By Robert J. Boumis  |  June 11, 2014

Category: Consumer News

LawsuitLogosPics_unum_iStock_disablity claim deniedUnum is facing a new insurance claim denial lawsuit. The latest Unum disability benefits lawsuit accuses the insurance company of acting in bad faith and denying a legitimate insurance claim in bad faith.

Plaintiff Yvonne West alleges that Unum wrongfully denied her insurance claim. Though the text of her complaint does not list details about her condition, Unum has faced similar cases in the past.

Unum is a company that specializes in long term disability insurance (LTD). LTD insurance is a type of insurance designed to help protect people when they become unable to work for medical reasons. LTD policies typically pay a percentage of the amount the policyholder made before their injuries.

West’s Unum lawsuit alleges that Unum acted in bad faith. Bad faith is a legal term that means one party in a contract is trying to avoid its contractual obligations. In the case of insurance law, it usually means that the company underwriting the policy tries to avoid paying out on a legitimate insurance claim.

Unum has been accused of acting in bad faith before. Other Unum bad faith denial lawsuits — and a 2002 investigation by “60 Minutes” — have alleged that Unum has used a variety of tactics to deny legitimate insurance claims. For example, the company has been accused of using in-house doctors to countermand the disability determinations of policyholders’ physicians. Additionally, Unum has been accused of stretching the definition of “not fully disabled,” in order to prevent patients from getting insurance payouts. The “60 Minutes” investigation revealed that Unum awarded a “Hungry Vulture Award” to the employee that denied the most disability insurance claims.

Disability insurance policies are governed under a federal law called the Employee Retirement Income Security Act or ERISA. ERISA was originally set up to correct problems with pensions, but it also applies to disability insurance. Under ERISA, a person may file an insurance claim denial lawsuit against an insurance company in a case of alleged bad faith, but only after exhausting any internal appeals process.

This Unum denied insurance claim lawsuit is formally titled Yvonne West v. First Unum Life Insurance Company, Case No. 3:14-cv-576-J-39JRK, in the U.S. District Court for the Middle District of Florida, Jacksonville Division.

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

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