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Ex-Wife Lies to Unum, Results in Denied Disability

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Arlington, VAKevin was diagnosed with multiple sclerosis in 1998, one year after he took out an Unum, or Unum Provident policy. After a messy divorce, Kevin says his ex-wife told Unum that he had MS in the 1980s, which meant he had a preexisting condition and would be denied Unum long-term disability benefits.

Kevin says he went by the book - he was completely honest with his insurance company. “I told Unum that I had MS and there was a contestability period where insurance companies do their due diligence,” says Kevin. “If they were going to terminate my benefits, that would have been the time.”

A few years later Kevin got divorced and also lost his job as an analyst in the medical field. In 2001, he applied for long-term disability due to his MS worsening; he was particularly having memory issues.

“Going into 2002, my ex-wife decided to call Unum; this is when she said that I was diagnosed with MS in the 1980s. Unum couldn’t find that diagnosis but they found my medical records,” adds Kevin. “Unum was still paying me disability benefits but now they were under ‘reservation of rights,’ meaning that they were paying me but also investigating the MS diagnosis because they had this complaint from my ex-wife.

“They saw that I suffered from migraines before I took out the policy and said they would never have underwritten my policy had they known. But the contestability period was over. Regardless, they charged me with insurance fraud in 2006.”

Kevin needed an experienced attorney. The MS society recommended a lawyer and sometimes his divorce attorney helped. Kevin ended up going to a settlement conference alone - his divorce attorney never showed up. “My attorney advised me to take a settlement if Unum offered it and stupidly I took their offer of $10,000,” Kevin explains. “I was by myself and didn't realize what I was doing, which is part of my MS condition.”

The next day Kevin talked with his family and tried to rescind the settlement agreement but the Unum attorney said it was a done deal. However, Kevin knew that he could rescind the agreement if there was fraud involved on their part. It was back to court…

“During part of discovery, there was an admissions stage,” says Kevin. “This is when I sent Unum a series of questions and asked them to admit to something.

“‘Do you admit that you did not have proof that I had MS in the 1980s?’ I first asked. Unum replied that indeed they had proof. In the second round of admissions, I was a bit smarter. ‘Do you have my medical record stating that I have MS from a doctor in 1980s?’ I asked, and this time they admitted they didn’t have my records. So Unum was fraudulent.

“In 2014, I had another hearing, and asked the judge to say the settlement agreement was not valid. But the judge denied my motion. He said that Unum had every right to rely on the testimony of my ex-wife, even though she was never in court.”

Unum is demanding that Kevin pay back $300,000, which amounts to the long-term benefits he received until Unum stopped paying him in 2006. “I have to find an attorney experienced with RICO and sue Unum,” says Kevin, “and get back what is rightfully mine.”

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READER COMMENTS

Posted by

on
I am pushing Unum for $330,000 and not accepting less then they owe me. They caused me some serious issues that I have no recourse against. The only way is to make them pay every penny possible under the law. I got lucky and got a judge that doesn't like what Unum does to the patients. My lawyer has taken Unum to the Supreme Court and won. He knows them very well. Good Luck

Posted by

on
I'm writing for my cousin, she was diagnosed with conjestive heart failure in march of 2014. She was off work in march 2014 and returned June 2014. She worked from June to Sept and went off work again because , her job performance had went down so her job sent her out to have a psychological and neuro evaluation. While waiting on the results from her evaluation she had a heart attack nonvember 2014. She had a MRI June 2014 by her PCP, and the MRI showed she had a stroke, approx around 2010 and that was the year she had fallen at work and hit her head on a file cabinet. Unum says she can't get long term disability because she only paid into short term disability and that it was a pre existing condition. She hasn't had a income since April 2015 she was paid only 4 to 6 months of short term disability and it took her 6 months to get that. Are there any options for her and I want to make sure unum is doing right by her. She worked at her job 28 years. I have been handling all her business Because she's in a fog sometimes so she gives everyone permission to speak with me.

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