If UNUM denied your long-term disability claim, you are not alone. The insurance company often uses unfair and aggressive tactics to minimize the number of disability claims that they acknowledge and payout. Therefore, it is in your best interest to consult with a UNUM disability claims attorney who understands how the company approaches claims and the specific tactics they use to deny claims.
Here are some of the main reasons your long-term disability claim was denied.
You lack a ‘qualifying’ disability
Each long-term disability policy has a unique definition of disabilities. The definition falls under two distinct categories. First, your own occupation disability is acknowledged if you cannot execute your job responsibilities due to injury, illness, or chronic health conditions. On the other hand, all occupations disability is acknowledged if you can’t perform any job due to psychological and medical conditions.
Though the insurance adjuster might agree to the fact that you are battling with a severe health condition, they might still argue that there are other jobs that you can do. In this case, you need an experienced lawyer to fight for your rights.
The insurer attacked your honesty and credibility
Like most long-term disability insurance providers, UNUM uses surveillance and character attacks to minimize the number of claims they pay out. The company’s adjusters often suggest that most claims are motivated by financial benefits instead of the insured’s mental or physical health challenges.
One of the common tactics involves requesting in-person meetings or interviews at your home to check for signs that you are overstating your limitations. The company might use a private investigator to monitor your online and real-life activities. In some cases, UNUM insurance adjusters my search for your medical records for inconsistencies. Remember, they just need something to raise concerns about your honesty and attack your credibility.
UNUM’s LTD policy excluded your claim
Many disability policies have numerous exclusions. If your long-term disability claim falls under any of the company’s exclusionary clauses, your claim will be denied. Some of the common exclusions include self-inflicted injuries, claims that are eligible for workers’ compensation benefits, pre-existing health conditions, when the insured misrepresented himself or herself when applying for the coverage, and injuries suffered during wars, riots, and conflicts.
Your long-term disability claim isn’t supported by the right documents and evidence
Other times, the insurance provider might present more nuanced arguments. Rather than saying that your health condition isn’t too severe, they will say that your symptoms are inconsistent with objective findings on X-rays, MRIs, and other common tests.
In this case, the insurance adjuster will deny your claim, arguing that your symptoms are self-reported. You need extensive medical evidence, knowledge, and a strong relationship with a specialized medical expert.
It would be best if you never assumed that insurance providers will always act in your best interest. If your claim was denied, there’s a good chance you can get compensated if you consult with an attorney who understands these issues.