Policyholder’s Lawsuit Against Unum Says Company Wrongfully Denied Her Long-Term Benefits

A policyholder has filed a lawsuit against Unum, saying that the company has wrongly denied her long-term disability benefits.

Plaintiff Mary Anne M. says that she worked for The Grable Foundation, which provided her with a long-term disability benefits plan through the Unum Life policy. She says that she became disabled on or around Feb. 13, 2016, while she was covered under the plan. Allegedly, she was denied ongoing long-term disability insurance though she was still disabled. She claims that this denial was wrongful, and was made in the interest of increasing Unum’s profits, at her expense.

Reference for Business states that Unum is the leading provider of disability insurance in the U.S. and the United Kingdom, but for Mary Anne, the company perhaps did not live up to its reputation. 

In her lawsuit against Unum, Mary Anne states that on or around Feb. 13, 2016, she stopped work while she was covered under the plan. She says that she suffered from a number of disabling conditions including cardiomyopathy, branch block, fibromyalgia, arthritis, memory loss, and dyspnea (shortness of breath). 

What Does the Class Action Lawsuit Allege?

The Unum life insurance class action lawsuit states that Mary Anne filed an application for long-term benefits under her plan in or around May 2016, and was approved on June 2, 2016. She says that she was paid benefits until May 31, 2018.

The LTD Unum benefits says that after May 31, 2018, she was denied for ongoing long-term disability benefits because Unum said that she could allegedly “perform her own occupation despite her multiple medical conditions.”

Mary Anne’s lawsuit against Unum goes on to note that they appealed this decision on November 27, 2018, submitting a vocational review, medical records, four medical assessment forms, and two letters from her doctors. She says that all of the records that she presented indicated that the she was unable to return to work because of the restrictions and limitations caused by her disability.

Mary Anne says that despite these compelling arguments, her appeal was denied on March 14, 2019. She says that Unum stated that its vocational consultant found that her previous occupation was performed at a sedentary physical level and also found that Mary Anne could perform work at a sedentary level.

The Unum wrongful insurance benefits denial class action lawsuit says that instead of obtaining an in-person examination of Mary Anne, as the policy allows, the company relied instead on its file-reviewing employee physician. Allegedly, that physician disagreed with Mary Anne’s four treating physicians who determined that she was still disabled.

The Unum insurance denial class action lawsuit says that Mary Anne exhausted her administrative remedies as required to file a long-term disability benefits denial class action lawsuit.

Mary Anne says that Unum also violated the terms of her life insurance policy, because the terms of her life insurance policy premium would allegedly be waived if she became disabled while covered, which she says she allegedly did. Because her disability benefits were denied, she says that she was required to pay more in life insurance premiums than she otherwise would have.

The Unum long-term disability insurance class action lawsuit says that Unum denied Mary Anne’s claim for continued long-term disability insurance in its own financial interests, and in so doing, caused her financial injury.

The Unum Long Term Disability Insurance Benefits Denial Lawsuit is Case No. 1:19-cv-00190, in the U.S. District Court for the Eastern District of Tennessee, Chattanooga Division.