Unum Denies Diabetes Policy Holder

Oshkosh, WIDespite the fact that Brian has diabetes—so serious that his vision is impaired and he had two toes amputated, Unum decided to terminate his long term disability insurance. On its website, however, Unum’s chief medical underwriter says that the world’s largest insurance company offers coverage to diabetics…

“I paid into an Unum long term disability group policy for more than 20 years through my employer,” says Brian. “I was a maintenance repair operations buyer and supervisor for Alliance Laundry Systems until my eyesight got so bad due to the diabetes that I couldn’t work anymore. So I filed for disability through Unum but they cut me off after two years.”

Brian says that his doctor sent letters and medical reports to Unum stating that he was completely disabled, but Unum said he didn’t have enough “medical paperwork” to be deemed disabled.

“I appealed Unum’s decision without an attorney, and that was likely a big mistake,” Brian explains. “The first time I was denied, my Unum representative told me that I had to see their independent medical examiner but it was 100 miles away and I couldn’t go. So they cut me off. Then I filed a complaint with the Wisconsin insurance commissioner. They said that I had to abide by Unum’s rules so I saw the medical examiner and that was the biggest joke I ever went through in my life.

“I was in his office for two hours. He moved my wrists, looked into my eyes, measured my ankles, and he kept doing the same stuff over and over again. He was an old fellow and said he worked for the insurance company. What a quack. He said I wasn’t disabled and listed four jobs that I could do: Order Supervisor, Expediter of Production, Procurement clerk and Employment Interviewer. Unum completely disregarded my medical records and relied only on this so-called doctor.

“I sent Unum another appeals letter because I have had so much laser surgery on my eyes that I can only see on a computer for 10 minutes a day. Purchasing work—the suggestion this medical examiner made-- is all on a computer so I have no idea how I could have filled these positions. And my eye doctor said as much. As well, two other doctors stated that I shouldn’t be on my feet.”

Eventually Brian was able to collect social security disability insurance, but it took more than a year. Interestingly, as soon as social security decided that Brian was legally disabled, he sent Unum the paperwork from social security administration. Bingo! Unum sent him a check—two years of back pay. But his fight with Unum is not over. “I just got a letter and their final decision is that I will no longer get benefits, based on their medical report. According to this letter, they are done with me.”

But Unum emphatically states that it has a “positive attitude to well-controlled diabetes and we do offer cover to diabetics… we take the view that a well-controlled diabetic [is] someone who is confident, proactive and competent in their management of their disease and who has a good work attendance history – can be covered by Income Protection. When we access applicants, if we can see that their diabetes is not too advanced and they are resilient, optimistic and not troubled by too many other medical conditions, we can generally find the right level of cover.”

In Brian’s case, that level of cover is now no level. Is this another case of Unum practicing bad faith? Although Unum says it is “done” with Brian, an Unum attorney can assess his case.