TopClassActions  |  August 22, 2013

Category: Labor & Employment

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Spinal Patient Denied Insurance Benefits Sues Unum

By Robert J. Boumis

 


Unum disability lawsuitMichigan resident Sinoun Liv is suing Unum Life Insurance Company over her denied Long-Term Disability (LTD) claim.
 
Liv became disabled while covered by a Unum LTD plan. According to the lawsuit, Liv suffered from failed back syndrome (also called post-laminectomy syndrome), peripheral neuropathy, and lumbar stenosis. Despite this, Unum denied her LTD claim.

The Unum lawsuit holds that Unum’s denial of Liv’s benefits is “arbitrary and capricious, and was contrary to medical and other evidence that overwhelmingly supports Plaintiff’s claims of total and permanent disability.”

Failed back syndrome is a name given to chronic, debilitating back pain experienced after spinal surgery. Often, further surgery only makes this condition worse. 

Lumbar stenosis consists of changes to the spine that lead to a compression of the spinal cord by the bones of the spine. Several different conditions can cause lumbar stenosis, including genetic issues or even aging. It typically causes back pain, but can also lead to damage to various nerves. 

Peripheral neuropathy consists of damage to the peripheral nervous system. These are any nerves in the body that are not part of the spinal column or the brain itself. However, damage to the spine, such as that seen in failed back syndrome and lumbar stenosis can cause damage to peripheral nerves, causing pain, numbness and even paralysis of almost any muscle in the body. 

A Canadian study by Waddell et al. established that generally, patients who have more than two major spinal surgeries will never work again. Beyond two spinal surgeries, it is unlikely that further surgical intervention can improve any kind of spinal damage. Repeated spinal surgery can cause scarring even as surgeons attempt to repair spinal issues. Usually, beyond the threshold of two spinal surgeries, any further attempts to intervene surgically will only make the patient work. At this point, the damage from repeated surgeries usually outweighs any benefits that might be gleaned from the operation. 

Liv says in the Unum lawsuit that she has exhausted all of Unum’s internal appeals processes, a key factor for many insurance ligation laws. The lawsuit seeks to gain the money allegedly owed to Liv per the terms of her LTD policy. The lawsuit frames this as a breach of contract. 

The case is formally titled Sinoun Liv vs. Unum Life Insurance Company of America, Case No. 1:13-cv-00852-JTN, United States District Court, Western District of Michigan, Southern Division. 

If you’ve found yourself with a denied long-term disability claim, you may feel powerless. Dealing with a large company and their bureaucracy may make it seem like their word is final. But you need to remember that you have rights, and there are steps that you can take to regain control over your situation. You can start by visiting the Unum/UnumProvident Disability Insurance Claim Denial Class Action Lawsuit Investigation. Learn more about your rights and submit your information for a free legal review to see if you qualify to seek compensation though a Unum lawsuit.

 

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