Seneca, SC"I welcome this opportunity to tell people who have a policy with Unum Health Insurance to get a lawyer on your side right away, before you get disabled," says Roger, "because I know firsthand that Unum will try just about anything to 'hoodoo' you and deny your benefits.
"I hope that I can maybe help someone else down the road by warning them about this company. I made a mistake and didn't call an attorney until it was too late—now I have to pay back three years of long-term disability benefits to Unum because I got social security benefits."
Can Unum legally require that Roger pay back $30,000? Roger says that the giant health provider is supposed to be paying him $238 per month; instead they cut him off once his social security benefits kicked in.
"Every policy holder has due process based on their documents and you have to be very careful with the appeals process in your policy," says attorney Greg Jones. "Any time limits are binding on the individual—it could be as early as 30 days, or even 120 days, depending upon Unum's contract." Jones adds that Unum often advises or asks the policy holder to file for social security benefits!
"Again, depending upon your payout and dates of disability, you may be entitled to so many years of Unum's benefits and maybe only one year of social security," says Jones, "but Unum and social security don't always equal out dollar to dollar or date to date."
Obviously it's complicated. "It says nothing in my Unum policy book that I have to pay back my benefits if I collect social security," says Roger. "I read over it with a fine tooth comb." Roger is right—ask an attorney to go over your policy, before you need to collect short-term and/or long-term benefits. Roger is struggling financially and believes he won't get "one red cent out of Unum."
"In my opinion Unum hoodwinked me because they are supposed to pay long-term benefits until I am 65 years old, regardless whether I am getting social security benefits," says Roger, who is now 58 and living in a double-lot trailer. He is also living with multiple sclerosis and brain tumors. "Fortunately I had everything paid for when I became disabled but it's really hard to live on social security alone. I worked for Dunlop for 28 years. When I got sick they were in the process of shutting down and moving to Malaysia so I lost my pension plan when they pulled out of the US, and as you can imagine, I'm not the only one. So I was really counting on Unum…
"I was getting over $1,000 per month from Unum. It took me three years to get my social security benefits (Social Security denied me at first and kept sending me to their doctors, but with the help of an attorney, I got three years of back pay). As soon as Social Security notified Unum, I got the phone call.
"The Unum claims person asked me if I got my social security payment and she asked how much I got. I got a lump sum of $28,000 but I had to pay my lawyer and child support so I had about $12,000 left over. 'Well we are going to stop your payments until you pay us $30,000 that you owe us, so we will deduct $238 per month,' she said. I have no idea how they arrived at this amount but I will have them paid back by May 2012.
"I hate to see someone else fall into this trap. Since this happened to me I have seen quite a few lawsuits against Unum—they will hoodoo you if they can."
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