Plaintiff Paula H. has filed a lawsuit against Unum Life Insurance Company of America for a reinstatement of benefits.

According to the complaint, Paula “was and is ‘disabled,’ as the term was defined in the long-term disability insurance policy funded and administered by Unum at all times material hereto.”

Unum has refused to pay Paula money through the disability insurance policy that covered her. She was covered by long-term disability insurance and life insurance funded and administered by Unum as part of an employee benefit plan where she worked.

Plaintiff: Reinstatement of Benefits Unfairly Depends Upon Unum’s Decisions

Unum makes the final decision on whether or not to approve any claims under Paula’s insurance policy. Paula says this is “an inherent conflict of interest between Unum’s duties to the plaintiff as an ERISA fiduciary and its duties to its shareholders as a for-profit corporation under federal law.”

ERISA stands for the Employee Retirement Income Security Act of 1974.

The complaint alleges that Unum’s denial of Paula’s reinstatement of benefits was due in large part to its conflict of interest to appease shareholders.

According to Paula, Unum has even “failed to comply with its own internal rules, guidelines, protocols and other similar criteria…”

As a result, Paula has been denied the ongoing long-term disability insurance benefits of which she is entitled. She also allegedly has been subjected to an unreasonable claims process that has allowed her to make no progress with the reinstatement of benefits.

Unum Previously Accused of Denying Legitimate Disability Claims

Many consumers pay disability insurance premiums hoping to never use them, but also having peace of mind in case they do.

Unum insures more than 17 million Americans who have disability coverage if they need it. Unfortunately, it is not always as easy as paying the premiums and submitting the required documentation.

More than once, Unum has been accused of denying disability claims from customers who have paid their premiums and become seriously disabled.

Unum would benefit by denying claims and denying the reinstatement of benefits because it makes their company appear more profitable to shareholders.

Insured policyholders have reported their claims were denied for several reasons, including the following:

• Unum allegedly changes the policy guidelines after claims are filed without policy holders being notified.
• Claimants allege Unum improperly investigates the claim, or places more weight on the analyses performed by their staff than on the analyses submitted by the policy holder’s medical providers.
• Unum allegedly misreads medical records or flat-out refuses to acknowledge a disability.

In 2005, Unum was ordered by the Department of Labor to resolve practices like these. But the disability benefits lawsuits keep accumulating as Unum continues its denials of claims

If you have been covered by an Unum disability insurance policy and been denied your disability benefits, you could be eligible for compensation through legal representation.

The Reinstatement of Benefits Lawsuit is Case No. 3:17-cv-267-J-25MCR in the U.S. District Court for the Middle District of Florida, Jacksonville Division.