Recently, two disabled employees of the HSBC Bank in Illinois and Nevada filed lawsuits against the Unum Life Insurance of America (Unum) for the wrongful denial of disability insurance benefits under the Employee Retirement Income Security Act (ERISA).
First Case – Disability attorney filed complaint at the District Court for the Northern District Of Illinois Against Unum
In Lavitta Galarde vs UNUM Life Insurance Company Of America, Administrator Of The HSBC North America Holdings, Inc. Long Term Disability Plan, the plaintiff Lavitta Galarde, through a disability lawyer, filed a civil suit against Unum at the District Court for the Northern District Of Illinois. The plaintiff filed the lawsuit in an attempt to secure disability benefits that she was allegedly entitled to under a disability benefits insurance policy that was underwritten and administered by Unum.
The plaintiff was formerly employed with the HSBC Bank as a Merchant advocate. By virtue of her employment, she was covered under the HSBC North America Holdings, Inc. Long Term Disability Plan. On July 12th 2007, due to suffering from a major myofascial pain disorder, chronic pelvic pain, diabetes, and secondary depressive disorder and anxiety, the plaintiff stopped working. She alleged that she became disabled on July 13th 2007.
Subsequently, a claim for short term disability benefits was filed with Unum and was approved on July 18th 2007. The plaintiff later filed a claim for long term disability benefits and was initially granted long term disability benefits under the Plan on December 20th 2007. However, on November 19th 2008, Unum terminated the plaintiff’s long term disability benefits.
An appeal was made with Unum on December 19th 2008. In support of her appeal, the plaintiff stated that additional medical documentations were provided to show that she was and is totally disabled from carrying out the material duties of her own occupation and any other occupation as defined by the HSBC disability plan.
Despite the evidence supporting the plaintiff’s total disability status, the plaintiff on March 24th 2009 was informed by Unum that it was reaffirming its previous decision to deny the plaintiff’s claim for long term disability benefits. Unum also informed the plaintiff on March 24th 2009 that she had exhausted all administrative remedies leaving the plaintiff with no alternative but to seek relief from the Court.
Second Case – Disability Attorney Sues Unum
In Roydene Bouck vs Unum Life Insurance Company of America, HSBC North America Holdings, Inc. Employee Disability Plan, filed at the District Court for the District of Nevada by a Nevada disability attorney, the plaintiff was also a former employee of the HSBC Bank. As an employee of the HSBC Bank, she was covered under a Group disability benefits insurance policy which was fully insured and administered by Unum.
The Nature of the Complaint Against UNUM by HSBC employee
The plaintiff stated in the lawsuit that due to suffering from serious medical conditions, she was unable to work in her occupation on June 1st 2008. Subsequently, she applied for short term disability benefits and received the maximum period for the short term disability benefits permitted under the Plan. Upon the expiry of her short term disability benefits, the plaintiff applied for transition to long term disability benefits and was granted approval by Unum on November 20th 2008.
Denial of Long Term Disability Benefits
On February 1st 2010, the plaintiff was requested to undergo an Independent Medical Evaluation. Based on the evaluation, Unum terminated the plaintiff’s long term disability benefits on March 24th 2010. The plaintiff appealed this decision by Unum on July 12th 2010 and provided additional documentations that supported her claim that she was unable to work in any occupation.
Despite the overwhelming evidence supporting the plaintiff’s claim, the plaintiff’s appeal was unsuccessful. Another appeal was made to Unum regarding the denial of disability benefits on April 6th 2011. This appeal was also rejected by Unum on April 11th 2011, within five days of it being submitted. Having being informed by Unum that all administrative remedies have been exhausted, the plaintiff was forced to seek redress through the Court by filing a lawsuit against Unum under ERISA.
Relief Sought By Both Plaintiffs
In the above two cases, both the plaintiffs were seeking to enforce their legal rights under ERISA. They also asked the Court to order Unum to pay all disability benefits that are due to them. An award of attorneys’ fees and costs were also requested by the plaintiffs together with any other relief that is deemed just and proper by the Court.