A former Unum employee has filed a bad faith insurance lawsuit against Unum Life Insurance Company of America for allegedly denying her long-term disability benefits.

Plaintiff Donna B. from Maine worked as a Customer Service Specialist for Unum, and had been entitled to long-term and short-term disability benefits, according to her bad faith insurance lawsuit.

Her job centered around interacting with customers on a daily basis. By 2011, her lawsuit said, Donna had begun experiencing pain in her arms and neck during her job, leading to an extensive medical examination from her physician.

Unum has been allegedly denying long-term and short-term disability claims for decades, allegedly having an established system of choosing which claims to approve or deny.

Overview of the Claim Denial Lawsuit

According to Donna’s physician, the plaintiff had bilateral levator scapula weakness, which essentially caused her posture to slant because of pain from her middle back. She was ultimately diagnosed with cervical neuritis and cervical spondylosis.

On June 29, 2011, Donna began to treat her back problems under the instructions of her physician, using therapeutic exercises and steroid injections. In November 2011, the plaintiff’s physician had noticed her hand pains had not improved, and felt that current treatment was not working. This resulted in Donna receiving open left carpal tunnel surgery on Nov. 15, 2011, the Unum lawsuit said.

This surgery did not help. On Jan. 9, 2012, her physicians acknowledged in writing that the plaintiff would no longer be able to continue her occupation, and that the actions such as typing and answering phones was worsening her condition.

While Unum had initially paid Donna’s short-term disability benefits for the entire coverage period, the company denied Donna long-term disability benefits.

Under Unum’s long-term benefits policy, the lawsuit said, as long as Donna proved that she needed the coverage for medically valid reasons, and that these medical reasons were the reason why she could not perform her job, she would receive the insurace. Despite the medical evidence she provided when she applied for long-term benefits, which included testimony from her physician, she was officially denied these benefits in mid 2012.

After the claim was turned down, Donna’s physicians sent a letter to Unum that explained her condition, emphasizing that she cannot work in her current occupation with her condition. The physicians also stated that she would be unable to work in a similar job, and would be unable to maintain her level of income.

Unum still denied her claim on May 22, 2012. This denial was allegedly decided without proof or proper examination of the claim, leading to Donna filing an appeal. Unum had denied her appeal on Nov. 30, 2012, leading to her Unum lawsuit.

This Unum insurance claim denial lawsuit is Case No. 2:15-cv-00053-NT, in the U.S. District Court of Maine.