Texas plaintiff Kathleen Sprinkle is suing Unum Life Insurance of America for wrongfully denying her disability benefits after she was no longer able to continue working. Sprinkle alleges that Unum dismissed her claim without proper examination or cause, and therefore acted in bad faith.

Before she became disabled, Sprinkle was a full-time employee at Luminex Corporation. Under the terms of her employment, she was fully insured by Unum for her short and long term benefits, according to her Unum lawsuit.

At the time she became disabled, Sprinkle had worked at Luminex for a number of years and had accumulated all the required work-related obligations to meet Unum’s policy requirements to be considered a full-time employee.  Unum took the opposite position.

Sometime in 2012, Sprinkle became unable to perform her job due to an injury, her Unum lawsuit says.  Medical records showed she was no longer able to perform the required job functions for her occupation, and would be unable to find a similar job or earn the same level of income. She submitted an insurance claim to Unum, following the company’s procedures and meeting the deadlines, but was denied in February 2013.

Sprinkle appealed this decision, resubmitting her doctor’s testimony along with any other requirements Unum had of her, but was still denied in June 2013. At this point, Sprinkle  exhausted all administrative options to receive her disability benefits, and was forced to take legal action against the insurance company.

Sprinkle is seeking all missed payments of the insurance money, plus interest, through the Unum claim denial lawsuit.

The Unum lawsuit is Kathleen Sprinkle vs. Unum Life Insurance of America, Case 1:14-cv-00188-LY, in the United States District Court of Western Texas, Austin Division.

Overview of Unum Claim Denial Policies

Unum Life Insurance is the largest disability insurance company in the world. The company has approximately 17 million policy holders in America and 25 million worldwide.  Despite these numbers, Unum has continually been the subject of numerous lawsuits filed by jilted policy holders, because the company allegedly deliberately practices denial tactics to dismiss claims.  Unum has been accused of picking out claims that do not seem as serious, and dismiss it using third-party opinions or using a legal technicality the claimant had missed.

Other tactics Unum has been accused of illegally using against claimants include:

• Making changes to the plan without the authorization of the policyholder
• Changing policies after the policyholder’s claims are filed
• Failing to notify the recipients about these changes
• Improperly, or inappropriately, investigating a claim
• Obtaining opinions from unqualified third parties
• Having contract medical examiners read over and misinterpret medical records
• Using these third-party medical examiners to deny a claim when the policyholder did not provide a medical exam, or giving the policyholder insufficient time to obtain a medical exam