Facing a denial from UNUM for a long-term disability (LTD) claim can be a disheartening experience, especially when individuals are grappling with the physical and financial challenges of a debilitating condition. However, policyholders have the option to take legal action by commencing a UNUM lawsuit. In this article, we delve into the process of initiating a lawsuit against UNUM after a long-term disability claim denial.
1. Understanding the Denial:
Before commencing a lawsuit, it’s crucial to thoroughly understand the reasons behind the denial. UNUM typically communicates denial reasons in a written letter, detailing the specific grounds for rejecting the claim. This denial letter becomes a crucial document during the lawsuit process.
2. Consulting with an Attorney:
Seeking legal counsel is a pivotal first step in commencing a UNUM lawsuit. Attorneys specializing in disability insurance law possess the expertise to review denial letters, assess the strength of the case, and provide guidance on the viability of legal action. The attorney becomes an essential advocate throughout the lawsuit process.
3. Reviewing the Denial Letter:
Attorneys carefully review the denial letter to identify potential grounds for a UNUM lawsuit. This includes assessing whether UNUM adhered to proper procedures, accurately interpreted policy terms, and considered all relevant evidence during the initial claims process.
4. Collecting Supporting Documentation:
To build a robust case, attorneys work with policyholders to collect additional supporting documentation. This may involve gathering comprehensive medical records, obtaining statements from treating physicians, and assembling evidence that directly addresses the reasons provided by UNUM for the denial.
5. Drafting the Lawsuit:
Once the attorney has a thorough understanding of the case and supporting documentation, they draft the lawsuit against UNUM. This legal document outlines the policyholder’s claims, details the alleged wrongful actions of UNUM, and specifies the relief sought, such as the payment of disability benefits.
6. Filing the Lawsuit:
The lawsuit is formally filed with the appropriate court, initiating the legal process. The filing includes submitting the lawsuit document, known as the complaint, along with any required court fees. UNUM is then served with a copy of the complaint, officially notifying the company of the legal action.
7. UNUM’s Response:
After being served with the lawsuit, UNUM has a specified period to respond. This response typically comes in the form of an answer, where UNUM addresses the allegations made in the complaint. UNUM may deny the claims, assert legal defenses, or admit to certain facts.
8. Discovery Process:
The discovery phase follows, during which both parties exchange relevant information and evidence. This includes interrogatories (written questions), requests for documents, and depositions (sworn statements taken under oath). The goal is to gather facts and build a complete picture of the case.
9. Negotiations and Settlement Discussions:
Throughout the lawsuit process, there may be opportunities for negotiations and settlement discussions between the parties. Attorneys engage in discussions to explore potential resolutions, which could involve UNUM reconsidering the denial, reinstating benefits, or agreeing to a financial settlement.
10. Pretrial Motions:
Either party may file pretrial motions to address specific legal issues before the case goes to trial. These motions could include requests for summary judgment, which seeks a decision in favor of one party based on the available evidence.
11. Trial Preparation:
If the case doesn’t settle, both parties engage in thorough trial preparation. This involves refining legal arguments, preparing witnesses, and strategizing the presentation of evidence. Attorneys work diligently to build a compelling case for the trial.
12. UNUM Lawsuit Trial:
The trial marks the culmination of the lawsuit process. Attorneys present their cases before a judge and, in some instances, a jury. Witnesses may be called, evidence presented, and legal arguments made to support the policyholder’s claims against UNUM.
13. Court Decision:
Following the trial, the court issues a decision, determining whether UNUM wrongfully denied the long-term disability claim. If the court rules in favor of the policyholder, it may order UNUM to reinstate benefits, pay past-due benefits, and possibly compensate for damages such as emotional distress.
14. Potential Appeals:
Either party has the right to appeal the court’s decision if dissatisfied with the outcome. The appeals process involves presenting legal arguments to a higher court, seeking a review of the trial court’s decision. Appeals can extend the overall timeline of the UNUM lawsuit.
Factors Contributing to a UNUM Lawsuit
1. Breach of Contract:
A common ground for a UNUM lawsuit is alleging a breach of contract. Policyholders assert that UNUM failed to fulfill its contractual obligations by wrongfully denying or terminating disability benefits. This may involve disputes over the interpretation of policy terms or UNUM’s adherence to contractual provisions.
2. Bad Faith Practices:
Policyholders may claim that UNUM engaged in bad faith practices during the claims process, leading to the denial. Bad faith practices could include inadequate investigations, unreasonably delaying claim decisions, or unjustly denying valid claims. Allegations of bad faith strengthen the grounds for a UNUM lawsuit.
3. Violation of ERISA Regulations:
Many UNUM LTD policies fall under the governance of the Employee Retirement Income Security Act (ERISA). A UNUM lawsuit may allege violations of ERISA regulations, such as improper denial procedures, failure to provide requested documents, or other breaches of the regulatory framework.
Navigating the Legal Terrain Against UNUM
Commencing a UNUM lawsuit after a long-term disability claim denial is a strategic and legal process that demands careful consideration and expert guidance. With the assistance of a knowledgeable attorney, policyholders can navigate the complexities of the legal system, build a compelling case, and seek the justice and financial support they rightfully deserve during times of long-term disability.
