Denise purchased a private Unum policy in 2001 when she worked on Wall Street. In 2007 an SUV hit her—she was a pedestrian—and Denise suffered herniated discs as a result of the accident. Even though she was in a great deal of pain, Denise just took two weeks off work and continued to work for the next 13 months. During that time she had 11 cortisone injections and her condition deteriorated.
"My doctor said I couldn't have any more injections because cortisone makes the bones brittle," says Denise. "I had a number of surgeries and they recommended a spinal fusion but couldn't guarantee any success so I declined. I went to a chiropractor, acupuncturist and several other doctors until I exhausted all possibilities of getting better. I applied for long term disability (LTD) from Unum but they denied my claim. I couldn't believe it—even with all my doctors' reports. The reason for their denial: there was an error because I didn't include my social security disability papers. What does that matter?
"I appealed and Unum insisted that I see their doctor. It's now 2008. I sent them a list of 10 doctors that I wanted to see (not including the doctors I had already seen), but Unum insisted that I see their 'independent medical examiner.' He kept me waiting in his office for one hour and looked at me for 15 minutes.
"Unum denied me again, this time saying that I didn't meet their definition of being disabled. 'What is your definition?' I asked my Unum representative. 'Read your policy,' was my answer. So I appealed again…
"Here is the clincher: After my benefits were denied, Unum continued to deduct premium payments from my checking account. I called my rep and she said that I had to send it in writing. At that point I used a few choice words: What f ***ing planet do you think I am on, continuing to pay my premiums after you deny my claim?
"So I had to go to the bank, pay the bank a fee to get Unum removed from my checking account and then Unum reimbursed my last payment of $39.60.
"I have medical reports and letters from Dr. Farmer, Associate Attending Orthopedic Surgeon at Hospital for Special Surgery in Manhattan, and another from Dr. Casden, both stating that I require a spinal fusion and that I am disabled. My family doctor also wrote that I cannot work, but none of those letters matter to Unum.
"I have been prescribed Vicodin, Percocet and a morphine patch for pain, but I told my doctor that I had to stop taking these drugs because I was afraid of becoming a drug addict. Now I'm on Tramadol: it is supposed to be non-addictive and it's not as strong as the other meds, but it helps. I'm also on a few other painkillers and a sleeping pill at night. I also take a nerve blocker and that is the main reason why I quit working—I couldn't even walk up and down stairs.
"Then social security disability kicked in. They even denied me at first but an experienced insurance attorney helped with my claim and I got my benefits right away.
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"I have researched and obtained lots of information about Unum and how it denies claims. And I found out that Unum's employees are paid incentives to deny claims. I am shocked to discover, again online, how many people have been denied their LTD benefits. I sent my Unum rep some articles from legal websites where people have won lawsuits against Unum. My rep simply said that I shouldn't believe everything I read on the Internet. But these cases are coming from legitimate law firms!
"Now I have an attorney reviewing my claim—there is a lot of information to gather. It's truly amazing how Unum can get away with these practices, but I intend to fight them and get what is rightfully mine."