By Robert J. Boumis  |  May 28, 2014

Category: Labor & Employment

Unum disability insuranceInsurance giant Unum has faced bad faith lawsuits in the past, alleging that the company has wrongfully denied insurance claims. A new Unum lawsuit has made similar allegations, saying Unum has deliberately denied a legitimate disability insurance claim.

Unum is an insurance company that specializes in long- and short-term disability insurance — insurance that is designed to protect policyholders financially when they have to take time off due to a debilitating injury.

The Unum lawsuit was filled by Virginia Miller. Miller’s disability insurance lawsuit alleges that Unum wrongfully denied her claim for a head injury.

In August of 2009, Miller allegedly suffered a fall and a severe head injury, leaving her with a variety of health problems, including memory issues, cognitive difficulties, and light sensitivity. Her condition deteriorated to the point that she could only work part-time in December 2009. Her physicians placed her on medical leave in January 2010.

Unum initially approved her long-term disability benefits in July 2010. However, in July 2012, Unum denied her benefits, claiming that her condition was a mental illness and thus she was only entitled to 24 months of insurance benefits under the policy. However, Miller appealed, with medical documents stating that her disability was from post-concussion syndrome, not a mental illness. However, after a series of appeals, her final appeal was denied in February 2014, according to Miller’s Unum lawsuit.

Congress passed the Employee Retirement Income Security Act (ERISA), which is supposed to protect Americans’ pensions and disability insurance. Though ERISA is designed to be enforced partially through civil lawsuits, it does require that policyholders exhaust any of their insurance company’s internal appeals processes.

Most insurance denial lawsuits against insurance companies allege that the companies acted in bad faith with respect to insurance claims. Bad faith is a legal term that means a party in a contract is trying to get out of their contractual obligations.

Unum has faced similar allegations before — both from other lawsuits, and a 2002 “60 Minutes” investigation. The “60 Minutes” interview alleged that Unum representatives were awarded for denying the most insurance claims.

The Unum bad faith lawsuit is Virginia Miller v. First Unum Life Insurance Company, Case No. 2:14-cv-02244-JP,  in the U.S. District Court for the Eastern District of Pennsylvania.

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

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