Unum Life Insurance Company is facing a recently filed lawsuit alleging wrongful disability insurance claim denial, and that the insurance company failed to follow through on its duty to act on behalf of their policyholder.

This claim denial lawsuit was recently filed by a woman from North Carolina, who alleges she experienced wrongful disability insurance claim denial and needed those benefits for her medical treatments.

Plaintiff Janet M. alleges the wrongful disability insurance claim denial involved the company ignoring relevant medical testimony that proved the severity of her condition. According to the claim denial lawsuit, Janet was previously fully employed at Jones Day and was supposed to be provided either short term or long term disability coverage should she ever need.

This reportedly became the case on May 14, 2015, when she had to cease working due to a number of different disabilities. According to the claim denial lawsuit, Janet reportedly developed coronary artery disease, fibromyalgia, osteoarthritis, and other debilitating conditions that prevented her from working.

At this point in time, Janet has been contending with her disabilities and will continue to need medical care.

Overview of Unum Disability Insurance Claim Denial

Janet claims she initially applied for short term disability benefits, and was approved on May 15, 2015, and received them through Aug. 17, 2015. Janet was reportedly notified that her benefits were being cut, which significantly undercut the amount of monthly benefits she could receive.

This sudden decision had reportedly forced Janet to file for long term disability benefits, which was reportedly denied on Aug. 24, 2016. While Janet had tried to appeal both the short term and long term disability insurance claim denial decisions but was reportedly denied on April 5, 2017.

Each time Janet had filed for disability benefits, she filed all relevant medical testimony and had followed all administrative procedure. In addition, Janet had met all eligibility requirements to receive benefits including losing a significant portion of her income and being unable to find work in a similar occupation.

Even though Janet’s disabilities have greatly reduced her quality of life and has left her unable to work, Unum maintains the disability insurance claim denial decision. According to the claim denial lawsuit, Unum reportedly never requested an independent medical examiner t to review Janet’s case to resolve this conflict and gave no medical reason to deny the claim.

According to the claim denial lawsuit, Unum may have opted for the disability insurance claim denial to maintaining a certain profit margin level. Unum allegedly has monthly financial targets, which are partially achieved by denying insurance claims.

These monthly financial goals are called “recovery plans”, which are the dollar amounts to be reached in the terms of reserves from denied or “recovered” claims. Unum Life Insurance Company is one of the largest disability insurance providers in the United States, with millions of policyholders signed up for coverage.

However, the insurance company has gained a negative reputation from the public, for allegedly denying insurance policies for insufficient reasons. Janet is allegedly one of these cases, claiming the wrongful disability insurance claim denial has exhausted all administrative remedies.

This Claim Denial Lawsuit is Case No. 1:18-cv-00094, in the U.S. District Court of Eastern Tennessee, Chattanooga Division.

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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