Unum Life Insurance Company of America is facing a new claim denial lawsuit, after allegedly denying additional coverage of her insurance premium waiver claim after initially approving the Sjogren’s syndrome disability claim.

This claim denial lawsuit was recently filed by a woman from Maryland, whose Sjogren’s syndrome disability claim was approved but her insurance premium waiver claim.

Plaintiff Monica W. had filed her Sjogren’s syndrome disability claim soon after becoming disabled from the condition, which she says made it impossible for her to work. According to the Unum lawsuit, Monica had been previously fully employed as a Nurse Clinician for Johns Hopkins Hospital.

With it being a very active job, Monica says she was expected to be on her feet for extended hours of the day and regularly experienced a demanding workload. So when Monica was diagnosed with Sjogren’s syndrome, she says she was forced to cease working on Feb. 27, 2017, with her long-term disability claim also citing other health problems.

Sjogren’s syndrome is a medical condition in which the immune system impacts how the body is able to function. This condition is often characterized by severe fatigue and chronic pain, along with internal organ complications, neuropathy, and even lymphoma development.

Due to the severity of this condition, Monica had been unable to work and had to file a long-term Sjogren’s syndrome disability claim.

Overview of Sjogren’s Syndrome Disability Claim

According to the claim denial lawsuit, Monica was approved for short-term disability benefits without trouble but faced difficulties when filing for long-term disability benefits.

Unum had reportedly denied Monica long-term benefits in her Sjogren’s syndrome disability claim in a letter dated March 6, 2018. However, Unum had reportedly reversed this decision when Monica filed an appeal.

Even though Monica’s long-term benefits from her Sjogern’s syndrome disability claim was approved, Unum had reportedly denied another important form of compensation. According to the claim denial lawsuit, Monica filed an insurance premium waiver claim, but Unum denied it on Nov. 3, 2017.

A premium waiver claim for a disability is a provision in an insurance policy which states that the insurance company will not require the policyholder to pay the policy’s premium if they are seriously injured.

These premium waiver claims vary between insurance companies, but the terms and conditions often depend on how long they premiums need to be waived if the policyholder becomes disabled. In addition, insurance companies may charge a higher premium to include the waiver in their policies.

This essentially means that Unum denied Monica’s request to have the premiums on her insurance policy waived, which means she still must pay them. According to the claim denial lawsuit, Monica has met all eligibility requirements and has not been able to work since she became disabled.

In addition, Monica says she has submitted all relevant medical testimony that highlighted the severity of her Sjogren’s syndrome disability claim, which stated that she will not be able to earn a sufficient income because she will not be able to work.

Monica had reportedly tried to appeal this decision, but Unum upheld its decision to keep the premiums on her disability insurance policy.

This Sjogren’s Syndrome Claim Lawsuit is Case 1:18-cv-02304-TDC, in the U.S. District Court of Maryland.

Do YOU have a legal claim? Fill out the form on this page now for a free, immediate, and confidential case evaluation. The bad faith insurance attorneys who work with Top Class Actions will contact you if you qualify to let you know if an individual lawsuit or Unum class action lawsuit is best for you. [In general, Unum bad faith lawsuits are filed individually by each plaintiff and are not class actions.] Hurry — statutes of limitations may apply.

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