Unum Sued By An Ophthalmologist And A BJC Healthcare Employee Who Both Were Denied Disability Benefits

Unum Life Insurance Company Of America (Unum) was sued in two different lawsuits filed in the Federal Courts of Missouri, by two plaintiffs who did not receive the long-term benefits that were entitled to them under the terms of their respective Plans that were issued and administered by Unum.

Western Division Case

In Dale L. v. Unum Life Insurance Company Of America, Administrator Of The Unum Disability Income Policy, Plaintiff through a Missouri disability lawyer filed this lawsuit due to his not receiving the disability benefits that were entitled to him under the terms of the Plan underwritten and administered by Unum. Plaintiff was employed as an ophthalmologist until he stopped working on October 25, 2000 due to degenerative and traumatic injuries that led to severe hearing loss and chronic back pain. This was shown to be caused by the Plaintiff moving an armoire.

Plaintiff filed an application for short-term disability benefits, which Unum granted. Plaintiff then filed an application for long-term disability benefits according to the terms of the Plan, which Unum initially agreed to pay. However, via letter on December 30, 2008, Unum denied further long-term disability benefits as defined in the Plan because Unum claimed the disability was caused by an illness, which limited the amount of payments according to the terms of the Plan. Plaintiff had 180 days to appeal this decision.

On March 1, 2010, Plaintiff requested an administrative review of the denial of benefits, supplying medical records and additional information to prove that he should be entitled to long-term disability benefits. However, on June 30, 2010, Unum affirmed its original decision and declared that Plaintiff had exhausted his administrative remedies. Due to this, the Plaintiff has filed this lawsuit.

Central Division Case

In Roxann P. v. Unum, the lawsuit was filed at the District Court in the Western District of Missouri Central Division because the Plaintiff seeks the withheld benefits that were to be provided under the terms of a disability insurance policy provided by her employer, BJC Healthcare, which was administered and funded by Unum.

As of May 19, 2008, the Plaintiff has ceased working due to being unable to perform the material and substantial duties of her regular occupation because of dementia that was caused by a stroke. She is also unable to perform the material and substantial duties of any gainful occupation for which she is reasonably fitted by education and has suffered a loss of 20% or more of her indexed monthly earnings.

Unum has refused to pay the benefits and issued a final decision on May 11, 2011. Due to exhausting all administrative remedies, Plaintiff has filed this lawsuit (more info about ERISA lawsuits & trials).

Relief Sought By The Plaintiffs

By filing these lawsuits, the Plaintiffs seek to gain the following relief from the Court:

Suing Unum for a disability denial? Tips from Attorneys Dell & Schaefer

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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, GoToMeeting.com 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.

Dell & Schaefer Client Reviews   *****

Craig (California)

Cesar and Michal helped me through my case against Prudential. That only touches the surface. I suffered a bad injury which made me a challenge as I often didn’t recall what was said and to whom.

Cesar took the leap of faith to help me but he didn’t treat me like a client but more as if I was part of your family. I don’t know how you were able to get transform the team to have such a great attitude but by far I must say I am treated well from the moment I called, retained your firm it helped me through the minute I faced IME’s. Cesar demonstrates empathy and cares for his clients. I know that I made the right decision to select your firm and am fortunate that firms such as yours are around to help go up against big companies.

I truly am happy to send you a note to advise of my complete satisfaction.

The first and most important matter you have at hand is to take care of your health and let your retained lawyers handle the information needed to not only be approved for long term disability but also to make sure that your claim is managed for the duration of your disability. The disability is a matter that may last a lifetime.

A thorough online yelp review was held prior to conversations with Cesar Gavidia Esq. and Michal Mizrahi from the firm of Dell & Schaefer. I decided to retain them to handle my disability claim. The law-firm has an elaborate web page that demonstrates their ability to go up against all the largest insurance with a stellar track record.

The ERISA law is complex and if you decide to battle the insurance company without representation the odds will be stacked against you. An insurance company has one goal alone and that is to generate profits. The representation of Cesar Gavidia Esq. and Michal Mizrahi were responsible for the successful appeal and approval of my case.

An insurance company typically will deny or delay the claim as the penalty for denial or delay is non-existent. In my case, I was prepared with retained council Cesar Gavidia Esq and Michal Mizrahi who prepared and submitted the ERISA appeal. The document was complete and included information to demonstrate that I was disabled and overturned a previous denial from Prudential.

I’m not only happy to say that I picked the right firm but that I have developed a trusting relationship with combination of Cesar Gavidia Esq. and Michal Mizrahi from the firm of Dell & Schaefer.

Cesar Gavidia Esq. or Michal Mizrahi will pick up calls and take the time to explain what is being done by the insurance company or return the call in a timely basis if they were busy. This was after I had signed to be represented.

I never met Cesar Gavidia Esq. or Michal Mizrahi in person but I consider them my friends versus just attorneys that have been hired.

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