A man has filed a lawsuit against Unum Life Insurance Company of America after he was denied HIV disability benefits.

Plaintiff Marcus A. was employed as a winch truck operator for Georgia Power, which provided group long term disability benefits to its employees through Unum.

Marcus stopped working in early May 2005 because of symptoms from cardiomyopathy, HIV and hepatitis B. He suffered from extreme fatigue and shortness of breath, among other debilitating symptoms. He received large doses of prescription medications to help alleviate some of his suffering.

He applied for long term disability benefits and was approved for them in May 2005. Unum paid his HIV disability benefits for about 11 years, until December 2016.

HIV Disability Benefits Terminated Without Cause

On Dec. 14, 2016, Marcus received a letter from Unum indicating his HIV disability benefits were terminating. The company had determined that he could perform three occupations even though his medical condition had not improved.

In May 2017, Marcus appealed the denied claim; in June 2017, Unum upheld its decision to terminate his HIV disability benefits.

Unum made their decision to stop his disability coverage in spite of a letter from his personal physician that said Marcus’ condition had not changed and that he continued to be “incapable of working due to his symptoms.”

Unum is accused of relying “on hearsay reports of physicians and other persons who did not examine” Marcus. The insurance company also allegedly “misquoted and misinterpreted” the medical data they had received from Marcus’ treating physicians.

Allegedly the HIV disability benefits were also denied because Unum chose to ignore the medical opinions of the doctors who treated Marcus and determined he was unable to return to work. Marcus claims Unum’s failure to provide him with a full and fair review of his claim are violations of the Employee Retirement Income Security Act (ERISA).

According to the HIV disability benefits lawsuit, Unum defines a person as disabled when the employee is limited from performing his regular job duties due to illness or injury and the employee has a 20 percent or more loss in his indexed monthly earnings due to the identical illness or injury.

Unum also indicates a qualifying disabled employee will receive benefits beyond a 24-month period if the person is “working in any occupation and continue to have a 50 percent or more loss in your indexed earnings due to your sickness or injury; or you’re not working and, due to the same sickness or injury, are unable to perform the duties of any occupation for which you are reasonably fitted by education, training or experience.”

Marcus alleged he meets the requirements, which means Unum unlawfully denied him of his HIV disability benefits. Unum stands accused of failing to administer the benefits plan in accordance with ERISA regulations.

The HIV Disability Benefits Lawsuit is Case No. 1:18-cv-00306-LMM in the U.S. District Court for the Northern District of Georgia, Atlanta 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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