Unum Life Insurance Company of America is facing a new claim denial lawsuit after allegedly denying a woman’s ERISA claim for long term disability benefits.

The claim denial lawsuit alleges the disability insurance provider failed in its civil duty to give the ERISA claim a fair and full review and denied long term disability benefits under bad faith insurance.

Plaintiff Veronica T. was previously fully employed by IMPACT Community Action as an executive administrator and became eligible for long term disability benefits under a group-sponsored policy governed by the Employee Retirement Income Security Act, or ERISA.

Like many companies throughout the United States, IMPACT had contracted Unum to be the insurance provider for disability benefits for their employees. Veronica was no different, so long as she met all ERISA claim requirements then she would be eligible for an ERISA claim.

Overview of Claim Denial Lawsuit

According to the claim denial lawsuit, Veronica was forced to cease working in 2015 due to severe pain and anxiety from fibromyalgia, back pain and depression.

Veronica reportedly filed her ERISA claim for long term disability benefits and life insurance waiver of premium benefits in a timely manner, and had followed all application filing procedure instructions. In addition, Veronica says she filed all relevant medical testimony that further proved her need for chronic disability coverage.

Even though Veronica purportedly met all eligibility requirements, Unum denied her ERISA claim. Veronica says the company gave no explanation of the denial. She filed an appeal in a timely manner with additional medical evidence, with Unum denying her ERISA claim again.

In both cases of ERISA claim denial, Unum reportedly ignored the testimony of Veronica’s primary care physician and relied on third party medical reviews from a third party physician. Having a third party physician or medical examiner review disability claims is one of the alleged claim denial tactics Unum has become well known for, the complaint says.

Unum Life Insurance Company of America is one of the largest and oldest disability insurance providers in America, with millions of policyholders throughout the country.

However, Unum has recently been facing public criticism for allegedly using claim denial tactics to dismiss eligible policyholders. Claim denial tactics often mentioned in lawsuits include, but are not limited to:

• Improperly investigating the ERISA claim
• Using unqualified third party witnesses
• Having their own independent medical examiners misread medical records
• Demanding repetitive and often unnecessary independent medical examinations
• Denying claim without a medical examination
• Refusing to acknowledge the disability, especially in the cases of fibromyalgia

Unum Life Insurance was supposed to provide Veronica disability coverage if she adequately proved that she could no longer work in her employment station. At the time she stopped working, Veronica could no longer perform her occupational duty and found it difficult to work sufficient hours.

In addition, Veronica has been unable to find similar work and has not been able to earn sufficient income. At this time, Veronica has exhausted all administrative remedies and has been forced to file legal action.

Veronica is still contending with her disabilities and is seeking compensation from Unum for allegedly wrongfully denying her ERISA claim.

This ERISA Claim Denial Lawsuit is Case No. 2:17-cv-857, in the U.S. District Court for the Southern District of Ohio, Eastern Division.