An Unum disability claim lawsuit has been filed by a Massachusetts doctor, alleging the disability insurance giant wrongfully denied her claim and failed to perform its duty to properly evaluate her claim.

The doctor says she had to file the Unum disability claim lawsuit after exhausting all other administrative remedies and repeatedly being denied by the insurance company without sufficient reason.

Plaintiff Priscilla H. filed the Unum disability claim lawsuit, alleging Unum Life Insurance Company of America failed to honor the disability policy that had been provided by her employer.

Priscilla claims she had been previously employed at Partners as an anesthesiologist, but had to cease her work as a doctor on May 6, 2014, due to painful symptoms preventing her from performing her work duties.

As her symptoms continued to progress, Priscilla applied for long term disability benefits from Unum on Oct. 8, 2014. During the filing process, Priscilla had submitted all relevant medical records and vocational testimony that proved the severity of her disability.

Unum initially approved her claim for long term disability benefits on Jan. 26, 2015, after reviewing her claim describing how her condition had limited her occupational duties as an anesthesiologist. Unum back paid her long term benefits from Aug. 4, 2014 through May 11, 2015, at which point the company reportedly terminated them.

Overview of Unum Disability Claim Lawsuit

Unum allegedly terminated Priscilla’s long term disability benefits even though her medical records indicated her condition did not improve, stating that she no longer needed them.

Priscilla appealed the decision on Oct. 19, 2015, submitting updated medical and vocational records and an independent medical examination that confirmed Priscilla’s disability prevented her from working. These papers also stated Priscilla would be unable to earn sufficient income and be unable to work in a similar occupation, which are eligibility conditions under the terms of her plan.

Even though she met all eligibility requirements under the terms of her Unum disability plan, Priscilla was still denied coverage. Priscilla had received notice of the decision on Jan. 18, 2016, and filed the Unum disability claim lawsuit soon after.

Priscilla alleges Unum never conducted a reasonable vocational assessment of her claim as required by her disability plan, which would have highlighted the severity of the disability.

It is important to note that Priscilla’s legal counsel had submitted additional medical records and independent medical records on Oct. 26, 2017, requesting the company review and reevaluate Priscilla’s eligibility for benefits. Unum’s Director of Appeals responded to Priscilla’s legal counsel on Nov. 10, 2017, upholding their decision.

Unum Claim Denials

Unum Life Insurance company is one of the largest and oldest disability insurance providers in America, with millions of policyholders across the United States. In recent years, Unum has garnered a reputation of unfairly denying disability claims from policyholders for insufficient reasons.

Unum has been accused of wrongfully denying claims based on false or insufficient evidence. This was also allegedly the case with Priscilla, who says she was eligible for long term disability benefits but was wrongfully denied.

At this point in time, Priscilla has exhausted her administrative remedies and has been forced to file this Unum disability claim lawsuit. Priscilla is seeking compensation for all missing disability payments, along with any relevant damages.

This Unum Disability Claim Lawsuit is Case No. 1:18-cv-10122-MPK, in the U.S. District Court for the District of Massachusetts.

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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