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  • Unum / Provident / Paul Revere Long & Short Term Disability Claims (Ep. 13)
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  • 24 Month Self Reported Symptoms Limitation in Unum Disability Policy Case Study
  • Tips About a Unum Medical Examination in a Disability Benefit Claim
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5 disability lawsuits recently filed against UNUM in TN, OH, MO, and MI

Five ERISA disability lawsuits have been recently filed against the UNUM Life Insurance Company of America for the wrongful denial of disability benefits. In each of the cases, a disability attorney from Tennessee, Ohio, Missouri and Michigan have filed suit for the payment of disability benefits that have been wrongfully denied and owed to their clients. Let’s take a closer look at each of the lawsuits.

Collecting Unum Disability Benefits Is A Reality

Case 1: Disability Benefits Lawsuit filed in Tennessee Against UNUM by Time Warner Employee

A miscalculation of disability benefits resulted in the filing of a lawsuit against Time Warner and UNUM Life Insurance Company of American under the Employee Retirement Insurance Security Act of 1974 (ERISA) in the United States District Court for the Middle District of Tennessee on August 9, 2011. In the lawsuit, the Plaintiff and his Tennessee disability attorney ask the District Court to order UNUM Life to “provide appropriate benefits” for the employee by correctly and accurately calculating the employee’s disability benefits and provide him with:

In the lawsuit, the employee accuses the insurer of being arbitrary and capricious in its denial to re-calculate his benefits. As a sufferer of Peroneal Muscular Atrophy, a progressive disease, the employee’s condition will not improve to any significant degree that would allow him to return to work. Disabled and receiving disability benefits since February 27, 2010, the Employee is some $721.28 short each month due to miscalculation of his disability benefits by the insurer. After repeatedly requesting a review of his disability benefits amount, and the swapping of emails in which UNUM’s evaluators provided the employee with confusing and contradictory information, the employee appeals for a reevaluation of his claim has expired, leaving him no option but to file suit against UNUM.

Case 2: Disability Benefits Lawsuit filed in Ohio against UNUM by Human Resources Manager

In the United States District Court of the Southern District of Ohio Eastern Division, a Human Resources Manager at CTL filed suit on July 15, 2011 against UNUM Life Insurance in an effort to procure his rightfully entitled disability benefits from the insurer. Gerald O. had worked for the engineering firm since 1992 performing the function of both office manager and facility manager until he succumbed to his disabling condition and ceased work on July 20, 2009 because of an inability to perform his assigned job duties. With duties that consisted of “both sedentary office work, as well as on and off sit non-sedentary work” requiring walking, transporting heavy objects and building maintenance duties (occasional landscaping and snow removal), Gerald O. became disabled following an injury at work that caused him to sustain “a lumbar strain/sprain injury to his lower back.” Suffering from a diagnosed disc bulge, Gerald O. suffers from “constant back pain and numbness in his legs.” Unable to walk, stand, sit or do any sedentary work due to” pain, Gerald O.’s September 2009 claim application to UNUM for long term disability was denied. Subsequently, his appeals were also denied by the insurer with UNUM determining that in its view Oreste’s pain was not so severe that it precluded him “from performing sedentary work.

Relying on on-site medical reviewers, all unacquainted personally with Gerald O., UNUM refused to reveal the identity of Gerald O.’s claim reviewers so as to give Gerald O. an opportunity to “rebut the reviewer’s findings as permitted by ERISA.” After supplying more documentation and medical records attesting to his condition, Gerald O. was unable to convince the insurer to recant its denial of disability benefits. With no other option available, Gerald O. and his disability attorney filed a two-count lawsuit against the insurer for wrongful denial of benefits and breach of fiduciary duties and requested that the Ohio District Court order the insurer to pay his disability benefits as well as attorney’s fees to make this situation right.

Case 3: Disability Benefits Lawsuit filed in Missouri against UNUM

A disability lawyer and his client filed a lawsuit against UNUM Life under the Employee Retirement Income Security Act of 1974 (ERISA) to assist Steve M. in his quest to receive the long term disability benefits he is entitled to under his employee insurance plan with his employer Central Bank of Kansas City. A bank employee since 1987, Steve M. ceased working in 2009 due to “severe chronic obstructive pulmonary disease, recurrent bronchitis, sleep apnea, Hepatitis C and Interferon therapy, and reactive depression, and anxiety. According to Steve M.’s physician, he is disabled. And according to the Social Security Administrative, which declared Steve M. totally disabled in 2005, Steve M. received SSDI benefits and then returned to work in 2007, only to be terminated in 2009 due to his disability.

Unable to work, Steve M. applied for his ERISA governed disability benefits from UNUM in 2009 and was summarily denied his long term disability benefits originally and on appeal, forcing Steve M. to file the subject lawsuit against the insurer. According to the complaint that Steve M. and his lawyer filed on August 15, 2011, UNUM wrongfully denied Steve M. his ERISA-protected benefits and has breached its fiduciary duty. Consequently, the two ask the Missouri District Court to:

Case 4: Disability Benefits Lawsuit filed in Michigan against UNUM

In their suit filed against UNUM Life Insurance Company in the United States Eastern District Court of Michigan (Southern Division), a health care employee and her disability attorney allege that the insurer ignored the medical records of Goldine F. when it discontinued paying her disability benefits in contradiction to the insurer’s ERISA plan terms and conditions. A sufferer of degenerative disc disease, Goldine F.’s insurance disability benefits relief was short-lived.

In a letter, dated March 16, 2009, the insurer enumerated Goldine F.’s maladies, all which supported her disability and proceeded to discontinue her benefits anyway. And, while all insurance policies provide for some discretion, UNUM’s discontinuation of Goldine F.’s disability benefits was unwarranted. Entitled to restoration of her disability benefits, Goldine F. has had to resort to hiring a disability lawyer to assist her in the pursuit of the restoration of her disability benefits from UNUM. With overwhelming evidence in support of her disabling condition, Goldine F. and her lawyer have asked the District Court of Michigan to enter a judgment in favor of Goldine F. and against UNUM and force the insurer to restore Goldine F.’s entitled disability benefits.

Case 5: Disability Benefits Lawsuit filed in Michigan against UNUM

An outside marketer, Henry L. was forced to cease work in August of 2009 due to multiple medical problems. Unable to “engage in any type of gainful employment,” Henry L.’s original claim for disability benefits to UNUM was honored and he collected disability benefits for nine months. Then, as of March 23, 2010, Laten’s disability benefits were revoked contrary to medial and other evidence of Henry L.’s disabling conditions.

Henry L. promptly appealed the termination of his disability benefits from UNUM and has wrongfully been denied his disability benefits by the insurer. Consequently, Henry L. and his disability lawyer filed a complaint in the United States District Court Eastern District of Michigan to ask the Court to force the insurer to award him entitled disability benefits, attorney’s fees, court costs, and interest.

Comments (21)

  • Lynda, unfortunately, most group disability policies have a change of definition after you have been paid 24 months under your “Own occupation” it is standard under most policies to change to whether you can perform any gainful occupation after 24 months of benefits.

    Rachel Alters Aug 5, 2021  #21

  • I have been receiving LTD from UNUM since December of 2019. I was an Asst Mgr at a casino buffet restaurant and required to be on my feet 10 hours a day. At the time of disability I had two bad knees, the right was worse than the left so my Physician decided to do a total knee replacement on the that one first. It was done in Sept of 2019 and I have not worked since then. After the surgery was done I had 2 more surgeries on the same knee to remove scar tissue. I still cannot bend the knee, it swells and is causing severe pain and again has scar tissue. Now the left knee is getting so bad I can’t walk at times. During this time I moved from Florida to Tennessee so I could move in with my parents because I wasn’t making as much money as I used to and they could help me when needed. Under my initial approval of getting LTD from UNUM it was based on weather or not I was able to perform the material and substantial duties of my regular occupation of the job which I was working at the casino. Today I received a letter from UNUM that they are changing the way they determine if you are disabled “Under a different definition of disability”. This change applies after 24 months to mean the inability to perform any occupation for which you are reasonably qualified by way of training, education and experience.

    In other words they are changing the definition as to what they consider disabled. Should this change not apply to new cases and not mine? Should I be grandfathered in to the original policy terms and conditions that I had prior to my disability? I was told as long as I was still disabled I would receive payments till I turned 66 years old (I’m almost 62 now) and at that time would be required to sign up for my social security benefits and their payments would stop. I just don’t see how they can force me to abide by new terms that were not included in my original policy.

    Lynda P. Aug 5, 2021  #20

  • Rita, I am sorry to hear all of your issues with Unum. It sounds like a series of unfortunate events and we will gladly assist you any way that we can. Please contact us at once so we can review your claim. And for others reading this comment, it is always important to remember that it is ultimately the claimant’s responsibility to get all records to the insurance company to prove their claim. Thus, you cannot rely upon anyone but yourself or your attorney (if you hired one). Thus, it is always best to get the records yourself (or with representation) from your providers and submit them directly to Unum. Often, doctors offices fail to send in records, or even when they do, Insurance Companies deny receiving them and most doctors’ offices don’t keep proof of such (like fax confirmations or tracking info). Lets see what we can do to get you back on claim, Alex

    Alex Palamara Jan 6, 2021  #19

  • Help, in September 2020 my doctor released me back to work mistakenly and UNUM stopped my benefits. I appealed UNUM decision and they requested medical records for several months and the Dr. did not submit them. UNUM would not over turn their decision knowing the Appeal was not complete. I also went back to my family practice Dr. and she sent UNUM records and letter that I was not able to return to work. Can you help me?

    Rita Jan 6, 2021  #18

  • Lucky,

    Thank you for sharing and for your pointers to people who may be in need of help.

    Stephen Jessup Jun 16, 2015  #17

  • Lucky,

    Thank you for sharing and for your pointers to people who may be in need of help.

    Stephen Jessup Jun 12, 2015  #16

  • My advice to anyone dealing with UNUM as their long-term disability provider:
    1. Remember that you have the right to ask for everything in writing. If you are suffering from pain and other physical ailments, your concentration & memory are affected; UNUM likes to contact via telephone because you (and other insureds) are vulnerable. If possible, buy or borrow a tape recorder, so you can record any phone conversation with UNUM. If your state requires notification of taping, just ask the rep if this call is being recorded; he/she is required to tell you. When he/she says yes it is, you can say, “Okay, that’s fine. I’m recording it, too.” If the rep gets upset and wants to know why, you can say you’re recording the call for the same reason UNUM is: so you’ll have a record and there will be no misunderstandings later.
    2. When someone from UNUM calls you, ask for his/her full name, and ask for the spelling. Keep asking until you get it down correctly. Then ask for their direct-dial number and extension – in case you get disconnected, of course.
    3. If a UNUM rep. says something to deliberately upset you, be as cool as you can. The best response is to say, “I don’t think I understood you. Did you just say, {repeat back what you heard} to me?” Understand that UNUM reps WANT to upset you. It’s part of their job.
    4. NEVER allow a UNUM rep to enter your home! In fact, never meet with anyone from UNUM without an attorney.
    5. Understand that the permission agreements UNUM sends you (to allow them to obtain information from your physicians, etc.) are not sacred. You can alter them. You are not legally required to give UNUM free rein to your medical records – only to those which affect your disabling condition. UNUM will try to access records to which it has no right, but you don’t have to allow it.
    6. If UNUM ever attempts to pressure you into a settlement, contact an attorney immediately. Make sure your attorney specializes in ERISA law; a general practice attorney isn’t sufficient.
    7. Never, ever give up hope. With the right attorney the right attitude, you can win.

    A Lucky UNUM Survivor Jun 11, 2015  #15

  • Unhappy,

    It will depend on the statute of limitations contained in the policy. Typically you will have 3 years from the date proof of loss is required. To play it safe we recommend pursing as soon as possible.

    Stephen Jessup Jun 10, 2015  #14

  • I have been receiving disability pay from UNUM since 2009. Last year they stopped paying me. I appealed, it tracked on and on and on and I am supposed to get the decision on the 11th. In the case that they sent a denial, how much time do I have to file a lawsuit under ERISA?

    Unhappy Jun 9, 2015  #13

    Was your policy employer provided? If your denial was in 2003-5, the chances are you are well outside the statute of limitations to file a lawsuit under ERISA. The policy will indicate the statute of limitations to bring a lawsuit, with 3 years from the date proof of loss was required (the date of the first denial).

    Stephen Jessup May 5, 2015  #12

  • I have been suffering from inflammatory vowel disease since 2000. In 2003-2005, I had several claims with Unum through my employer at the time. They refused to continue my claim even though my doctor assured them I could not return to work. Due to the lack of income, I was financially ruined. I always knew this was an unjust decision. I wonder if you could tell me the statue of limitations in Pennsylvania?

    MJ CARPINO May 4, 2015  #11

  • Joan,

    I do not believe you would have a viable legal action against your agent for selling you the policy as you would have to prove some level of professional negligence.

    Stephen Jessup Apr 15, 2015  #10

  • I sued Unum for breach of contract. I have on Own Occupation policy with UNUM (Provident Life and Accident). The Judge asked the Jury to decide if Unum breached the contract or if I breached the contract. The jury came back with neither one of us breached the contract. Figure that one out! I had my Physician from Spaulding Rehabilitation Hospital testify on my behalf. So much for suing UNUM in Massachusetts!

    My belief is that the jury did not understand the medical terminology and did not understand the policy.

    The jury did ask for 12 copies of the policy but were denied.

    The Judge called me “the walking wounded” but that did not get into the transcript.

    Appeal: No lawyer will take the case. I guess they know that they cannot win in Massachusetts.

    Now Unum is trying to change my occupation because I have been on SSDI. I reapplied for benefits because I now have another physical problem. I guess once they beat you in court they feel they can continue to deny your claim.

    Unum is back to their old tricks that 48 States Attorneys General sued them for denying own occupation policies.

    I am at the point of suing the Agent who sold me the policy. He had me change carriers because he told me that Provident Life and Accident (under Unum’s umbrella now) was a good Company and their policy was better. This is when UNUM (Provident Life and Accident) sold the own occupation policies to Doctors, Dentists and Pharmacists. Can I sue the Agent who sold me this policy?

    Joan Apr 14, 2015  #9

  • Sam,

    Without an understanding of your occupation, the language in your LTD policy, and your eligibility under the policy it would be hard to say. As with any disability insurance policy, a diagnosis alone does not guarantee the definition of disability will be met under a policy. Please feel free to contact our office to discuss your situation in greater detail.

    Stephen Jessup Oct 24, 2014  #8

  • I have recently been diagnosed with end-stage liver disease, with portal hypertension. I have to have a liver transplant. What are my chances for LTD with my employer? Iam currently on STD. I work in healthcare. Does cirrhosis qualify for disability?

    Sam Oct 23, 2014  #7

  • Terri,

    It is not uncommon for a treating physician to not cooperate in completing forms or supporting disability. Unfortunately, as you entered into a voluntary settlement with Unum on your disability benefit there is nothing that can be done at this point to right any of the wrongs you’ve experienced through the years.

    Stephen Jessup Sep 26, 2014  #6

  • Has anyone been forced to settle or their benefits will be changing and possibly discontinued due to your status with Dr. visits?

    I was forced to close my case with Unum I believe in 2011. They refused to work with me on the settlement, after I settled I received a letter telling me that my life insurance will drop but they will continue to pay it until age of 65, but to insure that I get what benefits I deserved I had to settle ASAP. What I settled for was not as much as I would have received, I was afraid I would lose my benefits so I settled, something like 60,000. I was receiving over 1000 from them a month and SSID around 740. I deposited the money and IRS froze my accounts and took the money for back payment of funds received through UNUM, and not filing or paying taxes, I did not realised I was supposed to do that. What is so sad is the ones truly injured they as in all insurance companies and the past employers treat you like you’re some kind of a disease. I did not ask for this to happen to me, I was 1st injured in 1988, years later I got better through a pain Dr. in Arizona, in which I went back to work there, I worked for MCM (Midland Credit Management), now they use Capitol something, in San Diego. I reinjured my self at their office in Phoenix, Az. My case was tossed out because my knee Dr. lied about how bad my knees were, leaving to return to Oklahoma needing help from my kids to survive until I got income.

    Terri Jaggers Sep 25, 2014  #5

  • Michelle,

    As the basis of your disability from work is related to an on the job accident, my advice would be to consult with a worker’s compensation attorney or employment attorney to discuss what rights, if any, you may have with the city.

    Stephen Jessup Jan 8, 2014  #4

  • I am duty disability from Detroit Fire Dept and I was injuried on the job and now the city is going to cancel our health insurance that we work our butts off and getting injuried on the job. I put my life on the line everyday working in the City of Detroit and getting injuried on the job all I get is 46.50 from SSI and if I am lucky a total of 220.00 a month from the City of Detroit by the time they take our my 556.00 health insurance payment. We only have 386 injuried firefighter/ems techs that were hurt on the job and that is 1% that Fox 2 news found out the information, yet the City can file bankruptcy and not have to take care of us retirees who put our years on the job and our lives on the line? We need help, can anyone one help us? Please let me know. My email is Michelle_wilson26@hotmail.com. I cannot continue to survive off of this joke of income, I make only 8,100.00 a year – way, way below poverty, not right… I was injuried on the job had 4 back surgeries and need another one and I could use a lot of medical equipment and prescriptions. Please help! Michelle Wilson 313 320 6794.

    Michelle Wilson Jan 7, 2014  #3

  • James,

    The experience you have had with Unum sounds terrible. Hopefully you will win your appeal. If your appeal is denied, contact us privately and we can discuss your lawsuit options. If you have any additional medical records that you have not sent to Unum, then you must file them now.

    Gregory Dell Feb 11, 2013  #2

  • I am considering legal action against UNUM LTD Insurance for discontinuing my LTD coverage. I am also considering legal action due to harassment and intentional infliction of emotional distress by one of UNUM’s claims reps for reasons outlined in the final two paragraphs.

    I was awarded LTD benefits from UNUM for a period of 24 months, which is the time limit imposed by UNUM for disabilities concerning mental illness. UNUM continued to disregard the physical disabilities and stopped paying my LTD benefits after the 24 month mental health period had expired. However, UNUM did continue to pay LTD for a few days after the max mental period expired due to a foot surgery.

    I have protested UNUM’s apparent dismissal of my physical disabilities and have appealed their decision to terminate my benefits. I have not received the response to that appeal, but I feel it very unlikely that the decision to terminate will be reversed.

    Other than the “mental health” issue that UNUM maintains is my only basis of disability, my primary care provider, Dr. Victor Chu, sent a letter to UNUM listing several of my disabling conditions that are not necessarily mental in nature. Some of my medical issues Dr. Chu relayed to UNUM included cardiac dysrhythmia, obstructive apnea, fibromyalgia, hypersomnia, osteoarthritis multiple sites, depression, chronic back pain, malaise and fatigue, thrombocytopenia, degenerative disk disease, chronic fatigue syndrome, memory loss, problems concentrating, migraine headaches and abnormality of gate. There are other issues DR. Chu did not disclose to UNUM. In that letter, Dr. Chu states that I am disabled and I would be a danger to myself and to others if forced by UNUM to attempt to return to work.

    I was also subject to harassment by one of UNUM’s claims reps. I was repeatedly called to questioned or to be ordered to do something that UNUM felt would be my best method of treatment. I had reminded UNUM of a direct link between sleep apnea and mental health issues. Shortly after that reminder I received a phone call by that UNUM rep stating that she had gone completely through my file and there was no mention of Sleep Apnea mentioned anywhere in my file. I knew this to be a total fabrication meant to harass or intimidate me, as part of my original claim request application sleep apnea was sited as a reason of disability.

    I received another call some time later, again by the same UNUM rep. telling me that she had contacted my counsellor and that I had not attended any counselling sessions. She told me that I had failed to follow her instructions to attend counselling and my benefits were being immediately terminated. After talking with my counsellor I discovered no one from UNUM had been in contact with her. I then contacted the UNUM rep to inform her that no one had talked to my counsellor and that I had attended every scheduled session. I told the rep the name and contact information for my counsellor, which I had provided to UNUM before I started attending counselling. The rep told me once again that she had gone through my complete file and there was no mention of my counsellor listed. This I also knew to be a lie as I had personally provided UNUM with that information months earlier. I complained of this re’s behaviour to her supervisor, who did verify to me via telephone that the information in question was indeed in my file.

    James Smith Feb 10, 2013  #1

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We represent Unum clients nationwide and we encourage you to contact us for a FREE immediate phone consultation with one of our experienced disability insurance attorneys.

Can you help with a Unum disability insurance policy?

Our disability insurance lawyers help policy holders seeking short or long term disability insurance benefits from Unum. We have helped thousands of disability insurance claimants nationwide with monthly disability benefits. With more than 40 years of disability insurance experience we have helped individuals in almost every occupation and we are familiar with the disability income policies offered by Unum.

How do you help Unum claimants?

Our lawyers help individuals that have either purchased a Unum long term disability insurance policy from an insurance company or obtained short or long term disability insurance coverage as a benefit from their employer.

Our experienced lawyers can assist with Unum:

  • ERISA and Non-ERISA Appeals of Disability Benefit Denials
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Yes. We are a national disability insurance law firm that is available to represent you regardless of where you live in the United States. We have partner lawyers in every state and we have filed lawsuits in most federal courts nationwide. Our disability lawyers represent disability claimants at all stages of a claim for disability insurance benefits. There is nothing that our lawyers have not seen in the disability insurance world.

What are your fees?

Since we represent disability insurance claimants at different stages of a disability insurance claim we offer a variety of different fee options. We understand that claimants living on disability insurance benefits have a limited source of income; therefore we always try to work with the claimant to make our attorney fees as affordable as possible.

The three available fee options are a contingency fee agreement (no attorney fee or cost unless we make a recovery), hourly fee or fixed flat rate.

In every case we provide each client with a written fee agreement detailing the terms and conditions. We always offer a free initial phone consultation and we appreciate the opportunity to work with you in obtaining payment of your disability insurance benefits.

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No. For purposes of efficiency and to reduce expenses for our clients we have found that 99% of our clients prefer to communicate via telephone, e-mail, fax, GoToMeeting.com sessions, or Skype. If you prefer an initial in-person meeting please let us know. A disability company will never require you to come to their office and similarly we are set up so that we handle your entire claim without the need for you to come to our office.

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