Disability insurance carriers are in the business of providing their insured with a sense of comfort and security in the aftermath of a personal injury or illness. Such incidents can truly be devastating to one’s personal and/or familial finances, especially if the person who becomes injured or ill is the primary breadwinner of the family. When an insured individual suffers a covered accident or develops an illness or health condition covered by the policy, the insurance carrier is to pay the agreed-upon benefit quickly (as is true for any other insurance company presented with a valid claim).
Disability insurer Unum has been named as the defendant in a number of cases for allegedly wrongfully denying the disability claims of its insured.
Background on Unum and Unum Provident Disability Insurance Claims
About 17 million Americans have disability insurance policies through Unum (previously known as Unum Provident and First Unum), which makes Unum one of the larger disability insurance companies in the United States. The insurer has been accused of wrongfully denying claims submitted by its insured customers. This has led to federal investigations through the Department of Labor, which recently ordered Unum to reevaluate nearly 200,000 claims that the insurer had denied since January 1, 2000 for reasons other than a settlement had been reached, the insured had died, or the insured had reached the maximum benefit of the policy. Unum was also ordered to reevaluate claims submitted between January 1, 1997 and December 31, 1999 upon the request of the insured involved in the denied claim.
A number of individual and class action lawsuits have been decided since 2001 and these suits have alleged a number of tactics and policies used by Unum to deny the claims of its insured customers:
- Unum is alleged to have changed the terms of an insured’s policy after the injury or illness has occurred and then used the new terms to deny the insured’s claim;
- Unum and medical examiners hired by Unum would allegedly “misread” the insured’s medical records and issue a denial based upon the “misreading;”
- Unum would also allegedly pay less than the full amount of benefits due to an insured under the terms of the policy;
- Unum allegedly would not recognize certain disabling conditions such as chronic fatigue syndrome and fibromyalgia;
- Unum would allegedly use friends, family members, and other individuals to attempt to impeach the credibility of the insured and use this as a reason to deny the claim.
Why an Insurance Claim Denial Action Against Unum May Be Appropriate
Insurance companies form contracts with their insured: So long as the insured complies with the policy, including making payments, when the “covered event” that is the subject of the insurance contract (such as developing a covered disabling condition or illness) occurs the insurance company pays the claim of the insured, up to the maximum benefit of the policy. Insurance companies are not permitted to use stall tactics or other similar measures to avoid carrying out their responsibilities under the insurance contract. If the insurance company has a true and genuine question about whether the claim is valid and whether it must pay out the policy’s benefit, the insurance company is to conduct a good faith investigation in a timely manner. These are all things that Unum and its subsidiaries are alleged not to have done.
Having a disability insurance claim denied can place immense financial pressure on an injured individual. Without benefits that the insured believed would be there in his or her time of need, the insured and his or her family must now find ways to pay for medical treatment and replace wages that the injury victim is not able to earn due to the injury or illness. In disability insurance denial claim cases, in addition to compensatory damages punitive damages may also be awarded to the plaintiff. These are damages designed to punish the insurer for behavior the court finds to be egregious and shocking to the conscious.
Stern Law, PLLC Assists Unum Insured Customers with Denied Claims
If you have a disability insurance policy through Unum or an Unum-owned company and have had a disability claim denied, let Stern Law, PLLC and attorney Ken Stern examine the facts and circumstances of your case to determine if you may be entitled to monetary damages. You may be able to file an individual lawsuit or participate in a class action lawsuit against Unum for wrongfully denying your claim or failing to investigate and negotiate your claim in good faith. Stern Law, PLLC prides itself on providing prompt, knowledgeable, and accurate legal advice to its denied insurance claim clients. If you have had a claim denied by Unum and believe the denial was unjustified, contact Stern Law, PLLC right away at (844) 808-7529.