Unum / Provident / Paul Revere

Disability Blog & Cases:
Eastman Chemical Company Employee Loses Lawsuit Against MetLife for Disability Benefits

In a case recently decided by an Arkansas Federal Court, MetLife prevailed in a lawsuit filed by an Eastman Chemical Company Employee. Ultimately, due to video surveillance, a lack of medical support, and the fact that the claimant had continued working at a side job (of which he had failed to inform MetLife of) while claiming to be disabled, the Court, it seems, had no choice but to agree with MetLife’s decision to deny Long Term Disability Benefits.


Disability Blog & Cases:
Bon Secours Employee Wins Lawsuit Against Unum who had Denied Him Disability Benefits

A former Engineer Director for Bon Secours, with the help of his Pennsylvania  Disability Attorney, were forced to file a federal ERISA lawsuit after Unum repeatedly denied his claim for Long Term Disability Benefits under a disability policy he was covered under through his employment with Bon Secours. After filing Cross Motions for Summary Judgment, the Court ultimately ruled in favor of the claimant and against Unum.


Disability Blog & Cases:
Do You Know The Job Requirements To Be A Lincoln Financial Disability Claim Specialist?

As a disability lawyer that has handled thousands of disability insurance claims I often wonder about the qualifications and experience of the disability company employee that is making the decision to approve or deny my client’s claim. During our routine activities of watching The Lincoln Financial Group, I came across an internet job posting for an “Associate LTD Benefit Specialist” at Lincoln Financial in Atlanta, Georgia.The qualifications and requirements for the Lincoln benefit Specialist position are also listed at the end of this article.


Disability Blog & Cases:
A Claimant’s View of a Prudential Disability Benefit Denial

We always welcome our clients and other disability claimants nationwide to share their experiences regarding the handling of their disability insurance claim. A client of our law firm that was denied long term disability benefits by Prudential Insurance Company recently posted her thoughts…


Disability Blog & Cases:
Do You Know The Differences Between ERISA Disability Policy And NON-ERISA Disability Policy?

Watch our video to learn more about long term disability insurance claims which are subject to ERISA.


Disability Blog & Cases:
Will A $38 Million Loss Result In More Prudential Disability Insurance Claim Denials?

Prudential is not very happy right now and disability claimants may suffer as a result. Prudential’s group insurance division, which includes long-term disability insurance policies, reported a 2012 first quarter loss of $38 million compared to a gain of $39, million a year ago…

In Jeffrey D Vs. Unum Life Insurance Company of America, the Plaintiff, with the help of his Connecticut Disability Attorney, filed this lawsuit due to the wrongful denial of long term disability benefits as promised under theERISA welfare benefit Plan that is underwritten and insured by Unum.

History of Plaintiff

Plaintiff, who is 46 years old, worked as a machinist at two companies in Bristol, Connecticut for a total of 16 years. He then worked as an Electrical Discharge Machine Operator at EDAC Technologies Corporation (EDAC) in Farmington, Connecticut since 2000. His job required him to position and secure workpieces on a table using clamps; measure parts; manually input data into a computer; and regularly exert between 10 and 50 pounds of force with his hands to move objects.

Plaintiff suffers from gout, a form of severe arthritis characterized by joint pain, tenderness, and reduced mobility in the areas affected. These areas usually include the hands, wrists, feet, and ankles. wrists, feet, and ankles. This medical condition causes him consistent severe pain, occasional complete immobility, and a regular inability to use his hands, wrists, feet, and ankles for almost anything, including grasping, pushing, holding, walking, and standing. His dominant (right) hand and wrist are affected more than his non-dominant hand and wrist. Plaintiff first suffered from gout approximately 20 years, and it has worsened progressively over the years.

Due to the continuing deterioration of his gout, Plaintiff can no longer operate as a machinist or in any other occupation. This has been the case since late-September 2010. Plaintiff takes powerful prescription drugs to combat the consistent pain, but the serious side effects from these medications include lightheadedness, forgetfulness, nausea, and fatigue. These prevent him from driving a motor vehicle or operating other types of machinery and industrial equipment.

Plaintiff filed an application for benefits under EDAC’s Unum Plan in September 2010. He was to have received 60% of his "monthly earnings" until a maximum age of "Social Security Normal Retirement Age." According to the terms of the Plan, the Plaintiff satisfied the definition of being disabled both regarding his own occupation (first 24 months of benefit collection) and any other occupation (after 24 months of benefit collection).

Unum Denies Claim

On June 29, 2011, Unum denies Plaintiff’s benefit application due to the reason that the medical evidence did not support that his gout was disabling under the Plan’s definition; he did not satisfy the Plan’s requirement that he work 35 hours per week prior in order to qualify for benefits; and he held another part-time job that he did not disclose to Unum, which disqualified him from benefit collection.

Plaintiff filed an appeal on September 24, 2011 disputing these reasons, which Unum essentially admitted as being true and that it was mistaken in Plaintiff having a part-time job. Plaintiff added 68 pages of medical records, letters from his physicians, Unum’s internal claim evaluation notes, and seven sworn records to his appeal.

Plaintiff underwent wrist surgery in fall 2010. His surgeon said in June 2011 that he will have no use of his right hand and wrist, further strengthening Plaintiff’s claim that he is disabled under the terms of the Plan. A fusion procedure that is recommended for the Plaintiff would prevent him from undertaking any gainful employment that requires Plaintiff to use his right hand to any significant degree.

Plaintiff also demonstrated that he has done no work for his wife’s vending cart business. Plaintiff also showed that he briefly dropped under 35 hours of work per week due to gout flare-ups in his feet.

Despite showing all of this, Unum denied Plaintiff’s appeal on October 20, 2011 on the same reasons as its original denial. Due to exhausting all administrative remedies, Plaintiff has filed this lawsuit against Unum.

Reasonings Behind the Lawsuit

Plaintiff claims that Unum’s failure to pay these benefits was wrongful, arbitrary, capricious, and otherwise unlawful. Additionally, Unum also chose to disregard the opinion of its own claim reviewer nurse who stated that "it is unlikely that the insured will regain his premorbid level of" functional capacity.

Unum also never requested that Plaintiff undergo an independent medical examination or functional capacity evaluation so that it could attempt to determine the severity of his gout or its impact on his ability to work in his own job or others.

Requested Relief

Plaintiff wants the following relief to be granted by this Court:

  • Payment of all unpaid monthly disability payments
  • All prejudgment interest
  • Costs associated with filing this lawsuit
  • All appropriate attorney’s fees
  • Reinstatement of Plaintiff’s eligibility for continued disability benefit payments in the future
  • All other relief deemed proper by this Court 

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.

Disability Blog & Cases:
At least five lawsuits were recently filed in Florida District Courts against Prudential for non-payment of disability benefits to deserving claimants

With at least five suits filed against them in July for denying disability benefits, Prudential Insurance Company of America has a lot of unhappy claimants in Florida.


Disability Blog & Cases:
California Consultant sues Northwestern Life Insurance Company for unpaid disability benefits

Northwestern Insurance beneficiary Todd W. and his California disability attorney‘s complaint against the insurer accuses Northwestern of breach of the Duty of Good Faith and Fair Dealing and Breach of Contract in response to its denial of Todd W.’s disability benefits.


Disability Blog & Cases:
Duke University Doctor sues UNUM Life Insurance Company for long term disability benefits

Dr. Karen M. and her North Carolina disability attorney filed a lawsuit against UNUM in the United Stated District Court for the Eastern District of North Carolina to acquire her long term disability benefits. The beneficiary of disability benefits under a plan provided through her employer Private Diagnostic Clinic PLLC at Duke University Medical Center, Dr. Karen ceased working as a general practitioner on February 23, 2007.

Disability Blog & Cases:
Question writer for Jeopardy/Sony Pictures files suit against Prudential

A California disability attorney and his client filed suit against The Prudential Insurance Company of America (Prudential) in the United States District Court Central District of California on October 28, 2011 for unpaid long term disability payments due per the terms of an employee disability insurance plan.


Disability Blog & Cases:
CIGNA under fire in Minnesota Federal Court for termination of claimant’s disability benefits

Beverly S. and her Minnesota disability attorney filed a lawsuit against CIGNA in the United States District Court for the District of Minnesota in an effort to procure her entitled disability benefits.


Disability Blog & Cases:
Electrical assembly worker for Northrop Grumman files a complaint against UNUM for denial of long term disability benefits

Fifty-nine-year old, former Northrop Grumman Corporation employee Rita L. and her Utah disability lawyer filed suit against UNUM Life Insurance Company and her employer in Federal Court in Utah. Claiming that the UNUM Plan Administrator erroneously denied Rita her disability benefits, the complaint asks the District Court to right this wrong.

Disability Blog & Cases:
Office Depot employee files suit against employer and Aetna for unpaid disability benefits

An Office Depot employee and her Georgia disability attorney filed suit against her employer and Aetna Life Insurance for unpaid disability benefits on November 3, 2011 in the United States District Court for the Northern District of Georgia Atlanta Division.


Disability Blog & Cases:
New Jersey BankUnited employee files suit against Lincoln National

Robert B. and his New Jersey disability lawyer go to battle against The Lincoln National Life Insurance Company to retrieve Robert B.’s entitled disability benefits as promised in his employee disability benefits plan.


Disability Blog & Cases:
New Jersey claimant files suit against New York Life, Unum and Paul Revere for miscalculated disability benefits

William M. never suspected that should he need to make use of his disability insurance policy (which he had faithfully paid premiums on for years) that the promised disability benefits would be denied him when he needed them most.

A sales representative for Long Forms, Inc., President and part owner of Advanced Transportation Systems, Inc. and The Institute of Logistical Management as well as an hourly employee of Temple University as a Criminal Justice instructor, William was diagnosed with Hodgkin’s’ Lymphoma in 1997. Between January 1997 and February 1998, William underwent surgeries, biopsies, chemotherapy, and radiation to combat the progression of the disease.

Disability Blog & Cases:
Northwestern Mutual sued by shareholder attorney for underpaying and denying long-term disability benefits

A Washington disability attorney filed a federal lawsuit in the District Court serving the Western District Court of Washington at Seattle against Northwestern Mutual Life Insurance Company (Northwestern). The Plaintiff, Scott D., worked as a shareholder attorney at a law firm in the state of Washington. Plaintiff was covered under a long-term disability policy purchased from Northwestern, who was contracted by the law firm to provide these benefits to its employees.


Disability Blog & Cases:
Bank of America, Boeing, and Cytec Industries employees file lawsuits against Aetna Life Insurance Company over disability benefits

Recently, three separate ERISA actions were filed against Aetna in Federal Court for wrongfully denying disability benefits to those covered under Aetna Long Term Disability Policies. Lets take a closer look at each of these cases.


Disability Blog & Cases:
Dental surgeon sues Paul Revere Life Insurance Company for wrongful denial of long-term disability benefits

A California disability lawyer filed a federal lawsuit in Federal Court against The Paul Revere Life Insurance Company (Paul Revere). The Plaintiff, Eric W., DDS, was employed as a dental surgeon and took out an individual long-term disability coverage policy by Paul Revere. The Plaintiff had paid all premiums on time, making him eligible for all benefits covered by the terms of the policy.

Disability Blog & Cases:
Five disability lawsuits recently filed against UNUM in Tennessee, Ohio, Missouri, and Michigan

Five ERISA disability lawsuits have been recently filed against the UNUM Life Insurance Company of America for the wrongful denial of disability benefits. In each of the cases, a disability attorney from Tennessee, Ohio, Missouri and Michigan have filed suit for the payment of disability benefits that have been wrongfully denied and owed to their clients. Let’s take a closer look at each of the lawsuits.


Disability Blog & Cases:
Disabled attorney forced to sue UNUM for her disability benefits

A 53-year-old disabled attorney and her New York disability attorney filed a Federal lawsuit against the insurer UNUM on July 15, 2011 for collection of her disability benefits. A Toxic Tort Trial and Litigation Attorney and partner at a well-known firm, the claimant was forced to stop working due to her deteriorating medical condition in April 2009.


Disability Blog & Cases:
Aetna Life Insurance Company sued by Bank of America and Huhtamaki employees for failing to provide ERISA benefits

Two Plaintiffs filed cases against Aetna Life Insurance Company (Aetna) in the Maine and California District Courts due to the failure to provide disability benefits provided by the Employee Retirement Income Security Act (ERISA) of 1974. In the previously mentioned cases filed through the plaintiffs’ disability lawyers, it is alleged that Aetna has wrongfully denied the Plaintiffs’ claims for disability benefits as provided by the terms of those respective plans.

On April 13, 2011, a Morgan Stanley employee and her California disability attorney filed a lawsuit against First UNUM Life Insurance Company for breach of the Employee Retirement Income Security Act of 1974(ERISA), after she was denied long term disability benefits.

On June 22, 2007, the claimant became disabled due to "a series of physical medical conditions, inter alia, a variant of Dejerine Roussy (Central Pain) Syndrome called central hypoperfusion syndrome, fibromyalgia, severe immunodeficiency, and server adrenal deficiency." Suffering from "chronic disabling pain of her right lower abdomen, whole body pain of muscles, joints and bones (including sensations of severe numbness and burning in her legs, face and neck, irritable bowel syndrome, dizziness and nausea, severe fatigue, severe migraine headaches, and chronic hormonal imbalances," the claimant takes powerful corticosteroids and other medications that cause side effects of cognitive difficulties, sleepiness, dizziness, fatigue and other symptoms that preclude her from performing her occupation as a Morgan Stanley Banking Associate.

Background of Banking Associate’s Disability Lawsuit against UNUM Life

Unable to perform "the substantial and material duties of her prior occupation as a Banking Associate," the claimant applied for long term disability benefits from UNUM, and was awarded those benefits on November 13, 2007. Approved for $5,000 per month in disability benefits, the claimant’s disability benefits were calculated incorrectly by taking into consideration only Sconiers’ base salary and failing "to calculate her basic monthly earnings as her HWEE defined as prior year annual gross W-2 earnings" as specified by the UNUM plan. In addition, without "conducting any reasonable or thorough investigation" and without having evidence supporting that the claimant’s condition had improved, UNUM terminated her disability benefits on March 24, 2010. The insurer asserted that the claimant "suffered from a mental condition" that had passed the disability plan’s 24-month limitation period and thus she "was no longer disabled under the terms of the Group Policy."

Disability Lawyer Goes to Battle for Claimant in California District Court

After filing several appeals to UNUM’s termination and miscalculation and being denied at every turn, the claimant and her disability attorney filed the subject lawsuit to obtain her entitled disability insurance benefits through litigation. Alleging that the insurer violated ERISA (the Employee Retirements Insurance Security Act of 1974), California law, and its fiduciary duty in respect to the management of her Stanley Morgan disability insurance plan, the claimant and her California disability attorney accuse the insurer of:

  • Denying benefits based upon an incorrect interpretation of total disability as defined in the plan;
  • Obtaining biased medical input constituting a conflict of interest;
  • Miscalculating the disability benefits the insurer did pay to the claimant; and
  • Improperly "interpreting disabling medical conditions as mental illnesses or psychological conditions."

The claimant and her disability attorney, in her complaint, ask the District Court to permanently enjoin UNUM from "ever again serving as a fiduciary with respect to the Plan," award the claimant attorney’s fees and costs, provide the claimant with appropriate equitable relief from UNUM and issue an order awarding the claimant the "full amount of benefits due since November 13, 2007," plus interest and "other losses resulting from UNUM’s breach."

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.

Disability Blog & Cases:
Radio personality files lawsuit against UNUM to recover disability benefits

A Radio Station employee and her Montana disability lawyer filed a lawsuit against UNUM Group in Montana Federal Court alleging that the insurer violated the Employee Retirement Insurance Security Act of 1974 (ERISA) when it wrongfully denied her entitled disability benefits per a policy she had with her employer, KMSO Radio.


Disability Blog & Cases:
CIGNA/LINA sued by Lockheed Martin employee for unpaid disability benefits

A lawsuit was filed August 1, 2011 in the Federal Court of New Jersey against CIGNA by a hardware analyst and her New Jersey disability attorney in an effort to procure the employee’s disability benefits. After suffering from melanoma of the uterus and courageous attempts to continue working, the claimant was unable to and filed for long term disability benefits. When CIGNA denied those benefits, the claimant was forced to hire an attorney and sue.


Disability Blog & Cases:
Liberty Life faces disability benefit lawsuits in Florida and Maryland for denying disability benefits

Four individuals, include two Comcast employees, with the help of their disability attorneys have filed Federal Lawsuits against Liberty Life Assurance Company of Boston for failing to pay long term disability benefits. Let’s take a closer look at each case.

Disability Blog & Cases:
Microsoft employee forced to sue Prudential for denial of ERISA disability benefits

Forced to hire a Washington disability lawyer to represent him in United States District Court to file an ERISA lawsuit against Prudential Insurance, a Software Design Test Engineer and his attorney allege that the insurer breached its contract, violated the consumer Protection Act, acted in bad faith, and was negligent in denying him ERISA long-term disability benefits.


Disability Blog & Cases:
Two Yellow Book employees sue Liberty Life Assurance Company of Boston for failing to pay ERISA disability benefits

Two different lawsuits were recently filed in California and Alabama Federal Court under the Employee Retirement Income Security Act (ERISA) against the Liberty Life Assurance Company of Boston. In both cases, it is alleged that Liberty improperly denied both plaintiffs their claims for long-term disability (LTD) benefits.


Disability Blog & Cases:
General surgeon files lawsuit against Provident Life and UNUM for disability benefits award

Having failed to uphold its obligation to provide disability benefits to one Provident Life and Accident/UNUM policyholder, the insurer now finds itself in litigation to solve the matter. A General Surgeon and his Florida disability attorney filed a complaint on July 11, 2011 in an effort to pursue the disability benefits he is entitled to under his UNUM insurance plan.