By Robert J. Boumis  |  February 4, 2014

Category: Consumer News

disability insurance appealIf you’ve had a long- or short-term disability insurance claim denied by Unum, you may not know what to do next. But you do have options and further steps that you can take in your situation.

Step One: Ask Unum

First, you must gather all of the information that you can about the initial denial. You will need to figure how exactly why Unum denied your disability insurance claim. For example, if Unum denied your claim because they felt that you could continue to do your job, ask them for the job description they are relying on. If they claim that you were not covered during the time in question, ask them to show you the clause in your insurance policy that disqualified you. Most importantly, figure out the deadlines for their appeals process.

Step Two: Gather Your Own Information

Next you will need to get your own information together. You may need statements from doctors, employers, and even family members to support your appeal. Sometimes a doctor can clarify the extent of your injuries, and a statement from them can help support you in an appeal or a future court case related to the denial of your disability insurance claim. You may want to start a journal to document the extent that your disability interferes with your day-to-day life.

Step Three: Submit Your Appeal

Make certain you submit your appeal of your disability insurance denial by the deadline specified. Include a cover letter outlining the situation, as well as any material that can support your claims. You should include letters from physicians, medical tests, and any other supporting documents you’ve amassed. You will want to follow up with Unum several weeks later by calling to verify that your materials have been received.

Step Four: Repeat as Necessary

Unfortunately, you may go through the process of appealing your disability insurance claim more than once. In this event, you will repeat steps one through three, adding and clarifying any issues you have.

Step Five: Take Legal Action

The Employee Retirement Security Act of 1974 (ERISA) is federal law that can come into play when dealing with disability insurance claims. ERISA was originally created to manage pensions, but disability insurance also falls under its purview. One key provision of ERISA is that you must exhaust your insurance company’s internal appeals process before seeking legal action. However, you may seek legal counsel at any time during the appeals process.

Alleged Bad Faith Insurance Tactics

Various Unum lawsuits have accused the company of using a number of bad faith insurance tactics to deny legitimate disability insurance claims. These tactics allegedly include bad faith practices like claiming a patient is not truly disabled, despite medical evidence to the contrary, or having their in-house physicians deny claims. Even if you face these insurance claim denial tactics, you must keep a clear head and not lose your temper. You must complete the appeals process in good faith, doing your best to fulfill any request for additional documentation they provide.

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

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Get Help With Your Long Term Disability Insurance Appeal

If you were denied a disability claim or had your disability benefits terminated without reason, you may be able to take legal action against the insurer. See if you qualify by filling out the short form below.

An attorney will contact you if you qualify to discuss the details of your potential case at no charge to you.

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