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Unum Lawsuit Plaintiff Wins Re-instatement of Unum Disability Benefits

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Sacramento, CAAn Unum lawsuit has recently been settled in favor of the plaintiff, who suffers from fibromyalgia and a horrific disease known scientifically as avascular necrosis but commonly referred to as “bone death.”

The plaintiff, Tracy Mondolo, was reported to have been previously diagnosed with leukemia and underwent the rigors of chemotherapy in an attempt to eradicate the disease. That necessary regimen of chemo, according to Mondolo’s doctors, may have resulted in the so-called bone death that left Mondolo with uncontrolled pain and weakness, together with difficulty in walking and a limited capacity for sitting or typing for prolonged periods.

And yet, Unum insurance denied Mondolo her disability benefits. Mondolo sued. The US District Court for the Central District of California ruled in favor of Mondolo, finding that Unum had abused its discretion in terminating the plaintiff’s benefits.

The denial on the part of Unum in the Mondolo case appears to mirror denials of other Unum disability claims historically, going back several years. To that end, the Court noted Unum’s history of biased claims administration.

Among other findings, the Court determined that Unum Group failed to properly determine just how much sitting the plaintiff could tolerate in association with carrying on regular administrative tasks, without incurring significant pain in the process.

The Court also took Unum Disability Insurance to task for failing to determine if alternative jobs the insurer claimed Mondolo was capable of undertaking were indeed appropriate for the claimant given her limited ability and mobility.

Unum, formerly operating as First Unum and Unum Provident before that, had insisted in defending its denial of Mondolo’s disability benefits that the plaintiff could sit between one-third and two-thirds of a work day. However, Unum was not able to prove beyond a reasonable doubt that Mondolo could perform the work the insurer insisted she was capable of performing.

The Court also noted the defendant, together with Unum disability reviewing physicians, failed to consider available psychological evidence, in spite of language in Mondolo’s policy that spoke to the due consideration of such evidence relative to the process of ruling on the appropriateness of benefits.

The Court ordered the insurer to immediately reinstate Mondolo’s Unum long-term disability insurance benefits, with interest. The Court also ruled that Mondolo’s attorneys could make a motion for costs and attorney’s fees.

Unum is one of the largest providers of insurance in the world. A Fortune 500 Company, Unum prides itself on contributing to charitable causes and not-for-profit initiatives. However, the insurer continues to suffer from a years-long reputation of unfair practices and accusations of bad faith insurance.

Such accusations are often tested in the courts with a Unum lawsuit. The Mondolo action is Mondolo v. Unum Life Ins. Co. of Amer., CV-11-07435 CAS (MRWx) (C.D. Cal. 2013).


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Posted by

I have worked for my company for five years.the last two have been very difficulty I have fribomaglia.osteoarthritis 2-disk that are bulging stenosis of the spine.I am in consistent pain. My iron level is extremely low.I had to wait to get into see a specialist unum has been giving me the run around for almost three weeks. Stating that they are waiting on information form my md. When I ask I Am told oh yes we have it is in the rreview process. How long should it take. I only get one third of my pay. I. Don't have two thirds less bills. My md and pain md have both stated that I am unable to work. Iwould rather not to be in chornic pain and fatique.I thought this policy was supposed to help if I was ever unable to work. I don't know what to do.all the while unum is gettting payment from the largest Catholic organization in Illinois. I pray for help.ihave no momey for bills and grocery.I am calling unum every day.alli get is. I will have your specialist call you back.

Posted by

I worked for the County of Monterey starting in January of 1990. About a year or two after I started, they offered some optional insurance benefits of various sorts, but they were all solely employee paid and optional, and they would deduct the payments from our checks. I chose to get two of these optional policies. One of which was a Long Term Disability policy by UNUM Insurance. In August of 1997, I suffered a serious back injury while on the job. To date, this injury has resulted in seven spinal surgeries with six Disc Fusions, an Ulner Nerve Transposition and countless tests and procedures. Right now I am having further difficulties and will likely need and eighth spinal surgery. During the period from the injury to March of 2003, I would go back to work after I recovered enough from each of the 2 spinal surgeries and the Ulner Nerve surgery albeit with a lot of pain and difficulty. In March of 2003, the Assistant Director of my department saw me at the end of the day barely able to walk and asked to see me in her office. She told me that management did not feel I could continue in my job, as I was far too disabled. She advised me to consult with my Doctor and see if he agreed, and if so, they would give me a disability retirement. I went to my monthly appointment with my Doctor and asked if he thought I was too disabled to keep working. He told me I should have stopped after the first spinal surgery and would support the decision for a disability retirement. So I took a disability retirement and filed claims with both Social Security and UNUM for my Long Term Disability policy. I was approved immediately by both. The UNUM policy contract had a whole list of things they deduct for before paying the 66 ½% of my salary that was guaranteed in my contract. So they deducted for my disability retirement pension, Workers Comp and also Social Security. A few months into the payments, I looked at my contract and noticed that Social Security was not listed as a deduction. So I called UNUM and they said they would look into it. It took a while, but I received a letter from UNUM saying they had made a mistake by deducting for Social Security and sent a refund check for the difference of the reduced payments and said Social Security payments would no longer be deducted from my benefit amount, as it was not part of my contract. This was signed by a Senior Claims Rep.

Even though I had a copy of the contract and a letter in writing from them, I called once a year for four years to make sure I would continue to receive my full amount and not have Social Security Payments deducted from my benefit which amounted to something over $1800. I was always assure that was true. So based on the contract, the letter and their verbal assurances, my wife and I decided to refinance our house and take enough money to remodel our 1949 house. Mostly is was used to convert the long one car garage that abutted our Master bedroom to a Bathroom, Laundry room and closet and install a Jacuzzi bath for me to soak in for my back pain, plus a new garage in the rear of the property. Had they not given their word both in writing and multiple times verbally, we would have never refinanced. Well about a year after the refinance, I received a small settlement from Workers comp for the temporary Disability for a surgery I had after I stopped working. According to my UNUM contract, I am supposed to report any settlements so they can get their cut. So, being an honest person I sent them a copy of the check and gave them the money they requested from the settlement. Instead of being rewarded for being an honest person, they told me that the Contract, the letter and all the verbal assurances that Social Security would not be deducted was a mistake, and they would start deducting for it from then on. This lowered by benefit from over $1800 a month to $645 a month. That was a $1200 cut in our income! That was in 2008. I of course appealed the decision and again sent copies of the contract and letter. But the appeals process is no handled by an impartial third party, but by UNUM Lawyers, so of course it was denied.

Even though both my pain Management Doctor and my Neurosurgeon have both sent them multiple reports saying I am 100% Permanently Disabled, ever two years they harass me by sending a pile of forms for me and my Doctors to fill out to prove I am still disabled. I just received the latest last week. So I called and spoke with he person that sent the package, who is like the sixth or seventh person that has handled my claim since 2003 and reminded him of my eight surgeries and that my doctors had already told them over and over that I am 100% percent disabled and will never be able to return to work. The agent threatened to stop my checks if I did not comply and was a disrespectful thug and bully. So I filled out his forms and included the report from the latest of the eight AME Doctors the Workers Comp Insurance Company has sent me to, all of which agreed that I am 100% permanently disabled. Then I brought up the Social Security issue again. He became even ruder and told me I was wasting his time as it had already been appealed. I told him it was not a fair appeal if it was made solely by his companies lawyers. I of course got nowhere. He also changed the story from the one I got in 2008. He said the contract had been renegotiated several times between my enrolment date and my claim, and that is was not a mistake like his predecessor told me in 2008. So now the story is completely different. I told him since I was paying the entire payment for the insurance, the contract that I signed should be the one in force and not any other. Especially since I never received any other copies of the contract other than the original one I got when I enrolled.

Since the $1200 decrease in my benefit, we have had to take the difference out of our savings just to pay the higher mortgage. I added up the amount I have lost since they lowered the amount in 2008 and it is over $54,000, and is rapidly depleting our savings. My life now consists of lying in bed 99% of the time, with the other 1% soaking in the bath or going to Doctors. With my secondary medical insurance, dental and prescription drug plan having just jumped to an 800% increase in monthly payments since the national budget passed and water going up 40%, it is becoming harder and harder to pay our bills, due to the lies and despicable business practices of UNUM Insurance.

Do you think I have a case,

Posted by

I worked in voluntary benefits which included disability benefits. Unum has seemingly devised a clever plan via this department to circumvent their previous engagements and boost their image. It's easy to piece together that these oft-issued plans are a guise; existing only to thinly veil their past repeated shortcomings, in an effort to say to the public, "See! We're a good company, we'll pay your claim!" I must admit, I never denied, nor was I forced to deny, a legitimate claim. Conversely, I denied many-a-noncompesnsable claim based on the merit and with plenty of oversight. That being said, and to the point: this department has taken on the brunt of rectifying Unum's wrongdoing(s). In paying these voluntary benefits claims, the company is shelling out a fraction of the money they would have had they paid their legitimate claims 10 years ago. This company has reached into the pockets of blue-collar laborers all across America to clear their image by paying supplemental amounts for simple injuries. All the while, these policies aren't issued to the people that have joined in on lawsuits. It's the ultimate slap in the face; to squash so many policyholders, then turn around years later and "wash thy hands" by paying claims to a different set of customers via policies that pay a mere fraction of those issued to the ones that were screwed over. By the end of my run there, I couldn't look myself in the mirror while getting ready every morning; knowing that I was commuting to the devil's house to do the small-time bidding and smoke-screening that the company should've nutted up to a decade before my employment. It's no surprise this company is consistently ranked as one of the worst insurance companies in the US. Any company that would shun their customers only to attempt rectification through a new group of people with inferior products and call that a "reprieve" deserves the worst fate possible.

Posted by

UNUM wrongly denied my benefits after two years on the policy. I had a diagnosis of chronic fatigue/fibromyalgia and later learned I had heavy metal poisoning after they refused to reopen my case. I have had pyrroles in the blood from stirring up these metals and many nutrient deficiencies which they now know is related to metals. Metals especially lead causes auto-immune conditions along with depression and anxiety. I also have had severe B-12 deficiency which causes weakness in muscles and connective tissues. I was wrongly denied reopening of my case they claimed I didn't respond to a letter they sent out in 2006. My disability actually started in 1994 and I had to fight for disability for 8 yrs. after Unum's denial.


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