Like many workers, Michelle Dawn Younce paid into the employer-chosen Unum long-term disability (LTD) coverage for years. Unum is the largest provider of LTD coverage for businesses in the country, but it is also the target of dozens of bad faith insurance lawsuits. A number of policyholders claim that the company allegedly denies claims without proper cause, or that their disability payments suddenly stop.

There are numerous Unum bad faith lawsuits claiming that the company makes it impossible to get due payments. There is even a CBS exposé featuring (now former) Unum employees who detailed just how much pressure they were under to deny the biggest claims. According to the exposé, there was a written bonus system where employees were financially rewarded if and when they denied key claims.

Younce is another alleged Unum victim, filing her bad faith insurance lawsuit on Jan. 28, 2014. According to the lawsuit, “Plaintiff was employed by Blue Cross Blue Shield of Tennessee as a provider liaison. Blue Cross Blue Shield of Tennessee maintained group long-term disability insurance for the benefit of its employees, under Group Insurance Policy Number 400431. Blue Cross Blue Shield of Tennessee’s provision of group disability insurance coverage constitutes an ERISA welfare benefit plan (hereinafter, ‘Plan’). Plaintiff is a participant or beneficiary of the Plan and is covered by the Policy that provides benefits under the Plan.

Plaintiff ceased work due to a disability on May 28, 2010, while covered under the Plan. Plaintiff has been and continues to be disabled as defined by the provisions of the Plan and Policy. Plaintiff timely filed an application for benefits under the Plan and Policy/”

Even during a time when policyholders are facing difficult circumstances, those like Younce make an effort to follow Unum protocol and get their paperwork filed in a timely manner. However, Younce didn’t know what was in store for her.

“Defendant initially approved LTD benefits. By letter dated Nov. 28, 2012 Defendant informed Plaintiff that her benefits were being terminated. Plaintiff timely appealed this denial, by letter dated December 31, 2012. Unum issued a second denial on March 8, 2013, stating that Plaintiff’s claim was not subject to further administrative review,” the Unum bad faith lawsuit states.

Younce wasn’t initially told why her claim was mysteriously denied after it had already been approved. “Plaintiff has exhausted her administrative remedies with respect to her long term disability claim. The entity that made the decision to deny benefits was under a perpetual conflict of interest because the benefits would have been paid out of its own funds. The entity that made the decision to deny benefits allowed its concern over its own funds to influence its decision-making,” the Unum bad faith lawsuit states.

Having no access to compensation is a situation that can quickly spiral out of control, although in some cases victims do receive Social Security disability benefits. When a person is permanently disabled, such as Younce claims to be, they often have little to no access for means of making an income.

Younce sums up her situation by stating that, “Plaintiff is disabled under the terms of the Plan. Defendant failed to provide benefits due under the terms of the Plan, and this denial of benefits to Plaintiff constitutes a breach of the Plan. The decision to deny benefits was wrong under the terms of the Plan. The decision to deny benefits and decision-making processes were arbitrary and capricious.”

Like many, filing a bad faith insurance lawsuit against Unum is her last potential avenue for getting her compensation reinstated and the backpay she needs in order to simply live (let alone pay for future medical costs and costs of living). “The decision to deny benefits was not supported by substantial evidence in the record,” Younce says.

The case is Michelle Dawn Younce v. Unum Life Insurance Company of America, Case No.: 1:14-cv-00034-CLC-SLK, in the United States District Court Eastern District of Tennessee at Chattanooga.