Beware of Traveling While on Disability with Unum

In the past several months our office has been hired by two separate clients who had individual disability policies purchased privately through insurance agents; that had received benefits for an extended period of time; and that were denied by Unum, in part, on the basis that their ability to travel was indicative of the ability to work. The first client, a doctor had coverage with Paul Revere Life Insurance Company, and the other client, a Court Reporter had coverage through New York Life Insurance Company- both of which are administered by Unum. 

The Ability to Travel Does Not Mean the Ability to Work

When purchasing a disability policy through an agent one of the most common riders selected is an “Own Occupation” rider in which “disability” is determined based on the inability to perform your actual job duties. More often than not this “own occupation” definition of disability is for the term of the policy. Both our clients had such language in their respective policies. 

In the case of the doctor, he had been receiving disability benefits for nearly 15 years when Unum terminated his claim due in large part to online investigations conducted which indicated that he had traveled extensively while on claim and had written about it on a personal blog.

traveling while on disability with Unum

As Attorney Stephen Jessup would come to find out our client took extended trips with his spouse in order to have additional days to rest as he would inevitably experience a great deal of pain from any physical activity; that the travel was usually in business or first class so he would be able to lay down through the flight (a position he spends most of his day in regardless); and given his love of writing he embellished the trips to make the blog posts more appealing to readers and often recounted the stories of friends he vacationed with an passed off as his own. To that and he provided Attorney Jessup with documentation to verify everything. However, prior to terminating his claim Unum made no inquiry whatsoever regarding the travel, nor did they seek any additional clarification as to what the travel entailed. Without verification, the claims manager found the blog posts on the internet and saw it as a “smoking gun” justification to deny benefits.

Administrative Appeal Challenges the Definition of Total Disability

Attorney Stephen Jessup prepared and submitted an appeal with Unum on our client’s behalf. Although an individual disability policy does not require an administrative appeal be filed it was agreed that given the horrible misrepresentations made by Unum in the denial letter it would be appropriate to clarify our client’s travel and provide additional medical information in support of continued benefits prior to filing a lawsuit. It is our position that our client’s travel does not have bearing on his ability to practice medicine or how Unum must review policy language to determine disability. The applicable portions of the definition of total disability contained in his policy read:

  • You are unable to perform each of the important duties of Your Occupation; and
  • You are not engaged in any other gainful occupation

There is nothing in that definition that defines disability to mean that one is disabled if they are unable to perform activities of daily living, or if you are unable to perform at the physical demand level your job requires as determined by the Department of Labor (ex: Sedentary, Light, Medium, Heavy, Very Heavy). Policies are written to mean that due to injury or sickness one is unable to perform one’s occupational duties.

So how is that Unum will justify the argument that the ability to travel is indicative of the ability to practice medicine? It essentially comes down to is the appearance of impropriety. Unum is more concerned with how something appears rather than the reality of the situation.

This was also the case with the second client who worked as a Court Reporter. Her policy contained substantially similar language regarding “disability” in that she would be deemed disabled if she was unable to perform her pre-disability occupation. Similar to our doctor, she had been on claim receiving disability benefits for a period of time, and Unum’s initial review of her continued eligibility was predicated on information that she had taken a once in a life time trip overseas. Unum argued in its denial letter that her ability to take an extended trip was indicative of physical ability to perform the “light” duty physical demands of her prior occupation. 

In both cases Unum’s reviewing doctors paid more credence to the “travel” than they did the actual medical records. No matter what information was provided Unum had blinders on and focused so heavily on the ability to travel as some great wrong that I believe they saw our clients more as frauds trying to “pull one” over on Unum.

Despite detailed clarification and strong additional evidence of disability, Unum denied the doctor’s appeal and Attorney Jessup is pursuing legal remedies on his behalf. The appeal for our Court Reporter client is still pending, but given Unum’s actions during the claims and appeal review of our doctor client it would not be unreasonable to expect Unum to continue with such behavior.

Beware.

In a world of social media and online postings insurance companies are now, more than ever, scouring the internet to obtain information about their insureds. The digital footprint you leave, no matter how seeming innocuous, can have lasting ramifications. Without a doubt disability policies do not define disability to mean you are unable to perform activities of daily living, but insurance companies will review your abilities to travel or perform normal activities as evidence that your symptoms may not truly be impacting your ability to work.

If you have concerns with your disability insurance carrier due to inquiries into travel, requests for interviews, or over video surveillance that may have been shown to you or sent to your doctors please contact our office to speak with Attorney Jessup or one of our other disability insurance attorneys to discuss your claim in detail.


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Showing 8 of 642 Reviews
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Reviewed by Dorothy on November 30th 2023   Verified Policyholder | November 2023 date of disability
I was injured at work. I did house keeping in a hospital. I tore just about everything imaginable in my knee. I was let go from my job, because I was no longer able to do ... read more >
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They closed my claim and I have been without income since they closed it

Reviewed by Mary C. on November 8th 2023   Verified Policyholder
Went off work on 9/26/22 due to back issues. Applied for Short Term Disability. On Jan 2023 switched over to Long Term Disability and Unum had me to apply for Social Secur... read more >
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I feel like Unum is giving me the runaround!

Reviewed by Rachelle H. on May 11th 2022   Verified Policyholder
I have contacted UNUM multiple times since I’ve needed them. I feel like they are giving me the runaround! Please help!
Reply
Sent on May 11th 2022 by Attorney Stephen Jessup

Rachelle, the law provides certain timelines and deadlines with which to provide information or decisions. Please feel free to contact our office to discuss your situat... read more >

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Unum terminated my benefits with no warning

Reviewed by K. Potter on September 9th 2020   Verified Policyholder
I was told I was covered with Unum through my employer (continuum). I got an email today for my termination, no prior talks of infractions with attendance, no warnings, no... read more >
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Sent on September 9th 2020 by Attorney Stephen Jessup

K. Potter, termination as in your employment was terminated or a disability claim was terminated? If your employment was terminated and you had not filed a claim for di... read more >

Unum

I've been trying to care care of my Unum benefits for over a year. They’ve been so rude

Reviewed by Tracey W. on August 30th 2020   Verified Policyholder
I have been trying to take care of my Unum benefits for over a year. I’ve called and back in November I did appeal letter, they say they never received. I did everything... read more >
Reply
Sent on August 30th 2020 by Attorney Gregory Dell

Tracey, I am sorry to hear of your issues with Unum. We would love to learn more about your claim to see if we can get Unum to pay or if we can sue them with you. Pleas... read more >

Unum

I've paid for STD for 20+ years. Now, I'm actually sick and can't get paid

Reviewed by Natalie on June 29th 2020   Verified Policyholder
My employer uses unum for short-term disability. I was hospitalized back on june 13 and discharged on june 25. I was admitted for double pneumonia and hypoxia, which I end... read more >
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Sent on June 29th 2020 by Attorney Rachel Alters

Natalie, hopefully your claim will be approved. If they deny the STD claim then you will need to appeal the determination.

Unum

Unum thought I was fine to work. I wasn't

Reviewed by Elizabeth L. on May 21st 2020   Verified Policyholder
48 yoa dentist POTs Dx aug 22. Attempted to return to work initially but got sick. Was going to go back 2 days/wk in September but could not. Then did go back part time as... read more >
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Sent on May 21st 2020 by Attorney Stephen Jessup

Elizabeth, please contact our office to discuss the denial of your claim and your rights to pursue legal action against Unum.

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Unum has made me feel like a criminal

Reviewed by Kevin on February 6th 2020   Verified Policyholder
Hi, I am currently receiving LTD from UNUM. I used to work as a Radiologist Tech at Vanderbilt Medical Center in Nashville, TN. for about 10 years. Than I started having g... read more >
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Sent on February 6th 2020 by Attorney Gregory Dell

Kevin, I am sorry to hear all that you are going through and the stress this is causing you. The policy governing your claim likely does allow Unum to conduct an in-per... read more >

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