Unum originally denied benefits to the plaintiff, Anne Forrest, in February 1998. After a failed appeal, the plaintiff's file was marked closed in March 2000.
In 2006 Forrest decided to attempt a reassessment of her claim pursuant to a settlement between Unum Group, various state insurance agencies and the federal Department of Labor.
However, according to a recent issue of Lawyer's Weekly, Forrest's request for a reassessment was denied on grounds that the plaintiff had failed to submit necessary documentation by the deadline of October 1, 2006.
In Forrest v. The Paul Revere Life Insurance Co. et al, the Court concluded, "Unum has moved for summary judgment. The central issue presented is whether the claim is time-barred....
"An ERISA cause of action for wrongful denial of benefits accrues when plaintiff's internal appeal is denied ...This means that Forrest's claim accrued on March 10, 2000, the date on which Unum denied her appeal and closed her file.
"Plaintiff accordingly had six years, or until March 10, 2006, in which to file her complaint."
The Court said it took no position as to whether Forrest had a valid claim of legal malpractice against a particular defendant. "She does not, however have a valid claim against Unum, as her claim is barred by the six-year statute of limitations for contract claims under Massachusetts law."
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As a whole, the various players in the insurance industry take steps to ensure that policyholders are making legitimate claims. Just as there are insurance providers who are accused of unfair tactics in attempting to delay or deny legitimate claims, there are claimants who unfairly attempt to extort money from insurance providers with regard to unfounded claims and health conditions.
In Anne Forrest's case, a missed deadline relieves Unum of any potential liability in association with her claim.