In Lamont Philip Richardson Vs Unum Group Corporation And First Horizon National Corporation, the disability insurance claimant alleged that he was improperly denied of his claim for long term disability (LTD) benefits by Unum. A lawsuit was filed for the recovery of disability benefits under an employee benefits plan and for enforcement of rights under the Employee Retirement Security Act of 1974 (ERISA) at the District Court for the Eastern District of Tennessee by a Tennessee disability attorney.
The Nature of the Lawsuit Against Unum Insurance
The plaintiff Lamont Philip Richardson was employed at the First Horizon National Corporation through the First Tennessee Bank at Memphis, Tennessee. By virtue of his employment, the plaintiff was a participant of an employee benefits plan maintained by the First Horizon National Corporation for the benefit of its employees and in which Unum was the Claims Administrator. The disability plan provides LTD coverage in the event of disability.
According to the disability lawsuit, the plaintiff became eligible to receive LTD benefits on May 31st 2008. The plaintiff stated that his UNUM disability application was approved and he began receiving LTD benefits from Unum beginning from May 31st 2008 until June 15th 2010. From the period of June 16th 2010 to September 15th 2010, the plaintiff was paid "extra-contractual benefits” by Unum.
Denial of Long Term Disability Benefits by Unum
On June 16th 2010, the plaintiff alleged that he was improperly denied his claim for LTD benefits. Subsequently, the plaintiff appealed Unum"s decision to deny him his claim for LTD benefits and submitted additional medical documentation to support his appeal. In the lawsuit, the plaintiff also stated that, on November 10th 2010, he was determined to be disabled by the Social Security Administration (SSA). Nevertheless, on March 8th 2011, Unum upheld its prior decision to deny the plaintiff his claim for LTD benefits.
The plaintiff argued that Unum had failed to accord proper consideration to SSA Administrative Law Judge"s determination of disability. The plaintiff also alleged that Unum had arbitrarily disregarded the medical opinions of his attending physicians and instead relied upon opinions of non-examining medical sources engaged by Unum in making its determination to deny the plaintiff"s claim for LTD benefits.
The plaintiff contended that the plaintiff"s treating physician(s) opinions/ restrictions/limitations as well as the SSA Administrative Law Judge"s determination of disability indicated that he was/is unable to perform any occupation. The plaintiff argued that Unum had failed to provide disability benefits that was due to the plaintiff under the terms of the Plan and that this denial of benefits was a breach of the plan as:
- The decision to deny benefits was wrong under the terms of the Plan.
- The decision to deny benefits and the decision-making process was arbitrary and capricious.
- The decision to deny benefits was not supported by the substantial evidence in the record, and failed to give substantial weight to the conclusions of the SSA Administrative Law Judge determination of disability in the plaintiff"s case.
Relief Sought By the Plaintiff
As a result of Unum"s actions, the plaintiff argued that this have resulted in him suffering damages. In addition, the plaintiff has exhausted all his administrative remedies and is seeking from the Court the following relief:
- Damages for unpaid benefits in the amount equal to the disability income benefits to which he was entitled through the date of judgment.
- An award of Prejudgment and post judgment interest.
- An Order requiring the Plan, the Plan Administrator, or appropriate Plan fiduciary to pay continuing benefits in the future so long as the plaintiff remains disabled under the terms of the Plan.
- An Order requiring the Plan, Plan Administrator, or appropriate Plan fiduciary to provide the plaintiff with ancillary benefits to which he may be entitled due to a finding of disability for so long as the plaintiff remains disabled under the terms of the Plan.
- An award of reasonable attorney fees and costs.
- Any other such relief deem by the Court as just and proper.
About the author: Gregory Michael Dell is an attorney and managing partner of the disability income division of Attorneys Dell & Schaefer. Mr. Dell and his team of lawyers have assisted thousands of long-term disability claimants with their claims against every major disability insurance company. To request a free legal consultation call 800-411-9085.