Florida lawsuit filed against UNUM by disabled woman for failure to pay disability benefits and to clarify plan's benefits

A lawsuit was recently filed at the Tampa Florida District Court against UNUM Life Insurance Corporation by Ms Larriane Braun through her disability attorney. The lawsuit alleged an action under the Employee Retirement Income Security Act (ERISA) and that UNUM was in breach of an employee benefits contract between UNUM and the plaintiff Ms Braun.

The Nature of the Complaint

According to the lawsuit, Ms Braun contended that she was covered under an employee welfare benefit plan which was sponsored by her employer. The plan administered by UNUM and which was funded by insurance policies had provided for long term disability benefits as well as life insurance benefits.

It was argued by the plaintiff that despite repeated requests, UNUM failed to provide the plaintiff with a copy of the insurance policy in order that the plaintiff may discover what her benefits under the insurance policy were.

In making the final decision to deny Ms. Braun her claim for disability benefits under the disability insurance plan, the plaintiff alleged that UNUM created an inherent conflict of interest between its duties to the plaintiff as an ERISA fiduciary and its obligation to the shareholders of UNUM as a for profit corporation.

It was also alleged that the actions of UNUM was not consistent with other similar cases to that of the plaintiff and that UNUM acted arbitrarily and capriciously as UNUM failed to conduct a “full and fair review” of the plaintiff’s claim for disability benefits as provided for under the provisions of ERISA.

In the plaintiff’s lawsuit, Ms Braun said that she was and is “disabled” as defined under the long term disability insurance policy which was funded and administered by UNUM. She contended that she was also subjected to an unreasonable claim process while trying to make a claim for her disability benefits with UNUM.

Claims for Relief

In the claim for relief, Ms Braun seeks the intervention of the District Court:

• To present evidence of her disability to the court and have the court decide the status of her disability as defined under the disability insurance plan.
• To clarify the plaintiff’s right to the long term disability benefits under the disability insurance plan established by the plaintiff’s employer.
• To declare that long term disability benefits under the disability insurance plan established by the plaintiff’s employer are payable by UNUM to the plaintiff.
• To declare that the plaintiff, due to her disability, is entitled to a waiver of premiums payable for the disability insurance plan established by the plaintiff’s employer.
• To award the plaintiff attorney fees as authorized under the provisions of ERISA.
• To award the plaintiff any other ancillary benefits, costs, interest as authorized under the provisions of ERISA and any other relief which the Court may deem appropriate.