Registered nurse & her california disability lawyer sue Unum Life Insurance Company for failure to pay disability benefits

A disability attorney recently filed a lawsuit in the District Court for the Central District of California against the Unum Life Insurance Company of America (Unum). In Marjorie McGill Vs Unum Life Insurance Company of America, Administrator of the HCA Management Services, L.P. On Behalf of HCA’s Affiliated Facilities (Los Robles Hospital and Medical Center) Long-term Disability Plan, the plaintiff brought the legal action under the Employment Retirement Income and Security Act (ERISA) to recover short and long term disability benefits that were wrongfully denied by Unum.

The Facts of the Case Against Unum Insurance Company

The plaintiff, Marjorie McGill, was employed as a “registered nurse” by Los Robles Hospital & Medical Center, a properly organized business entity doing business in the State of California. By virtue of her employment, the plaintiff was a covered beneficiary at all times relevant to this action under a group disability benefits policy issued by Unum’s Long-Term Disability Plan. The long-term disability plan would provide a monthly benefit of $4,400 in the event that the insured was considered unable to perform her “own occupation.”

Due to plaintiff’s degenerative injuries, the plaintiff ceased actively working on May 29, 2008, as on this date, Plaintiff suffered from pain and repeated bouts of emesis and was admitted to the ER for severe abdominal pain, diarrhea, and vomiting. Plaintiff alleges that she became disabled on May 29, 2008 and filed for short-term disability benefits with Unum.

Due to suffering from uncontrollable bowel incontinence that results in the inability to perform tasks continuously, severe abdominal pain, nausea, and neuroma, and the failure of medications to ease the pain for Plaintiff to maintain the pace, persistence, and concentration required to maintain competitive employment on a full-time basis, Plaintiff filed for long-term disability benefits through the plan administered by Unum on December 10, 2008.

Denial of Unum Disability Benefits Claim

The plaintiff stated that she was denied herapplication for long-term disability benefits by Unum on April 29th 2009. Subsequently, Unum denied further long-term disability benefits under the Plan pursuant to a letter to the Plaintiff dated April 29, 2009. This letter allowed the Plaintiff 180 days to appeal this disability claim denial.

On November 24, 2009, Plaintiff pursued her administrative remedies set forth in the Plan by requesting administrative review of the denial of disability benefits. Plaintiff submitted additional information, including medical records, to show that she is totally disabled to perform her own or any other occupation under the Plan.

The Plaintiff also submitted documentation to Unum that the Social Security Administration issued a fully favorable decision on Plaintiff’s claim for disability benefits under Title II and Title XVI of the Social Security Act.

Unum notified Plaintiff on August 31, 2010 that Unum had upheld their decision to deny benefits and that Plaintiff had exhausted her administrative remedies. Plaintiff’s only remaining option was to file a long term disability lawsuit with the assistance of her California Disability Lawyer.

Allegations In The Disability Denial Lawsuit Against Unum

According to the lawsuit, the plaintiff alleged that Unum has wrongfully denied disability benefits to Plaintiff in violation of Plan provisions and ERISA because the plaintiff is totally disabled, leading to her not being able to perform the material duties of her own occupation or any other occupation which her medical condition, education, training, or experience would reasonably allow.

Plaintiff also alleged that Unum failed to afford proper weight to the evidence in the administrative record that shows that the Plaintiff is totally disabled. Plaintiff argues that Unum’s interpretation of the definition of disability contained in the policy is contrary to the plain language of the policy, as it is unreasonable, arbitrary, and capricious.

Therefore, Plaintiff claims that Unum has violated its contractual obligation to furnish disability benefits to Plaintiff. Since all available contractual and administrative remedies have been exhausted, all future appeals would be futile.

Relief Sought By Plaintiff In The Unum Lawsuit

As a result of Unum’s actions, the plaintiff is seeking the following relief from the Court:

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Do you help Unum claimants nationwide?

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
  • ERISA and Non-ERISA Disability Benefit Lawsuits
  • Applying For Short or Long Term Disability Benefits
  • Daily Handling & Management of Your Disability Claim
  • Disability Insurance Lump-Sum Buyout or Settlement Negotiations

Do you work in my state?

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.

Do I have to come to your office to work with your law firm?

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, 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.

How can I contact you?

When you call us during normal business hours you will immediately speak with a disability attorney. We can be reached at 800-682-8331 or by email. Lawyer and staff must return all client calls same day. Client emails are usually replied to within the same business day and seem to be the preferred and most efficient method of communication for most clients.

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