Unum is facing a new claim denial lawsuit, alleging the insurance giant had denied fibromyalgia long term disability coverage to the claimant.

The claim denial lawsuit was filed by a woman from California, who alleges her fibromyalgia long term disability coverage was denied under bad faith insurance circumstances and that the company was infamous for unfairly denying fibromyalgia claims.

Plaintiff Louisa V. alleges she needed fibromyalgia long term disability coverage, with her expensive treatments and inability to work. Fibromyalgia is a disability in which the patient experiences widespread pain in their muscular and skeletal system, which may also increase pain sensations due to how the disease affects the brain.

Even though fibromyalgia is a very painful condition to live with, it is reportedly one of the conditions commonly denied by Unum. Unum is one of the largest disability providers in the United States but has garnered a negative reputation for unfair claim denials.

The company has allegedly developed systemic claim denial tactics for disability claims, including refusing to acknowledge disability pertaining to fibromyalgia and mental illness.

Overview of Unum Claim Denial Lawsuit

Before becoming disabled, Louisa claims, she worked at the Orion Renewable Energy Group as Real Estate Counsel and was a full-time employee for years. Before her Orion employment began in 2014, she was diagnosed with fibromyalgia in 2011 and had varying success in different treatment methods.

Fibromyalgia had reportedly caused Louisa to experience a number of painful side effects including chronic pain, depression, and cognitive disabilities. This disease greatly impacted her ability to work full time as a lawyer, she alleges, and she was forced to reduce her workload in August 2016 but attempted to keep working despite the painful disability.

However, she says this accommodation was not enough, and she had to further reduce her workload in March 2017. At this time, Louisa filed a claim for fibromyalgia short term disability benefits but was reportedly denied by Unum in a letter dated April 21, 2017.

Just several weeks before receiving the notice, Louisa ceased working on Aug. 4, 2017 and applied for fibromyalgia long term disability benefits on Sept. 7, 2017. Unum once again denied Louisa’s claim, and again when Louisa requested a review of this denial.

Even though Louisa filed an appeal, Unum still denied her fibromyalgia long term disability coverage on Aug. 31, 2018. According to the claim denial lawsuit, Unum had failed to refer Louisa to an independent medical examiner and had ignored relevant medical testimony from her physician.

Unum had allegedly used their own medical reviewers Dr. Scott Norris and registered nurse Christine Galloway to conduct a “paper review” of Louisa’s file. She claims Norris and Galloway had allegedly selected specific portions of Louisa’s claim to help their superiors deny the claim for fibromyalgia long term disability coverage.

Louisa alleges that Unum had denied her claim for fibromyalgia long term disability coverage under bad faith insurance, by acting on their own behalf instead of hers. At this point in time, Louisa has exhausted all administrative remedies and has been forced to file legal action.

Louisa is seeking compensation for all missing disability payments, along with any other relevant damages.

This Claim Denial Lawsuit is Case No. 3:18-cv-05534, in the United States District Court for the Northern District of California.

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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