A 42-year old Maryland resident has filed a disability insurance lawsuit against Unum Life Insurance Company of America and its subsidiary Provident Life and Accident Insurance Company after being denied long-term disability benefits.

Ronald U. claims that despite the plethora of evidence he provided to the two insurance companies of his long-term disability status, he was denied benefits under both policies. The plaintiff alleges that the decision to deny his disability benefits was “arbitrary, illegal, capricious, unreasonable, discriminatory and not made in good faith.”

Ronald states that he filed the Unum claim denial lawsuit after exhausting all other options to remedy the situation with the two insurance companies. According to the bad faith insurance lawsuit, Ronald was initially denied long-term disability benefits and when he appealed the decision, he was denied a second time.

The plaintiff reports that he is owed $1,498.40 per month under the Unum group policy that his employer provided and $531 per month based on his individual long-term disability insurance policy through Provident (Unum’s subsidiary).

Unpaid Disability Benefits

According to the Unum lawsuit, Ronald was employed as a record specialist until back pain due to herniated disks forced him to stop working. He underwent lumbar surgery to try to fix the issue, but the medical documents he submitted state that Ronald should only lift 5 lbs. and stand for no more than 30 minutes every 8 hours. According to his occupational duties as a record specialist, he was required to stand 6-8 hours of his working day and lift between 30-50 lbs.

Under the Unum group policy Ronald has through his employer, Unum states that an individual is considered disabled when “you are limited from performing the material and substantial duties of your regular occupation due to your sickness or injury.” Ronald alleges that he provided substantial evidence of his disability but was denied disability benefits.

Through his personal policy through Provident, “total disability” also means you are unable to perform your occupational duties and “you are not engaged in any other occupation.” Again, Ronald alleges that despite his proof of disability, he was denied the benefits owed him.

Ronald believes the denial was also due in part that Unum “mischaracterized” his occupation from “record specialist” to “file clerk,” which could be considered light work.

The bad faith insurance lawsuit is seeking the unpaid disability benefits of $1,498.40 and $531 per month that are past due in addition to that same benefit going forward until the plaintiff has reached the age of 67, which is what the policy claimed it would cover.

Bad Faith Insurance Lawsuits

Unum handles nearly 40 percent of all disability insurance policies in the U.S. However, the company has been accused in thousands of lawsuits for what is referred to as “bad faith practices.”

Some of the most commonly reported Unum bad faith practices include:

• Omitting records to record reviewers when it would show a claimant as disabled.
• Misreading medical records in order to deny claims.
• Investigations that are performed by biased and sometimes unqualified “experts.” 
• Claims representatives who take favorable opinions of nurses over physicians when it comes to disability reports.

Many Unum settlements award plaintiffs hundreds of thousands of dollars and in some cases even millions. If you were denied Unum disability benefits, contact an Unum lawyer to find out if you have legal claim.

The Unum Lawsuit is Case No. 8:15-cv-01767-PJM, in the U.S. District Court for the District of Maryland.