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A man from Alabama is suing Unum Life Insurance Company of America to restore long-term disability benefits denied allegedly without justification.
Plaintiff Charlie W. also names General American Life Insurance Company of America as a defendant. He alleges that the company and Unum both administered his disability insurance policy.
Charlie claims that after Unum and General American paid him benefits for years, he suddenly had his long-term disability benefits denied for no good reason.
Charlie says he was the owner and cook at Charlie’s BBQ until his disabilities forced him to stop working in January 2009.
His purported disabilities include a long list of conditions that could have significant effects on a person’s ability to work and earn income.
Charlie says he has been suffering from “degenerative joint disease in his right knee, osteopenia, chronic bilateral hand numbness, carpal tunnel syndrome, persistent joint pain and inflammation, gastroesophageal reflux disease, severe intractable pain, coronary heart disease, and chronic fatigue.”
He claims these disabilities have completely compromised his ability to work. In particular, the nerve problems in his hands prevent him from gripping objects, and they often cause him to drop things, he claims.
His knee problems have been severe enough to prevent him from standing or walking for long periods of time, he says.
Long-Term Disability Benefits Denied Despite Medical Evidence
According to his Unum lawsuit, Unum and General American had been paying Charlie disability benefits for years. But in April 2014, he had his long-term disability benefits denied.
Charlie says that even after two appeals of that denial, the companies upheld the denial both times, issuing their final decision on May 15, 2015.
The defendants said in their denial that Charlie’s condition has improved, he says. Charlie says that conclusion flies in the face of the records of his doctor’s visits in June 2014 and February 2015.
He says those records show he reported no improvement in his carpal tunnel syndrome, despite treatment. His other conditions also showed no improvement, he says.
Other evaluations from around that time determined that Charlie’s tolerance for work activities was “sedentary at best.” They said he was unable to climb, kneel, stoop or squat, he says.
Nevertheless, Unum and General American determined that Charlie still had the physical ability to perform three particular jobs that involve sedentary work.
As evidence that his conditions meet the policy’s definition of “disability,” Charlie points out that the Social Security Administration found him totally disabled under its own standard, which he argues is stricter than the standard in his disability insurance policy.
Charlie accuses the companies of cherry-picking evidence in the record to support their denial, while ignoring evidence to the contrary. He claims Unum and General American completely disregarded the opinions of his own treating physicians in favor of the opinions of their paid medical reviewer.
He says the denial was “grossly wrong, without basis, and contrary to the evidence.”
Charlie’s Unum lawsuit raises claims for breach of contract and for tortious or bad faith. He is asking the court for all available damages, equitable relief and any other relief he may be entitled to.
The Unum Denied Disability Benefits Lawsuit is Case No. 4:16-cv-01110 in the U.S. District Court for the Northern District of Alabama, Northern 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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