When you pay for long-term disability insurance, you expect to receive benefits if you can’t work due to injury or illness. Unfortunately, many people with policies from Unum are unpleasantly surprised when they file a claim. An Unum long-term disability denial is an all too frequent occurrence for policyholders. Here are some things you need to know.
Unum Group is a prominent disability insurance company in the United States and in the United Kingdom. The insurance company provides both short and long-term disability insurance coverage to individuals and employers.
Despite its standing in the insurance industry, and annual revenues in the billions of dollars, many policyholders are denied benefits for valid disabilities. Numerous lawsuits have been leveled against the company as a result of their unfair practices.
It’s important to understand what insurance companies mean when they use the term disability. Generally, the term refers to conditions that prevent you from performing work associated with your occupation. However, insurance companies may expand their definition of ability to work to include any job, even if it’s not within your current occupational field.
The following illnesses and injuries typically qualify for disability benefits:
These are severe traumas resulting from a blow to the head hard enough to cause the brain to hit the inside of the skull. These injuries are often caused by a fall, car accident, striking your head on or being hit in the head with a heavy object.
The brain is such a delicate organ that even a mild trauma can result in debilitating symptoms such as vertigo, inability to concentrate, sensitivity to light and sound, and memory disruption. Victims of TBI may not be able to work for a long period of time or may not ever return to work.
Like a TBI, injuries to the spinal cord can cause serious impairments. The spinal cord consists of nerve bundles connected to the brain and other body systems. These nerve bundles carry electrical signals back and forth from the brain and enable us to move and function.
If the spinal cord is partially damaged, there may be some function below the injury which could improve with rehabilitation. If the spinal cord is completely compromised, there may be no feeling or movement below the injury site. Unfortunately, this condition is usually permanent.
Car accidents, industrial accidents, and even accidents in the home can result in the amputation of an extremity. With advances in medical technology, prosthetic devices have improved but are not a perfect replacement for a missing body part. Individuals who lose an extremity may not be able to perform work associated with their previous occupations.
In addition to the injuries noted above, the loss of hearing or vision is devastating and can potentially render an individual unable to work for long periods of time.
Serious illnesses such as cancer, kidney failure, heart disease, major depression, or post-traumatic stress disorder (PTSD) are also valid reasons for long-term disability benefits. In the case of mental illness, many insurance companies try to withhold disability benefits. The help of a good disability or ERISA attorney can help you fight such a denial.
Unum Insurance has a long history of denying disability claims, even valid claims, and is experienced at finding reasons for their denials. Here are just a few:
Unum doesn’t use one definition of disability and instead reviews each claim for specific qualifications in the individual’s policy. They deny claims by disqualifying your disability, questioning its severity, claiming you may still do other work, and claiming your income is sufficient for your needs.
Unum often excludes conditions that are legitimate reasons to receive disability benefits. They may exclude your claim because, in their view, it was a pre-existing condition, the injury was self-inflicted, you were injured while in prison, you participated in a riot, or your injury was a result of a war. The extraordinary nature of these allegations demonstrates Unum’s intent to deny as many claims as possible.
Unum may claim you failed to follow application procedures and deny your claim. Incomplete information and missed deadlines are common reasons for claim denials. Unum claims adjusters may employ deceptive practices to obtain information used to deny your claim.
At CJ Henry Law Firm PLLC, we know what leads to Unum long-term disability denials. Contact us today to learn more about how we can help you prepare an appeal.
