Ironically, Cindy was a medical claims clerk for Workers Compensation before sinus problems (she underwent nine surgeries) and severe facial pain resulted in her disability.
“I knew all the procedures to file a claim and I paid into the Unum policy for many years in case anything happened to me,” says Cindy, who is now a single mother of two. But she wasn’t counting on her soon-to-be ex-husband to be malicious and for Unum to jump at the chance of denying her benefits.
“I was at my divorce attorney’s office when I found out what my ex-husband had done,” Cindy explains. “My doctor was in my attorney’s office earlier for a deposition regarding my long-term disability case. He told my lawyer that my ex-husband said I was able to work—Unum had asked him.
“Of course Unum jumped at the chance to use this information against me. I didn’t appeal because Unum offered me a few thousand dollars and my attorney advised me to take it. I guess I was young and naïve—this happened back in 1996--so I just did what he told me to do and, like most other people, I trusted my attorney. I figured he knew more than me and this was my only recourse. In retrospect I would have appealed.”
Unfortunately, Cindy didn’t retain an experienced insurance attorney that was familiar with Unum bad faith practices, and an attorney that would be on her side. Instead, the attorney she had was referred to her by Chubb Insurance, the company she worked for. “I guess my employer wasn’t on my side either,” Cindy adds.
“When Unum paid me this pittance, this “lump sum”, I asked my attorney that if I accept the payment, would I still get my medical and dental insurance premiums paid? Would Chubb continue to pay Unum on my behalf? I understood that if you receive benefits, your employer pays your premium. My attorney said, ‘Oh yeah, we will deal with that after you sign on the dotted line’. Well, you know what’s coming next.
“I called my attorney and he apparently talked to Unum after the fact—after the settlement. When you take a buy-out, you no longer get premiums paid. Now I understand that, because I wasn’t approved for benefits, I got this settlement basically to get rid of me.
“I went back to court and at least my ex-husband had to pay medical and dental for the kids. He called my attorney after he found out that he would have to cover their insurance and apologized for lying about me not being disabled. ‘I said that Cindy could work because I thought she would stay with me once she realized that she didn’t have any money to support herself,’ he told my attorney.
"But my attorney knew that Unum wouldn’t believe him. ‘Once a liar, always a liar,’ my attorney replied to my ex. Why would Unum believe him now? Even if Unum knew he was finally telling the truth, I am sure they wouldn’t change their mind.
“Then I applied for social security benefits, which took a few years. It took so long because I didn’t get a social security attorney at the beginning of the process. To this day I have had nine sinus surgeries and all my doctors were in agreement that I was disabled so I figured that I wouldn’t need an attorney. I was denied social security a few times, until I got legal help.
"I was so mad at my ex-husband for doing this to me. But I think of my kids first and they have a father, so what can you do? I’ve been scraping by since then with two young kids to support. They were seven and eight when we split up so it has been tough. I had a 401k that I cashed in and that supported us pretty much until social security kicked in. As you can imagine, I cut a lot of coupons.
"I believe that if I had an experienced, independent insurance attorney, and not an attorney from my employer, I would have received long term disability benefits from Unum. I bet the two Unum reps who were in that court celebrated. They saved Unum hundreds of thousands of dollars by denying me. They would have had to pay me about $800 per month (and increasing with the cost of living rate) for the rest of my life.
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(Unum, formerly Unum Provident, were forced by the Department of Labor to reassess about 200,000 claims denied or closed since January 1, 2000 for reasons other than settlement, death, or reaching benefit maximums. They were ordered to allow for reassessment, upon request, of claims similarly denied or closed between January 1, 1997 and December 31, 1999. According to the settlement, Unum accepted and reevaluated claims, whether or not the claimant was still disabled, until December 31, 2006.)
“I am still hopeful because your attorney from California contacted me and said that I should find an attorney in Wisconsin to represent me, regardless of the statute of limitations,” says Cindy.