Has UNUM Denied Your Long-Term Disability Claim?
Have you filed a long-term disability (LTD) claim with UNUM recently, only to be denied? We have noticed an unfortunate trend with UNUM denying claims without sufficient grounds.
Whether you have been receiving disability benefits for years, or recently applied for benefits, you shouldn’t just walk away if you received a denial letter in the mail from UNUM. Our long-term disability attorney is trained in the law governing these LTD claims and can help you understand your rights, appeal a wrongful denial and get the benefits you deserve.
About UNUM Disability Policies
UNUM is a Fortune 500 company and a top insurer for long-term disability claims. Your LTD policy may be underwritten by UNUM, or one of the UNUM group companies like Paul Revere or Provident.
UNUM has quite the reputation in the disability insurance industry. It is also one of worst offenders for wrongfully denying for disability benefits. The motivation for denying claims is simple. Insurance companies like UNUM are in business to make money. If they can reduce the number of people “on claim," they can increase profits for their shareholders.
Courts have found many of UNUM’s denials to be wrongful, and those same decisions have noted that the company used improper incentives and unfair practices to encourage claims to be denied. If you are one of the newest victims of a wrongful denial by UNUM, please know that you are not alone. Our long-term disability attorney is ready to assist you in fighting back.
Why Did UNUM Deny Your Disability Claim?
You will know if UNUM denied your claim when you receive a denial letter in the mail. In your denial letter, UNUM’s representative will detail why you do not qualify to receive disability benefits. The receipt of this letter means that UNUM has determined that your benefits shall be terminated.
There are many reasons why UNUM may have terminated your benefits, including:
- Insufficient medical evidence that supports your disability and restrictions
- UNUM has hired medical or vocational experts who say you are not really disabled
- UNUM says that the policy excludes coverage for your medical condition
The above may be why UNUM says you do not qualify for LTD benefits, but you should not accept it at face value. UNUM has a history of wrongfully denying claims, and sometimes the information contained in a denial letter may be incomplete, misleading or flat-out wrong.
A denial letter can cause stress and anxiety, especially if you are counting on your benefits to make ends meet. If you have just received a denial letter notifying you of your loss of benefits, please know that you have legal rights. You can take action to get your benefits back, but you must act quickly.
Appealing a Disability Denial by UNUM
After receiving a denial letter from UNUM, you have a legal right to an administrative appeal if your policy is governed by ERISA (the Employee Retirement Income Security Act). Most group disability plans purchased through an employer are governed by ERISA. If you aren’t sure if ERISA applies, check your denial letter to see if it references ERISA.
ERISA claims are different. ERISA favors insurance companies. Short deadlines apply. Usually, you have only 180 days from receipt of the denial letter to file an appeal. There are many special rules and regulations that apply to ERISA appeals, and these rules are complicated. For this reason, we strongly recommend that you at least consult with an experienced long-term disability lawyer who is trained in ERISA before filing your appeal.
What to Include in Your UNUM Appeal
Under ERISA, you must file an administrative appeal to overturn UNUM's denial prior to filing a lawsuit. Your appeal must contain all legal and medical support for overturning the denial. You will want to add as much as possible to support your claim. If your appeal is denied and you have to take UNUM to court to dispute their denial, you will not be able to add new evidence later.
In an ERISA lawsuit, you cannot add new evidence, cannot conduct “discovery,” and cannot call witnesses. The judge even gives the benefit of the doubt to the decision of the insurance company. Remember, we told you that ERISA favors the insurance company!
So, make sure that all the information you need to support your disability claim is included with your appeal, including:
- Medical records (past and present)
- Your doctor’s opinion regarding your restrictions and ability to work
- Letters from friends, family or other witnesses of your disability
After You Appeal UNUM’s Denial
After you submit your appeal, UNUM will have 45 days for deliberating before they make their decision on your claim. They can choose to repeal their denial, or second their decision and deny your appeal as well.
UNUM could ask for one extension of 45 days if they need more time to review your materials. After this time has ended, they must submit their decision. If they deny your appeal, ERISA permits you to file a lawsuit and ask a judge to review your claim and decide if benefits should be reinstated. The best outcome will be that UNUM simply pays you the benefits they owed you in the first place.
Hire an Experienced Long-Term Disability Lawyer
If you want to appeal your UNUM disability denial, you should not go it alone. ERISA is a complicated area of law, and UNUM has a team of medical and legal professionals ready to fight. You will benefit from having an experienced long-term disability lawyer to guide you through the process and build the strongest appeal possible to get you back on claim.
Our long-term disability lawyer is ready to assist and would be happy to speak with you about your UNUM denial. Please contact us today at 816-203-0143, and we will review your denial letter for FREE and provide a strategy tailored to your particular case.