Unum challenges the long term disability claim of a blind salesman
Our client, a window coverings salesman, began developing significant vision loss in November 2006 and approached Dell Disability Lawyers for assistance in applying for long-term disability benefits with Unum. His policies stated that he would be entitled to benefits for the rest of his life if he were totally disabled prior to his 65th birthday or if he qualified as totally disabled under the “Presumptive Total Disability” provisions of his polices.
The policy defined total disability as “inability to perform the substantial and material duties of your occupation.” Through the efforts of Dell Disability Lawyers, our client will now receive total disability benefits for the rest of his life.
After applying for benefits and struggling with an elusive diagnosis, our client was found to suffer from psuedotumor cerebrii, a condition that can result in degeneration of the optic nerve, leading to blindness. Our client’s treating doctors repeatedly advised Unum that our client was legally blind and he could no longer perform any work. Unum spent nearly two years questioning our client’s vision loss before they finally conceded that he has been legally blind since early 2007. During the disputed period of time, Unum paid benefits on a monthly basis under a reservation of rights. This means that Unum was reserving their right to ask for all the money back if they believe that the claimant has not been eligible for benefits.
Unum first started fighting our client’s disability claim by questioning the “late notice” of his claim, despite providing proof of loss as soon as was reasonably possible. Despite continuing to provide ample evidence of our client’s medical condition and his entitlement to benefits, Unum continued to refuse to pay, citing lack of information. Unum also cited to the medical records of one doctor, who claimed there were inconsistencies with our client’s claim, as a justification for continued evaluation, despite clear medical evidence supporting disability from six other treating physicians.
Our client also was subjected to disability video surveillance during the course of his claim, and Unum insisted on numerous conference calls with a number of our client’s treating physicians. Unum also disputed whether our client was actually totally blind. Throughout this process, Dell Disability Lawyers continued to closely monitor the status of the claim and provide continuing proof of loss to Unum.
Eventually, Unum scheduled our client for and Independent Medical Exam. Once Dell Disability Lawyers insisted on having a videographer present at this exam, Unum cancelled this appointment at the last minute. Several months later, Unum re-scheduled this exam with a different doctor who also refused to allow a videographer. Dell Disability Lawyers managed to have this exam conducted with an investigator present in order to protect our client’s rights.
Finally, in January 2009, Unum accepted liability for the claim, acknowledging that our client had suffered total and irreversible loss of his vision, and had been blind as of April 30, 2007. These two determinations by the insurance company mean that our client will receive total disability benefits under the terms of his three policies for the remainder of his life.
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Q: Does UNUM periodically review Group Long Term Disability Insurance claims/payments? For example, do they verify medical eligibility every five or ten years?
Q: My group long term disability insurance allows me to work part time up to 20% of my pre-disability earnings without affecting my benefit. If I take advantage of this, will Unum use this to deny my benefit?
Q: Unum discontinued the "long term Buy out option" in 2014. I was never aware of or informed of this action by Unum.
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Reviews from Our Clients
Very satisfied with the work of this team. Took well care of my case and took all the necessary time to be responsive and attentive when I had questions. Guided me through recovery and returning to normalcy. All thanks to Jason & Tabitha, thank you!
I’m extremely satisfied with the experience I have had with this firm from day one. The lawyer who has handled my case, Alex, is very efficient and attentive to all my questions and concerns. They are always aware of how my case has gone and they care about my health. I feel optimistic with them because they are very attentive during the process of my claim. I would not hesitate to recommend families and friends if in any situation they need their services. Kathleen as well has been very well and assisted me with this case. I highly appreciate everything they have done for me.
It’s unfortunate when disability insurance companies come after older disabled policyholders just to help their bottom line. It can be a living nightmare the damage they can do to a family. Dell Disability Lawyers are polite, understanding and knowledgeable. They call you back and answer any question you have no matter how unimportant it can be. The amount of stress they took off of myself and family was incalculable. I recommend them highly to take care of any disability case whether it be filing for benefits or reversing a claim decision. They are outstanding.
I could not have been happier or more appreciative of the hard work they performed on my behalf. I was well briefed on my case and it was closed in a timely manner with a financially successful resolution.
Mr. Symonds and Sonia as well as everyone else we have worked with throughout this process have been very helpful, professional and caring to our situation. We are very thankful to have this great team on our side.
Without them my LTD company was dropping my plan with me still suffering from my accident, even with doctor’s statements I’m still disabled. The LTD company didn’t want to advance my policy to the next stage of years of pay. Dell Disability Lawyers saved my policy, and helped to enforce the LTD company’s own policy (for its policy holder, me) that I would be covered still under the LTD policy I had paid for at my previous job, when my accident occurred. These lawyers know what they are doing and can help you too. LTD companies will try to drop you when you still need coverage just because they don’t want to pay on your policy anymore. Don’t let them break contract with ya because they are trying to get out of it. Hit em with legal action to ensure the continuation of your policy you paid for. Dell Disability worked very well for me and continue to do so.
I was denied long term disability benefits from The Hartford after being on it for years. I found Dell Disability Lawyers after doing research online. In a matter of days they responded and explained to me everything that would be done. Dell Disability Lawyers were able to settle my suit against The Hartford very quickly and responded to me quickly. I would definitely recommend this team of lawyers for anyone that is fighting for their disability insurance.
I have had nothing but a great experience with Dell Disability Law Firm. Mr. Alex Palamara and his team went above and beyond my expectations. They will respond to emails and phone calls in a timely manner. Thank you once again for taking my case.
This law firm is the best so far. MetLife denied me two times, they appealed two times for me and they won of course. So if you are on disability and want a chance at winning your case use this firm Dell disability lawyers, kind courteous understanding and they get the job done. You won’t be disappointed.