Last month, a federal judge ruled in favor of an individual in a lawsuit filed against First Unum Life Insurance Company. In doing so, the claimant was granted long term disability insurance benefits retroactively beginning in 1995. In addition, it was discovered that Unum operated under a conflict of interest by not only acting as the claim benefits payer, but also the claims administrator. The claimant in this case was insured through a disability policy purchased by his employer and later under a conversion policy. Initially, Unum denied coverage citing that the policy had terminated and the conversion policy did not apply because the allowable time for filing a claim had expired. Unum unsuccessfully argued this point and in addition argued that the claimant should not be entitled to benefits because the claimant had tried to return to work during this time period. However, the attorneys for the claimant successfully argued that the attempted effort to return to work was involuntary due to his financial situation. The court agreed.
The Law Firm of J.P. Gonzalez-Sirgo, P.A. represents individuals that have had their valid long term disability benefits denied, delayed or terminated irrespective of whether the policy was purchased individually or issued through an employer group policy. The firm is available to assist individuals with the initial application process, during the administrative appeals process, handling denials of claims or termination of benefits, litigation in state or federal court, and negotiating a one-time lump sum settlement or buy-out. Please contact our office to discuss your case in more detail.