Policyholders Continue to Deal with Unum Claim Denials

For the twelfth consecutive year in 2012, cancer is the most common reason for Unum to deny long-term disability claims. Currently, there are thousands of Unum policyholders fighting to claim their insurance money.

Unum cancer claims were nearly 16% of the entire long-term disability claims, while back disorders made second place at 15.1%. For short-term disability claims, first place was maternity at 18.9% and other non-back injuries at 10.5%.

All disability claims submitted to Unum are investigated and reviewed to determine whether the claimant meets Unum’s conditions to receive benefit. If the insured is found to meet the conditions of the disability as written, then monthly benefits are paid. If the disability insurer finds the insured does not meet all of the conditions, then the claim is denied.

For one man in Detroit, Michigan, who chose to remain anonymous, his Unum disability insurance claim has been paid out, but he fears it will be stopped four years before it should.

“I lived with severe heart failure for years,” He says. “It culminated in April 2009, when I had both a heart and a kidney transplant. I had originally bought a policy that was signed on May 5, 1982, with Provident Insurance Company. I paid into it for 25 years, but never used it until I was 59 years old. It was not part of a company plan, it was an individual plan I purchased on my own”.

Unum started paying for this man’s benefits after a 90-day waiting period, and because of his disability, he was immediately given social security disability. The plaintiff had paid for social security supplemental but had come to an agreement that when the social security was activated, the monthly payments would be reduced. The company told him that he would have to substantiate that he was still disabled, requiring monthly paperwork.

“On March 15, 1985, I received an addendum to my Provident policy, which I read to mean that my disability payments should run out 10 years after I started receiving payments, which would be 10 years after March 2009. But Unum, which bought out Provident, says they will stop paying me on the birthday I turn 65, which will be in 2015. So that’s four years earlier than I expected,” he explained.

After he was told that his benefits would run out on his 65th birthday, he immediately got an attorney. Alleging that the addendum was different than what he originally agreed to with Unum, and that the company is simply interpreting the contract to their benefit. The plaintiff admits that age 65 had been mentioned in the original addendum, but the language is confused by the addendum’s wording for policyholders over the age of 55. He further states that Unum had purposefully made the contract ambiguous in the hopes that it would save some profit

Take Legal Action

If you believe that you or a loved one have been denied by Unum or have been denied less than total benefits, please visit the Unum/UnumProvident Disability Insurance Claim Denial Class Action Lawsuit Investigation. Learn more about your legal options and submit your information for a free legal review to determine if you have a case.