Unum Group and Unum Life Insurance Company Of America (Unum) were recently sued by an Oklahoma disability attorney for his client’s reinstatement of long term disability benefits. The Plaintiff, Donald J., worked as a recycle fiber operator for Weyerhaeuser Corporation (Weyerhaeuser), which contracted with Unum to provide a long-term disability insurance plan to its employees. The Plaintiff was enrolled in this plan because of his employment at Weyerhaeuser.
Case Facts Against Unum
Plaintiff worked as a recycle fiber operator at Weyerhaeuser for 26 years. He seriously injured his left shoulder via an accident at work in July of 2002. Plaintiff has endured numerous operations on his left shoulder since that injury. He has been unable to work since November 2002.
Unum notified the Plaintiff by letter on July 25, 2003 that he qualified for long-term disability benefits beginning on May 13, 2003. The terms of the Plan indicate that the participant cannot perform the material and substantial duties of his regular occupation due to injury or sickness, incurs a 20% or higher loss of his indexed monthly earnings due to that injury or sickness.
Additionally, if the participant needs assistance in performing two activities of daily living (such as eating, bathing, dressing, toileting, and continence) or has impairment in cognitive function, the Plan will provide payments beyond the initial 12 months.
Plaintiff continued received long-term disability payments until September 30, 2010.
Unum’s Discontinuation Of Plaintiff’s Long-Term Disability Benefits
On September 30, 2010, Unum notified Plaintiff by letter that his long-term disability benefits have been stopped due to the fact that Plaintiff did not lose the ability to perform fewer than two functions of daily living as stated in the Plan or that his cognitive functions were impaired.
Plaintiff appealed the decision, but Unum upheld it via a letter dated December 3, 2010.
Plaintiff again appealed the decision, and again, despite evidence to the contrary, Unum upheld its original denial of benefits via a letter dated May 4, 2011.
Due to the Plaintiff exhausting all administrative remedies, Plaintiff has filed this lawsuit against Unum.
Unum Lawsuit Filed by Oklahoma Disability Attorney
This lawsuit states that Unum made the following wrongs against the plaintiff:
- Committed arbitrary, capricious, and unlawful denial of the benefits that were provided to the Plaintiff under the terms of the Plan
- Denied the benefits that were owed to the Plaintiff as defined by the terms of the Plan
- Violated both the terms of the Plan and of ERISA, which requires a full and impartial review of the Plaintiff’s claim for benefits
- Financial and mental hardship toward the Plaintiff
Following Relief Sought By Plaintiff From The Unum Lawsuit
Due to Unum’s unlawful actions, Plaintiff requests the following relief from the Court:
- Plaintiff is entitled to future long-term disability benefits as defined by the terms of the Plan
- Plaintiff is entitled to all past unpaid benefits as defined by the terms of the Plan, along with all pre-judgment interest that is allowable by law
- Unum must pay restitution for the losses that Plaintiff has incurred due to the wrongful conduct committed by Unum
- Unum must pay all Plaintiff’s attorney fees and court costs
- Plaintiff should receive all other relief that the Court deems to be proper and right