A registered nurse filed a bad faith insurance lawsuit against Unum Life Insurance Company alleging her long-term disability benefits were unjustly terminated.

According to the Unum lawsuit, Carrie S. had to stop working at Baptist Health Care Systems because of her disabling condition, which was diagnosed as “spinal stenosis and cervical radiculopathy.”

Initially, Carrie was granted both short-term disability and then long-term disability benefits by Unum in 2005 because she showed she was permanently disabled and needed assistance with at least two activities of daily living, according to the Unum lawsuit. Unum paid Carrie long-term disability benefits from 2005 until 2013 because it was determined she was limited in performing the duties of her occupation.

However, in August 2013, Unum allegedly performed a “comp check” on Carrie through social media searches, in-house Unum physician interviews, vocational assessments, and surveillance, which led Unum to terminate Carrie’s long-term disability benefits, claiming that she was not disabled anymore. The company allegedly refused to provide Carrie with as explanation of their reports and reviews.

Carrie responded by giving Unum more medical information, but Unum continued to deny her claim. Carrie appealed the decision and provided a supplemental written opinion that she got from her primary care doctor, stating that she is permanently disabled.

The Unum lawsuit states that Unum upheld its decision to terminate her long-term disability benefits, claiming Carrie could perform sedentary work, though Carrie’s doctors have deemed her permanently disabled.

Unum Bad Faith Insurance Practices

For years Unum allegedly has been practicing what lawyers call bad faith insurance denials. Some of the most common insurance claim denial tactics reportedly utilized by Unum are:

• Misreading medical records. Courts have reversed insurance claim denial decisions from Unum due to inaccurate conclusions from medical records in order to deny claims. Unum has also been shown to provide record reviewers with incomplete files of medical records, omitting records that show a claimant as disabled.
• Improper claims investigations by obtaining opinions from biased, sometimes unqualified “experts.” Unum utilizes a variety of staff and outside experts on their payroll to evaluate new and existing claims. Sometimes, claims representatives allegedly have taken the opinion of an in-house nurse that favored a denial of benefits over a physician’s opinion of disability.

Unum Lawsuits

Carrie filed the Unum lawsuit in the hopes of trying to force Unum to reinstate her long-term disability benefits. Countless bad faith insurance lawsuits have been filed against Unum, all similarly claiming the Unum, without explanation, terminated or denied a policyholder’s claim.

If you have been unfairly denied disability insurance benefits by Unum after providing records of proven debilitating conditions, you may be eligible to file an Unum lawsuit.

The Unum Disability Insurance Denial Lawsuit is Case No: 5:15-cv-00310-DAE, in the U.S. District Court for the Western District of Texas, San Antonio Division.