By Robert J. Boumis  |  September 15, 2014

Category: Consumer News

Unum disabiliy insurance problemsA North Carolina woman disabled from spinal problems has filed a bad faith insurance claim denial lawsuit against Unum Life Insurance.

Plaintiff Anastasia Derzko of Cary, N.C., said her spinal problems required several surgeries. Within the course of a year, Derzko underwent two back surgeries. In these surgeries, surgeons fused the vertebrae of her lower back and neck, respectively. According to her Unum lawsuit, the spinal fusion surgeries didn’t help her spinal problems enough to continue working, and culminated in failed back syndrome.

Her Unum lawsuit states that Unum initially approved her claims, but terminated them on the grounds that her failed back symptom was based on “self-reported symptoms,” which would limit her payout based on the insurance policy. The Unum lawsuit states that she exhausted the company’s internal appeals process, which is important because the law requires that a policyholder pursue any disability benefits appeals process with the insurance company before filing a claims denial lawsuit.

Derzko’s disability insurance lawsuit alleges that Unum’s denial was in bad faith, that the company is cutting off her benefits even though she is disabled under the policy’s terms. Her Unum lawsuit seeks to have the court order Unum to continue to pay out on her insurance policy, and pay back-owed money dating to the time of the insurance claim denial.

In legal terminology, bad faith means that one party of a contract is trying to get out of their obligations under a contract. In the context of insurance, bad faith usually refers to the insurance policy as the contract. Bad faith insurance lawsuits like this Unum lawsuit typically allege that insurance companies’ insurance claim denials are intended to save the company money by not paying out on legitimate insurance claims.

Derzko’s Unum insurance claim denial lawsuit is not unique. Unum has faced many lawsuits alleging that the company denies legitimate insurance claims. A 2002 segment by “60 Minutes” alleged that Unum systemically denied legitimate insurance claims. The investigation alleged that Unum agents had “denial quotas” and that Unum issued a “hungry vulture award” to the employee that denied the most insurance claims.

The Unum Lawsuit is Anastasia N. Derzko v. Unum Life Insurance Company of America, Case No. 5:14-cv-00480-BO, filed in the United States District Court for the Eastern District of North Carolina’s Western Division.

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

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