Unum Provident Benefits Denial Caused Depression

Oceanside, NYColleen had surgery for vertigo in 1998 but it caused her to lose hearing in one ear and she suffers from severe headaches--she hasn't been able to work since. And because Unum life insurance denied her claim, she suffers from depression due to financial burdens. Even though her doctor has sent numerous letters to Unum Provident, even though social security eventually granted her long term disability benefits, she didn't receive a dime from Unum long term disability.

"I worked for 20 years and never once got sick," says Colleen. "But I never recuperated from surgery and nobody can help me. Two years ago I began to notice that my ear 'went in' and if you look at me straight-on, you cannot even see my ear. My neurologist said I could have surgery again but I said, 'No thank you'. He said there is nothing more that can be done except drug therapy and have surgery to correct the way my ear looks. I don't care about how I look—the headaches are debilitating.

When I started working for the Reliance Insurance Company 11 years ago, I took out a long term disability (LTD) policy with Unum Provident—all employees were encouraged to do so. I put money into this insurance company but when it was time for them to help me, they just turned their backs—they denied my claim. I had the surgery on March 30th and they stopped my short term benefits (STD) on June 13th --because I did not die from the surgery! I really think that is what it would have taken to qualify.

Herein lies the problem; even though I haven't been able to return to work, my neurosurgeon said I might be able to return to work in June—the month I was cut off.

I had an appointment to see my neurosurgeon in June. I went to his office and he was not there. So how could he say I could return to work without seeing me? I have proof that I had an appointment; when I arrived at his office the receptionist said that she tried to call me and cancel, 'but I guess you had already left,' she said. I rescheduled an appointment and finally saw him in September--four months later, without any income.

Meanwhile I saw my primary care physician who had many questions for the neurologist. My GP's receptionist kept calling his office and leaving messages but they never got a call back. When I saw the neurosurgeon I was dripping water from my nostrils and my headaches were worse. I asked Dr. Cohen why he hadn't returned my doctor's calls or Unum's calls. 'You said that you examined me in June but you never did,' I said. He didn't say anything. Talk about bad bedside manner.

When Unum terminated my STD benefits, I appealed and I was denied based on the neurosurgeon's report. My GP wrote several letters to Unum stating that I was unable to work but they fell on deaf ears. I never saw one of Unum's 'independent examiners' either, although I would welcome the chance to see another doctor. I also want to know what is happening with me; my health has not improved.

I applied for social security benefits on my own and they denied me at first. I got a disability lawyer to help and I won! I remember the judge. 'Don't worry, everything is going to be OK,' he said, because I was crying at the hearing. It was such a relief.

My attorney explained this to me: between social security and Unum I would have been getting $2500 per month. Instead my payments started at $1600 per month and because of inflation, I now receive $1900 per month.

After my lawyer helped me to appeal and I won, I saw something on TV—there was a disability doctor in California representing clients who were denied their claims with Unum. I phoned an attorney in California who advised me to file a reassessment because the Department of Labor was looking at Unum's denial of claims and they had to reassess thousands and thousands of policy holders who were denied their benefits.

But I lost because my statue of limitations had run out, even though I had a pretty good case. (I urge anyone to appeal if they were recently denied.)

Unum kept telling me that my injuries (headaches and depression) had nothing to do with my first claim. This is one of their tactics, to say that your symptoms are not related. I can't believe how they can treat people this way; how can they get away with it? The ERISA law protects insurance companies—isn't it about time that our laws are reassessed? They are not fair to people who are sick.

I hope the laws can change because Unum has harmed and destroyed a lot of people. My primary care physician said 'Colleen, you have never been sick, this is the first time.' Now I am taking anti-depressants and painkillers and don't see anything changing. I have three children to support and it has been hard.

When I was working I had money; now I have to clip coupons and watch every penny. My kids don't understand that they can't have what their friends have and it breaks my heart—that is why I got depressed. My depression was caused my financial anxiety; in other words, Unum caused my depression, which is a direct result of my first claim, when they denied me."