How Long Does It Take UNUM to Process a Claim? It Depends
If you’re applying for short-term or long-term disability benefits, you’ve probably heard that UNUM is notoriously difficult to deal with. The company has a reputation for denying valid claims, delaying benefit payments, and violating state and federal insurance laws. However, you can fight back.
At Bryant Legal Group, we help people stand up to UNUM and other disability insurers. In this blog, learn more about disability insurance claim deadlines and what to do if your adjuster unreasonably delays paying your benefits.
What Happens After I Apply for Disability Insurance Benefits With UNUM?
After you’ve filed a short-term or long-term disability benefits claim form with UNUM, the company will follow a series of steps:
- Assign an adjuster: An adjuster or claims representative will serve as your point of contact throughout your disability insurance claim. This individual is a UNUM employee and is under pressure to deny as many claims as possible.
- Investigate your claim: Next, the adjuster will review your claim. This process typically involves requesting medical records, scheduling “independent medical examinations,” and assessing your credibility.
- Ask for additional information: Don’t be surprised if UNUM reaches out to you and asks for more information. Sometimes, you’ll only need to fill out some additional forms. Other times, a UNUM representative will ask for an in-person meeting, which might be a form of surveillance.
- Approve or deny your claim: Once the adjuster thinks they have enough information to reach a decision, they will either approve or deny your short-term or long-term disability benefits. If you disagree with UNUM’s decision, you can file an appeal.
Individual Disability Policies Have Different Deadlines Than Employer-Sponsored Plans
There are two types of disability insurance: private, self-funded policies, and employer-sponsored ones. Depending on the type of policy, different laws apply to your claim. UNUM sells both types of disability insurance policies, so you’ll need to identify which rules apply to your claim.
RELATED: Disability Insurance in a Nutshell
Employer-Sponsored Plans: UNUM Has Up to 150 Days to Investigate Your Disability Claim
Employer-sponsored plans are offered by companies as a benefit, and many people get a modest amount of short-term disability or long-term disability coverage from their employer. If your employer funds your disability plan, a federal law, ERISA (Employee Retirement Income Security Act of 1974), applies to your claims.
Under ERISA, UNUM must complete its claim review within specific deadlines. Typically, the company has 45 days from when it received your application to either approve or deny your claim. However, the company can request several extensions:
- 30 days: If UNUM needs more time to finish its investigation
- 45 days: You get at least 45 days to respond to UNUM’s requests for more information.
- 30 days: There’s a second 30-day extension if the insurance adjuster still needs more time.
Overall, it could take up to 150 days for the insurance company to process your employer-sponsored disability insurance claim (45 days + 30-day extension + 45 days to respond + another 30-day extension). UNUM must send you a written notice if it needs more time and must explain its reasoning. If they fail to send you a letter, contact a disability insurance lawyer right away.
Self-Funded Policies: UNUM Can’t Take an “Unreasonable” Time to Process Your Disability Insurance Claim
ERISA does not apply to private disability insurance policies. Instead, the insurance company must follow Illinois’ insurance laws, which take a different approach to unnecessary delays.
Illinois law requires that the company handle your claim in good faith, which means:
- It cannot unreasonably deny or delay your claim
- The company must follow its own policies and procedures as well as state and federal laws
- The adjuster must communicate with you promptly and regularly, returning your calls and answering your questions
If UNUM does not meet this standard, you may be able to file a bad faith insurance claim against the company. However, the definition of what’s “unreasonable” will vary.
When you file a bad faith insurance lawsuit against UNUM, the court must look at a variety of factors. The court will consider the company’s attitude towards you, the amount of time you had to wait, and whether you had to file a lawsuit to get the benefits you deserve.
Every private disability insurance claim is different. In some cases, a 90-day or 180-day delay could be justified, but often it isn’t. In UNUM’s own documents, the company says it typically processes short-term disability claims in five days, while LTD claims tend to take 35 to 45 days. If you believe that UNUM’s delay is excessive, consult a disability insurance lawyer right away.
When Should I Consult a Disability Lawyer About My UNUM Claim?
The sooner you speak with an experienced disability insurance lawyer, the better. UNUM often tries to take advantage of unrepresented claimants by offering them unfairly low settlements, delaying their claim reviews, and discouraging them from pursuing an appeal.
Unlike UNUM’s insurance adjusters, a disability insurance lawyer will be on your side, giving you honest and practical advice. At Bryant Legal Group, we offer free initial consultations, so there’s no risk in getting expert advice about your case.
Bryant Legal Group: Chicago’s Trusted Disability Insurance Law Firm
Bryant Legal Group is one of Illinois’ premier disability insurance law firms. We help professionals and other disabled individuals get the benefits they deserve, and we have a reputation for standing up to UNUM. If you’re frustrated by the amount of time your long-term or short-term disability claim is taking, contact us today.
29 CFR § 2560.503–1 (2001). Retrieved from https://www.govinfo.gov/content/pkg/CFR-2016-title29-vol9/pdf/CFR-2016-title29-vol9-sec2560-503-1.pdf
215 Ill. Comp. Stat. §5/155 (2004). Retrieved from http://www.ilga.gov/legislation/ilcs/fulltext.asp?DocName=021500050K155
Claims FAQ: Ongoing. (n.d.) UNUM. Retrieved from https://www.unum.com/eeportal/claimsfaq/help/ongoing
The content provided here is for informational purposes only and should not be construed as legal advice on any subject.