By Robert J. Boumis  |  April 9, 2014

Category: Labor & Employment

Unum disabiliy insurance problemsAn Arizona woman has filed a lawsuit against Unum Life Insurance Company of America, alleging that the company denied a legitimate insurance claim in bath faith.

Sandra Rose suffered from a series of problems with her back and knees, including spinal stenosis and degenerative disc disease. According to her Unum lawsuit, the problems with her knees and spine left her unable to work due to pain and the narcotic-based painkillers required to control her pain.

According to the Unum lawsuit, Rose initially applied for short-term disability insurance starting in November 2011. She was later approved for long-term disability benefits in May 2012. According to the insurance policy, long-term disability insurance could potentially continue to pay her monthly until her 65th birthday.

In August of 2012, Rose had a spinal fusion surgery to try and help her with her pain and difficulties moving. The majority of her physicians agreed that Rose was permanently disabled. Even after surgery, she allegedly continued to suffer from serious complications, including debilitating pain. Her physicians concluded that she was unable to work due to the pain and the narcotic-based pain medication, the Unum lawsuit explains.

However, an in-house physician from Unum stated that Rose was “past the typical recovery time.” In January 2013. According to the lawsuit, only one of Rose’s attending physicians concurred with the letter, who assented solely by checking a box on a form.

The Unum denied claim lawsuit alleges that insurance company’s actions constitute bad faith. Bad faith is a legal term that means that one party in a contract is trying to avoid fulfilling their end of a contract. In this context, Rose’s lawsuit alleges that Unum is trying to avoid paying out on a legitimate insurance claim.

Unum has faced several individual and class action lawsuits, making similar allegations. Previous Unum class action lawsuits have alleged that Unum uses a variety of tactics to deny legitimate insurance claims. There was also an investigation by 60 Minutes on CBS News disclosing Unum’s tactics. The tactics include having their in-house physicians attempt to “override” statements by the policyholders’ physicians in order to declare them non-disabled, and thus disqualified for insurance payouts.

The Unum lawsuit is Sandra S. Rose v. Unum Life Insurance Company of America (an ERISA Plan Fiduciary), Case No. 2:14-cv-00575-SRB, filed in the U.S. District Court for the District of Arizona.

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

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