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"Unum Buyer Beware," Says Attorney Greg Jones

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Wilmington, NCIf you have a long term disability policy with Unum, "it may not be what you signed up for, especially with professional policies," says attorney Greg Jones.

Unum has a long history of arbitrary denial, as Jones has seen firsthand. "A number of my clients who were initially accepted by Unum for long term disability (LTD) have their benefits cut off," he says, "without any medical justification except by Unum's own medical examiners. And it isn't uncommon for Unum medical examiners to deny benefits without even seeing you. "In fact, one of my clients was advised by her doctor to call a lawyer, because Unum is very deceptive in the way they handle cases."

One method of deception employed by Unum is the company's interpretation of "own-occupation," which means that you will be entitled to benefits when you are no longer able to work at your principal occupation, regardless whether or not you can work at a different kind of job. The Office of Labor Relations defines totally disabled when, "due to sickness or accidental bodily injury, you are unable to perform the material and substantial duties of your occupation. After 24 months of benefits, you are considered totally disabled if you are unable to perform the material and substantial duties of any occupation for which you are reasonably fitted by education, training, or experience."

According to Jones, "Own occupation" policies written back in the 1980s meant that the insurance company would have to pay benefits if you could no longer do your job. Times and policies have changed. "If I am an injury trial lawyer and I'm disabled, Unum will tell me that I have to be a different kind of lawyer," Jones explains. "But even though I can practice some other kind of law, Unum still has to pay me."

Jones says that Unum looks for ways where you can continue to work at your regular occupation, even if your doctor has determined that you are disabled. And if you refuse, Unum could terminate your claim.

Say you're a chiropractor and you also sell orthotics and other products associated with your practice. Jones says that Unum will disallow your case—you won't be eligible for benefits—because you are still able to sell pillows and orthotics and any products that are a part of your chiropractic profession. "Ten years ago, you would be covered under an 'own-occupation' policy, but not anymore," says Jones. "For example, if you are a surgeon and can no longer perform surgery, Unum will tell you that you can still do office visits. If you are a trial lawyer and can't go in front of a court, Unum will tell you to get a desk job."

Does this mean that you could be forced to work as a Wal-Mart Greeter or a parking lot attendant? Maybe. Jones says a former emergency room nurse was denied LTD, despite medical reports to the contrary, and is now reviewing medical reports for lawyers. "An Unum policy ain't what you signed up for," he says. Before you sign an Unum policy, it might be a good idea to have a qualified insurance lawyer review it first.

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