, in the U.S. District Court of Western Missouri.
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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