Unum Life Insurance Company Denials Attorney
Has Unum Life Insurance Company Of America Denied Your Disability Claim?
Disability claims under Unum Life Insurance Company of America policies often involve disputes over long term disability coverage and ERISA governed benefit determinations. Unum Life Insurance Company of America is a primary issuing insurer for employer sponsored disability plans and operates as a subsidiary of the Unum Group.
At Eric Buchanan & Associates, we represent policyholders nationwide in disability insurance and ERISA claims involving Unum Life Insurance Company of America disability policies under the applicable policy and legal standards.
Documented History of Unum Life Claim Practices
Federal courts have examined how disability claims issued by Unum Life Insurance Company of America were investigated and evaluated based on the evidence presented during litigation.
Courts and insurance regulators have reviewed disability claims involving Unum Life policies, analyzing how medical evidence and policy terms were applied to benefit determinations.
Following regulatory investigations, Unum Life Insurance Company of America was required to comply with regulatory settlement agreements addressing claims handling procedures, including medical review practices and claim evaluation standards.
Our Successful Cases Against Unum Life Insurance Company of America
Boersma v. Unum Life Ins. Co.
In Boersma v. Unum Life Insurance Co., 546 F. Supp. 3d 703 (M.D. Tenn. 2021), the court reversed a long-term disability (LTD) benefits denial for a former executive who became disabled due to chronic pain. Despite Unum’s reliance on an independent medical examination (IME) and the lack of objective physical markers, the court found that the plaintiff’s condition—which inherently relies on self-reported symptoms—was sufficiently corroborated by medical records, treating physician opinions, a functional capacity evaluation, and witness statements. The court specifically rejected Unum’s skepticism toward self-reporting, noting that such evidence is valid for the condition at issue and that the plaintiff’s long history of professional success weighed against any inference of exaggeration. Ultimately, the court held that the plaintiff carried her burden of establishing her disability, concluding that her symptoms made it impossible to maintain a full work schedule even in a sedentary capacity.
Willard v. Unum Life Insurance Company of America
In this ERISA litigation, the court found that Unum Life Insurance Company of America acted arbitrarily and capriciously by denying a client’s long-term disability benefits based solely on a “clearly inadequate” file-only review. Despite the client providing substantial objective medical evidence and his physicians recommending a physical examination, Unum’s in-house reviewers discredited his subjective complaints and failed to perform an independent medical exam. Applying the standard set in Shaw v. AT&T Ben. Umbrella Plan No. 1 and Gilrane v. Unum Life Ins. Co. of Am., the court determined that Unum failed to provide a reasoned or rational explanation for its denial, especially given its refusal to seek additional evidence that likely would have confirmed the disability. Consequently, the court ruled in favor of the client and remanded the case to Unum for a properly considered determination of benefit eligibility.
Mitchell v. Unum Life Insurance Company of America
In this ERISA-governed disability case, Unum denied a claimant’s long-term disability benefits despite extensive documentation from multiple treating physicians—including a cardiologist and a pain management specialist—who detailed her inability to perform sedentary or physical work due to chronic orthopedic and cardiac conditions. Although Unum justified its denial by claiming a lack of objective medical evidence and opted for a file review over an independent medical examination (IME), the claimant’s legal team presented new MRI evidence that documented severe spinal degeneration. The federal court ultimately ruled that Unum acted in an arbitrary and capricious manner by selectively ignoring this objective MRI data and failing to conduct an IME to reconcile the clinical findings with the claimant’s functional limitations. Consequently, the court remanded the case back to Unum, ordering a formal review by a specialist and a physical examination to properly assess the claimant’s capacity for work.
Wells v. Unum Life Insurance Company of America
In this discovery dispute, the court granted the Plaintiff’s Motion to Compel after Unum Life Insurance repeatedly failed to respond to Interrogatories, Requests for Production, and deposition notices served in March 2008. Despite multiple “good faith” letters from the Plaintiff and a direct warning from the court, Unum ignored deadlines and failed to offer substantial justification for its silence, resulting in a waiver of all objections to the discovery requests. Consequently, the court ordered Unum to provide all written responses within ten days and arrange depositions within forty-five days. Furthermore, pursuant to Federal Rule of Civil Procedure 37(a)(5)(A), the court found Unum’s noncompliance unjustified and moved to award the Plaintiff reasonable attorney’s fees and expenses, pending a final opportunity for the Defendants to be heard on the matter of sanctions.
Bennett v. Unum Life Insurance Company of America
In the landmark case of Bennett v. Unum Life Ins. Co. of America, the court established a pivotal exception to the general rule restricting ERISA reviews to the administrative record, granting the Plaintiff’s request for discovery into Unum’s alleged institutional bias and procedural irregularities. Balancing ERISA’s goal of efficiency against the necessity of protecting employee benefits, the court ruled that discovery is permissible when a claimant identifies specific procedural challenges and makes an initial showing of a “reasonable basis” for those claims. The Plaintiff successfully cleared this hurdle by presenting testimony from former Unum employees regarding profit-driven bonus structures for claims adjusters and the intentional destruction of files to insulate denial decisions. By finding that these “serious and specific” allegations moved the request beyond a mere “fishing expedition,” the court allowed discovery into whether Unum’s financial interests improperly influenced the termination of benefits—a standard further broadened in Myers v. Prudential Insurance Co. of America, which removed the requirement for an initial evidentiary showing in cases involving structural conflicts of interest.
Barnes v Unum Life Insurance of America
In Barnes v. Unum Life Insurance Co. of America, No. 1:19-CV-138, 2020 WL 10221073 (E.D. Tenn. Nov. 24, 2020), the court conducted a de novo review of a long-term disability claim filed by a medical clinic CEO suffering from orthopedic issues and cancer. After Unum terminated benefits based on a file-only review and the plaintiff’s refusal to undergo a radiation-heavy MRI against his surgeon’s advice, the court found the termination improper, citing a wealth of objective evidence—including X-rays, medication history, and a Functional Capacity Evaluation (FCE)—that supported the plaintiff’s inability to perform even sedentary work. The court rejected Unum’s attempts to undermine the FCE’s credibility, noting that the insurer failed to exercise its right to physically examine the claimant and instead relied on skeptically viewed file reviewers. Ultimately, the court awarded benefits under both the “own occupation” and “any gainful occupation” standards to avoid giving the insurer “two bites at the apple,” while also denying Unum’s counterclaim for Social Security offsets because the plaintiff had already dissipated the specific funds, precluding an equitable lien under ERISA.
Gooden v. Unum Life Insurance Company of America
In Gooden v. Unum Life Ins. Co. of America, 181 F.Supp.3d 465 (E.D. Tenn. 2016), the court addressed whether a disability insurance policy obtained through an employer was governed by federal ERISA law or state bad-faith law. The plaintiff had secured an individual policy after a Unum salesperson met with employees, and while the employer facilitated the plan through payroll deductions and received a group discount, it did not contribute funds or negotiate the terms. Applying the Department of Labor’s “safe harbor” regulations, the court determined that the policy was exempt from ERISA because the employer’s involvement was limited to administrative tasks and did not constitute an endorsement or financial contribution. Consequently, the court found that a non-negotiated discount and simple payroll deduction did not trigger federal jurisdiction, allowing the plaintiff to pursue their claims under more favorable Tennessee state law.
Mistick v. Unum Life Insurance of America
In Mistick v. Unum Life Insurance Company (2020), the court ruled in favor of a claimant whose long-term disability benefits were terminated after Unum shifted her eligibility criteria from an “own occupation” to an “any gainful occupation” standard. Despite Unum’s contention that the claimant could perform sedentary work, the court applied a de novo standard of review and determined that the preponderance of evidence supported a finding of total disability. A central factor in the court’s decision was the relative weight of medical testimony: the court discounted the opinions of Unum’s “medical consultants” because they performed only paper file reviews and “piecemealed” the claimant’s health issues rather than conducting physical examinations or assessing her condition holistically. Ultimately, the court found that Unum’s reliance on these file-reviewing doctors was insufficient to overcome the convincing evidence from treating physicians, concluding that the claimant’s cardiomyopathy and related complications rendered her incapable of even sedentary employment.
Unum Life Claim Practices and Legal History
Federal courts have reviewed disability determinations issued by Unum Life Insurance Company of America in ERISA litigation nationwide. In these cases, courts examine whether the insurer’s decision was supported by the administrative record and consistent with the policy’s definition of disability.
Judicial review focuses on how Unum Life Insurance Company of America evaluated medical evidence, addressed treating physician opinions, interpreted occupational duties, and applied policy language. Courts do not simply ask whether a claimant has a diagnosis. The question is whether the insurer’s reasoning is supported by substantial evidence in the record.
In cases involving Unum Life Insurance Company of America, courts weigh the insurer’s stated rationale against the full administrative record and the precise contractual terms governing the claim.
Why Unum Life Insurance Claim Practices Matter to Your Case
Claims under policies issued by Unum Life Insurance Company of America are often reviewed under ERISA standards that limit courts to the administrative record. New evidence is typically not permitted once litigation begins.
The appeal stage is critical. Medical evidence must address functional limitations under the policy’s definition of disability, and the insurer’s stated reasons for denial must be directly rebutted.
If the administrative record does not clearly support disability under the policy’s terms, courts may uphold the denial.
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Financial Pressure on Claim Decision Makers
Courts evaluating disability claims have recognized that insurers administering claims and paying benefits operate under an inherent structural conflict of interest.
When reviewing benefit denials, courts may consider this structural conflict as part of the overall analysis, particularly where claim determinations depend on disputed medical evidence, vocational assessments, or interpretations of policy language.
This discussion reflects how courts analyze disability benefit decisions under the law. It does not speculate about how claims are handled today
How We Approach Unum Life Disability Claims
Unum Life Insurance Company of America disability policies often involve detailed policy language, medical evidence requirements, and procedural rules governing benefit determinations.
Our approach focuses on:
- We analyze how the policy defines disability and occupation
- We ensure medical evidence directly addresses those definitions
- We identify gaps or inconsistencies relied on in claim denials
- We build a complete and well supported record during the appeal process
In ERISA governed claims, courts often limit their review to the evidence submitted during the appeal, making that stage critical to the outcome.
Our Role As Advocates
The court decisions and regulatory actions discussed on this page are part of the public record and explain how disability claims are reviewed under the law.
At Eric Buchanan & Associates, we represent policyholders and advocate for our clients within the legal rules that govern disability claims.
If your disability claim was denied or terminated under a Unum Life Insurance Company of America policy, weare prepared to help you evaluate your options and determine next steps.
Contact Us Today!
You don’t have to deal with the insurance company alone. If your claim was denied, delayed, or handled unfairly, our team is ready to review your case and help you understand your next steps.
Call: (877) 634-2506