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An Unum policyholder from Rock Hill, South Carolina, has filed suit against Unum, alleging a bad faith insurance denial.
The text of the Unum lawsuit is sparse on details, but holds that Plaintiff Caroline B. had an Unum policy through her employer. According to her Unum lawsuit, Caroline suffered a disability that forced her to stop working. At this point, she applied for long-term disability benefits, which Unum allegedly denied. After exhausting Unum’s internal appeals process, Caroline filed an Unum lawsuit alleging that the denial was a bad faith insurance denial.
Bad faith is a legal term meaning that one party in a lawsuit is trying to avoid their obligations under a contract. In the case of a bad faith insurance denial, the contract in question is the insurance policy. Unum lawsuits like this one typically allege that Unum undertakes bad faith insurance denials to avoid paying out on legitimate disability benefits claims. Moreover, Unum lawsuits often claim these bad faith insurance denials are the result of an inherent conflict of interest. Specifically, it is a conflict of interest that the party responsible for paying out on disability benefits claims is the one deciding if the policyholder is really disabled.
This Unum lawsuit was filed under the Employee Income Retirement Security Act, or ERISA. ERISA, a federal law, was originally designed to protect pension plans, and was created after the high-profile failure of several companies—who had no provisions for their pension plans. ERISA also applies to disability insurance plans like those run by Unum.
Unum is the industry leader in disability insurance, but it is also the center of many controversies. An exposé by the television newsmagazine 60 Minutes aired allegations that Unum aggressively sought to deny claims, regardless of their legitimacy. The 60 Minutes segment included interviews with Unum policyholders who alleged that Unum denied their claims. One claimant was a former eye surgeon who developed Parkinson’s disease; three physicians ruled that the disease left the doctor unable to perform surgery safely due to a hand tremor. Unum used a video of the doctor playing football in the backyard to claim the surgeon wasn’t disabled—footage the doctor claimed was actually his son.
The 60 Minutes segment also interviewed former Unum employees that alleged that management set monthly denial quota, requiring Unum agents to deny millions of dollars in disability insurance benefits, regardless of their validity. Failing to meet these denial quotas could result in “blitzes,” impromptu audits held to try and find claims that Unum could deny. Former employees described the pressure to deny claims as “intense” and that supervisors and mangers had to sign off on the denials.
The Unum lawsuit is Civil Action No. 0:15-49-TLW, filed in the United States District Court for the District of South Carolina, Rock Hill Division.
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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