Unum

Minnesota attorney Ann Wessberg prevailed in her ERISA lawsuit against Unum after the insurer terminated her long-term disability benefits despite documented cognitive impairments linked to chemotherapy. The court found that Unum relied on flawed reasoning and non-expert reviewers, ignoring credible medical evidence. It ordered Unum to reinstate benefits and pay attorney fees and interest.

Mercer filed for long-term disability due to chronic conditions including fibromyalgia and chronic fatigue syndrome. Unum denied her claim, arguing she was not continuously disabled during the plan’s 180-day elimination period. Although Mercer submitted strong support from her doctors and a vocational expert, the court upheld Unum’s denial, finding it reasonable under ERISA’s “arbitrary and capricious” standard.

Yvette Eggleston, a nurse from Florida, lost her long-term disability appeal against Unum after the insurer terminated her benefits based on social media activity and a reassessment of her chronic pain conditions. Despite support from multiple treating doctors and a functional capacity evaluation showing she couldn’t sit or stand for long periods, the court ruled in Unum’s favor. It found the decision was not arbitrary or capricious under ERISA standards.

A Minnesota trial attorney diagnosed with multiple myeloma, sued Unum after the insurer wrongfully terminated his long-term disability benefits. Despite medical records and expert testimony confirming that Hardy’s cancer-related symptoms prevented him from working full-time, Unum relied on file reviews by non-examining physicians to justify the termination. The court found that Hardy remained disabled under the terms of his policy and ordered Unum to reinstate his benefits, pay back benefits, and cover attorney’s fees.

A facilities technician who received long-term disability (LTD) benefits from Unum for several years following back surgery lost his case after the insurer terminated his claim and the court found the decision was reasonable and supported by substantial evidence. The court rejected his arguments challenging Unum’s medical reviewers, vocational analysis, and alleged conflict of interest. …

A claimant with cardiac impairments lost his long-term disability (LTD) case against Unum at both the district court level and on appeal to the Tenth Circuit. The courts found that while Dardick’s cardiac conditions were not in dispute, the medical record failed to establish that those conditions actually prevented him from performing his sedentary occupation. …

Case at a Glance Claimant Win Case Abrams v. Unum Life Insurance Company of America Court United States District Court for the Western District of Washington Decided December 27, 2022 Claim type Long-Term Disability (ERISA) Insurer Unum Employer Schwabe Law Firm Occupation Trial and Appellate Lawyer Conditions Long COVID, chronic fatigue syndrome (CFS) Disclaimer: This …

The claimant received two years of long-term disability benefits before Unum terminated the claim under the policy’s mental health limitation, arguing that his chronic pain didn’t amount to an independent physical disability. The court sided with Unum, ruling that the claimant failed to prove chronic pain alone left him unable to perform any gainful occupation. …

After suffering a stroke at work, Gregg Arenson argued that resulting cognitive impairment left him unable to perform his prior job duties, but Unum denied his long-term disability (LTD) claim, concluding his testing didn’t show a disqualifying impairment. Applying the deferential arbitrary-and-capricious standard of review, the court sided with Unum, finding its reliance on multiple …

Unum stopped paying Susan Moseley’s long-term disability (LTD) benefits under her policy’s mental illness limitation, but the court found that Unum’s failure to order an independent medical examination before terminating her claim was itself an abuse of discretion — regardless of the underlying dispute over her Lyme disease diagnosis. The court remanded the case, ordering …

Jonni Marselle sued Unum in state court alleging breach of contract after it denied her long-term disability (LTD) claim, but Unum removed the case to federal court since the policy qualified as an ERISA plan. The court denied Marselle’s motion to reverse the denial, finding Unum’s decision was the product of a reasoned, well-documented process …

Unum paid Deroo’s long-term disability (LTD) benefits for years before terminating them, concluding she could work as a Nurse Triage or Medical Claims Review Nurse instead. The court sided with Deroo, ruling that no suitable job actually existed that would let her elevate her leg as frequently as her lymphedema required. Case at a Glance …

Drew A. Carson (“Carson”) sought long-term disability (LTD) benefits for chronic pain and related mental health conditions, then argued that Unum Life Insurance Company of America (“Unum”) acted arbitrarily and capriciously by relying on file-only medical reviews rather than examining him in person. The court disagreed, finding no prohibition on file-only reviews by qualified physicians …

Unum Life Insurance Company of America (“Unum”) paid Wittmann 24 months of mental health long-term disability (LTD) benefits but denied her claim to the extent it was based on fibromyalgia and related physical symptoms, finding no medical evidence that she couldn’t perform her duties as an attorney. The court sided with Unum, ruling that its …

Unum paid Fleming’s long-term disability benefits for over a decade before terminating them based largely on two days of surveillance footage showing her carrying groceries and driving. The court ruled in Fleming’s favor, finding Unum improperly gave outsized weight to fifteen minutes of surveillance and cherry-picked statements from a paper-only review, when weighed against a …

Kouzmanoff sought short- and long-term disability benefits, arguing his diabetes combined with the stress of a quota-driven sales job made him unable to work safely. Unum denied both claims, and the court agreed, finding Kouzmanoff failed to show his diabetes actually caused any work limitation — his own doctor pointed instead to personality, medication inconsistency, …

The judge stated that, "the record, the policy, and the Parties’ arguments do not support the assertion that Plaintiff was disabled as of July 2012 (termination of LTD benefits) and August 2012 (termination of LWOP benefits). The Court, therefore, has no alternative other than to affirm Unum’s decision to deny Plaintiff’s benefits.”

Cara R. Denney (“Denney”) was an employee of Wagner Equipment Company (“Wagner”) where she was a Computer and Technology Instructor.  Her job duties “required extensive computer use” and “the ability to instruct employees on the use of various computer systems.” She was also required to travel up to fifty percent of the time, be able to …

The Court concluded that Warner’s motion must be granted because Unum abused its discretion in denying her claim without substantively explaining its rejection of her functional capacity evaluation and relying exclusively on the absence of objective tests confirming her subjective symptoms when denying her claim.

Susan Usztics (“Usztics”) was employed as a program manager for MSX International, Inc. Through her employment, she held a short-term disability benefits policy which was administered by Unum Life Insurance Company of America (“Unum”). Her last day of work was February 4, 2014, following which she applied for short-term disability benefits because of fibromyalgia, anxiety, and …