Unum

What can I do if Unum has declined my clain twice?

Reviewed by Shenida on July 23rd 2014   Verified Policyholder
Hi, I had a cesarean on 3-20-2014 due to delivery of 3rd child. I was out of work on maternity leave under STD. On 4-1-2014 I had to undergo surgery a 2nd time due to having blood clots within my incision. Unum had me scheduled to go back to work on 5-14-2014 from the original date of the first cesarean. I noticed on 5-13-2014 that my doctor left staples in me by mistake which was a month later the day before I was scheduled to go back to work. I went to have those removed on 5-13-2014. My doctor gave me authorization to be out of work until 5-28-2014 my next follow up visit to check the incision and do birth control. I was released to go back to work on 5-29-2014. Well Unum denied my claim for those 2 additional weeks. I have sent medical records and doctors notes. I was denied twice. Now I am at the appeal process. My doctor advised it should be 8 weeks for recovery with no complications but clearly I had a few more than expected. Please give me your opinion. Thanks.
Reply
Sent on July 23rd 2014 by Attorney Jay Symonds

Shenida, without an understanding of the facts and circumstances I would not be able to provide an adequate opinion. Typically though, if Unum has denied your claim twice already there wouldn’t be any additional administrative appeals and you would be required to file lawsuit to secure the remainder of your benefits.