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Putting the Pressure on Unum

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Vacaville, CAThree months ago Unum Group cut off benefits to John Hilley of Banner Elk, North Carolina, after learning from his surgeon that Hilley had recovered. But the surgeon made a mistake, as an X-ray from a second surgeon proved. Still, Unum refused to review the claim—until Action 9, a local TV station, put the pressure on Unum.

When Action 9 called Unum, a spokesperson said the company "was still waiting for information from Hilley's doctors and working toward a resolution," even though Unum had enough documentation to show that Hilley was still disabled. According to The Associated Press, Hilley then received a check for $9,000 that covered the last three months of disability payments.

Countless other Unum policy holders who have been cut off or denied their long-term disability benefits go the legal route for help. Bob C from Vacaville, California, didn't even make it to first base with Unum, even though his medical report states that he was unable to return to work. Bob's attorney is in the process of helping him file a disability claim with Unum.

"I injured by trigger finger and wrist, which is crucial to my job as a biomedical equipment techie, but my employer (Stryker—one of the biggest medical companies in the world) wouldn't file a disability claim with Unum," says Bob. "Unum said they couldn't help because my policy required my employer's HR to send them medical documents. It's a catch-22 for me—neither would respond." Over a four-month period, Bob's condition worsened (he has carpal tunnel syndrome) and he was terminated—after working five years with a stellar record. Bob is convinced that he was fired due to his injury, and he believes that Unum should still accept his claim.

"Unum was fully aware of my injury before I was terminated but they told me I couldn't personally submit my claim," says Bob. "I read and re-read my policy and nowhere does it say that I couldn't submit a claim; neither does it say that an injury has to be work-related.

"Since my injury doesn't have to be work-related, I wanted Unum to get the ball rolling; obviously Stryker wasn't going to push the issue to get the treatment I needed. I had enough information from my doctor to get disability benefits but it's like there is some kind of collusion between Stryker and Unum; I'm not a conspiracy theorist but I really believe this is one of Unum's bad faith practices.

"I don't know if I am a special case or just one of thousands that Unum has denied; I do know that it has done every stalling technique. I now have medical reports from seven doctors, all of whom said I need surgery. So I've had two surgeries since I was fired but Unum still wouldn't recognize it. Workers' Compensation covered my surgery expenses but I have never received long-term disability benefits.

"I called Unum recently and they basically told me to go to hell—I was shocked at how nasty they could be. The first person I spoke to—a receptionist—tried to do everything to stop me from speaking to someone in the claims department. I finally did connect with a claims rep and explained my situation all over again. I asked him why I couldn't apply for Unum's benefits if it wasn't a work-related injury. 'It's just the way your policy is set up,' he replied—he was bound and determined to do nothing. He refused to send me a claim application and I couldn't get it from HR. So now I'm hopeful that my attorney can pressure Unum…"

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