Unum
Unum denied our claim because of "lack of diagnosis" leaving us bankrupt. Sorry, Unum, but some conditions don't have a diagnosis yet.
In Feb. 2011 my husband who was 32 years old, came home from work and told me his arm hurt. I sent him to the ER and they had no idea what was wrong. We went to see an arm specialist and within 2 weeks the pain had spread to his legs and by 2.5 weeks his entire body. Once it had spread he was unable to walk and was taking steroids, pain killers, and was walking with a cane just so I could get him to the doctors appointments. There wasn’t a doctor / specialist in town that could give us a diagnosis, I felt like I was in a bad episode of “HOUSE”. Unum called us (sometimes multiple times a day) telling us they needed a diagnosis. Doctors were telling us to get our Living Will together (one told him to say goodbye to his kids and record videos for their major milestones) we had a newborn baby and weren’t married a year. (they wanted him to prepare for the worst). Jason was bleeding into his muscles and it was clotting causing his muscle to die. In May 2011 (while we were staying at the Cleveland Clinic) Unum backdated our insurance to Feb. and as of April 2011 we didn’t have Insurance coverage. Unum’s decision was made in under 90 days and caused all of our medical payments to be returned, they didn’t notify us until the end of June 2011. We had 1,000’s of blood tests, a few MRI’s, a couple CT scans, X-rays, a biopsy and surgery (we were now responsible for 100% of the cost). We had 4-5 Specialist we were seeing and stayed at the Cleveland Clinic with some of the best doctors in the world ($100,000’s in medical bills). They denied our claim for “lack of diagnosis” and because they denied it, my husband’s work was forced to let him go. We couldn’t continue treatment or his medications, he had to stop 100’s of mg steroids and Oxy cold turkey. It put a strain on our marriage and left us in so much debt we have been considering bankruptcy. I am not sure what can be done if anything. I still have all of our records and Unum paperwork.
Reply
Jaime, if the denial of benefits was in 2011, unfortunately there may be very little that can be done. The overwhelming majority of disability insurance policies provide 3 years to file a lawsuit from the time “proof of loss” is required- this is usually interpreted by the Courts as 3 years from the date of the initial denial.
