A New Jersey woman is suing Unum Life Insurance Company for allegedly wrongfully denying her disability benefits.

Plaintiff Cheryl Nita had been employed at Aramark Corporation, but had been allegedly denied her benefits though the defendant’s alleged bad faith insurance practices, according to her Unum lawsuit.

Nita was a food service director for her previous employer, and had worked as a full-time employee for a number of years. Records indicate that the she was eligible for short-term and long-term disability benefits under Unum’s policy, if she submitted medical evidence to prove her condition, according to her benefits denial lawsuit.

As long as Nita proved that her disability prevented her from performing her job duties and had lost over 20 percent of her monthly income, she qualified for Unum’s long-term disability plan, the Unum lawsuit said. She filed for the benefits on April 20, 2011, reporting that she was suffering from chronic fatigue syndrome, immune dysfunction, and cognitive impairment. All of these conditions were verified by her treating her physician, and such testimony was filed with the claim, according to the Unum lawsuit.

Overview of Unum Claim Denial Lawsuit

On Feb. 10, 2012, Unum approved her for long-term disabilities, but on Jan. 11, 2013 she was told that her claim would be reevaluated due to a policy change. Instead of saying that she was unable to perform the necessary duties for her job, the policy was changed to “being unable to perform any job function to which she was reasonably qualified for.” Additionally, it also said that her medical conditions reported were self-reported despite the medical evidence, according to her insurance claim denial lawsuit.

Despite following all administrative procedures and turning over all required medical documentation, her bad faith insurance denial lawsuit said, Nita’s benefits were terminated on Sept. 27, 2013. Unum did not provide an exact reason for this change of decision, but instructed her to file an appeal if she disagreed with the decision. She appealed on March 9, refiling her medical records, physician testimony, and notifying Unum that she was eligible to receive Social Security benefits for her condition. Unum denied her appeal on June 24.

Unum explained that her conditions were classified as pre-existing and self-reported, despite all the evidence provided, the Unum claim denial lawsuit said.

This Unum Claim Denial Lawsuit is Cheryl Nita v. Unum Life Insurance Company of America, Case No. 2:14-cv-04420-SRC-CLW, in the U.S. District Court of New Jersey.

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

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