Texas plaintiff Maureen L. O’Hara is suing Unum Life Insurance Company of America for allegedly denying her long-term disability insurance in violation of her contract.  O’Hara alleges in the insurance bad faith lawsuit that Unum unreasonably denied her benefits, despite the medical evidence presented.

O’Hara alleges in the Unum bad faith lawsuit that she was fully-employed until 2011, and was entitled to both long-term and shot-term insurance benefits under her employer’s insurance policy.  Ideally, should the plaintiff ever needed either form of coverage, medical bills and income would be supplied from Unum, as long as the required documentation had been submitted accordingly.  Despite following protocol, O’Hara found herself completely denied disability insurance, and with no way to adequately support herself.

O’Hara had become disabled through unspecified circumstances, which had forced her to cease working in her occupation.  Medical records indicate that this condition would prevent her from working in any similar occupation, as well as prevent her from earning an equivalent income.  Along with her physician’s testimony, O’Hara filed her first claim for long-term disability benefits.

Unum’s reply letter was a blatant denial, stating that there was not enough medical reasoning to presume O’Hara would be unable to work.  The plaintiff filed an appeal to the denial, but was met with the same result; at this point, O’Hara has exhausted all administrative remedies to this situation.  The plaintiff’s legal team allege that Unum had denied her claim without sufficient medical evidence, and therefore not classified as a reasonably decision.  Unum reportedly ignored relevant medical evidence, including the physician’s testimony, but rather used biased opinions from unqualified third-party “experts”.

As of now, O’Hara is seeking a complete and thorough review of her claim, along with compensation for the missed payments along with interest.  O’Hara hopes that her case will encourage more reasonable review practices from the defendant company.

Overview of Unum Claim Denial Tactics

Unum is the oldest disability insurance company in America, and the largest disability insurance provider in the world.  For years, people have been suing this insurance giant for wrongfully denying claims or for allegedly using unethical claim denial tactics.  The tactics Unum and other insurance companies often use against claimants include but is not limited to:

• Changing policies after claims are filed (and without the authorization or knowledge of policy holders)
• Improperly investigating the claim and obtaining opinions from unqualified witnesses
• Misreading medical records, often by their independent medical examiners
• Demanding repeated requests for independent medical examinations or denying a claim without any medical examination
• Refusing to acknowledge their disability, especially mental disorders, fibromyalgia, and chronic fatigue syndrome
• Arguing that the claim is a pre-existing condition
• Denying a claim with the intent to wear the claimant down to a lower settlement
• Partially paying a claim for total disability
• Use of detectives, friends, co-workers and neighbors in an attempt to discredit the disability

Under the federal retirement policy, ERISA, policyholders have the right to reasonable pension and retirement; therefore Unum violated this policy by wrongfully denying her claim, O’Hara alleges.

This case is Maureen L. O’Hara vs. Unum Life Insurance of America, Case No. 6:14-cv-00257-MGL, in the United States District Court of South Carolina.