If you are researching UNUM disability insurance claims, you have probably read a lot of worrisome things. The company is notorious for wrongfully denying claims and prioritizing profits over its insureds. However, with the right knowledge and tools, you might get the short-term disability benefits you deserve.
In this article, Bryant Legal Group’s disability insurance lawyers highlight some of UNUM’s tactics and suggest ways you can fight back.
UNUM Short-Term Disability Insurance: An Overview
UNUM is one of the largest disability insurance companies in the United States. They sell policies to both individuals and employers that provide a monthly benefit if you cannot to work due to an illness, injury, or chronic medical condition. Depending on the terms and conditions of your short-term disability policy, you will receive these monthly payments for a period, often between 3-12 months.
How UNUM Defines Disability
Most, but not all, short-term disability plans include an “own occupation” definition of disability. If you have an “own occupation” policy, you must show that you are unable to do your actual job due to your injuries or medical conditions.
Some short-term disability policies adopt the stricter “any occupation” standard, where you are eligible for benefits if you cannot do any type of work due to an illness or injury.
Unfortunately, UNUM has a long history of denying legitimate disability claims. The company has a large collection of older policies that include generous terms and benefit rates. To save money, the company has financially incentivized the denial of claims and offered unreasonably low settlements. These (and other) practices drew the attention of every state’s insurance commissioner—and led to $23 million in fines.
Now, let’s explore some of UNUM’s favorite tactics.
Tactic #1: Delay, Delay, Delay
At first glance, applying for short-term disability benefits seems simple. However, the process requires more than filling out a brief form and giving UNUM your medical records.
Do not be surprised if UNUM’s claims adjuster asks you for the same information repeatedly, and continually requests more time to review your records, get additional updates, and consult with experts. Sometimes, these delays are inevitable. However, other times, the insurance company is just trying to stretch out your claim, hoping that you will give up. After all, many people decide that six months of short-term disability benefits is not worth the effort.
If UNUM is giving you the runaround, it is best to consult with an experienced disability insurance lawyer. An attorney can help streamline the process and combat unnecessary delays. Additionally, if you have a private disability insurance policy, an insurance company’s intentional holdups could result in a bad faith claim.
Tactic #2: Use a Field Interview to Attack Your Credibility
UNUM frequently sends representatives to visit claimants. However, these representatives are often highly trained investigators who are looking for reasons to deny your short-term disability benefits. As you update them on your medical treatment, they are scrutinizing everything: how often you shift positions, the cleanliness of your home, and your demeanor.
UNUM often uses anecdotal evidence from field visits and surveillance to deny claims, arguing that you are more physically active and capable than you claim to be.
If your short-term disability policy requires your attendance at field interviews, you should meet with UNUM’s representative. However, you can choose to speak with them at a neutral location, like your disability insurance lawyer’s office or a library.
RELATED: UNUM Field Visits: How to Protect Your Privacy and LTD Claim
Tactic #3: Mischaracterize Your Duties at Work
While “own occupation” short-term disability policies are more generous than “any occupation” plans, that does not mean that UNUM will quickly approve your claim. Sometimes, the insurance company will try to redefine the scope of your work and argue that you can perform your job.
For example, suppose you are a dentist who owns and operates your own practice. In addition to treating your own patients, you have hired a team of dentists who serve your community. UNUM might argue that because you handle the practice’s day-to-day operations and manage other professionals, that arthritis and inflammation in your hands does not limit your ability to work—ignoring all of your hand-intensive clinical work in order to justify denying your claim.
If UNUM tries to mischaracterize your job, it is likely that you will need legal representation. In these cases, your disability insurance lawyer might need to work with vocational experts and your doctors to clearly articulate your job duties and limitations.
Tactic #4: Use “Experts” to Deny Your Claim
UNUM has relationships with “independent” experts who they routinely hire to assess short-term disability eligibility. However, these doctors, whether they are acting as physician consultants or performing “independent medical examinations,” typically side with the insurance company.
While you cannot stop UNUM from hiring these biased experts, you can minimize their impact with strong medical evidence and skilled legal representation. If you need medical care, see your doctors and make sure they understand the severity of your symptoms and functional limitations. That way, your lawyer can rebut UNUM’s claims with clear and consistent information.
Tactic #5: Look for Loopholes and Exclusions in Your Short-Term Disability Policy
Most short-term disability policies have specific exclusions and limitations. Sometimes, UNUM tries to argue that you have a preexisting condition or that your specific condition is excluded from coverage. (This is particularly true if you have a disabling mental health condition, like schizoaffective disorder.)
Additionally, UNUM tries to use the fine print in its policies to deny claims, sometimes stretching elimination periods, disputing disability coverage, and terminating benefits too early. Do not assume that UNUM is interpreting your policy accurately. Instead, have an experienced disability insurance lawyer review your plan’s language, investigate your claim, and get an honest and fair assessment of your eligibility.
RELATED: Disability Exclusions: We Answer Your FAQs
If any of these scenarios feel familiar, do not wait to reach out to our team of disability insurance lawyers for clarity and assistance. You are never alone in a tough situation; there are people ready with resources and tools to fight back against these unfair practices.
Bryant Legal Group: Illinois’ Trusted Team of UNUM Disability Lawyers
At Bryant Legal Group, our practice focuses on disability insurance law. We have a long history of standing up to UNUM, helping disabled professionals get the benefits they deserve. We have recovered millions in benefits for our clients, and we can help you understand your short-term disability insurance options.
To schedule your free consultation, call us at 312-561-3010 or complete our online form.