Sacramento, CAAn Unum lawsuit has recently been settled in favor of the plaintiff, who suffers from fibromyalgia and a horrific disease known scientifically as avascular necrosis but commonly referred to as “bone death.”
The plaintiff, Tracy Mondolo, was reported to have been previously diagnosed with leukemia and underwent the rigors of chemotherapy in an attempt to eradicate the disease. That necessary regimen of chemo, according to Mondolo’s doctors, may have resulted in the so-called bone death that left Mondolo with uncontrolled pain and weakness, together with difficulty in walking and a limited capacity for sitting or typing for prolonged periods.
And yet, Unum insurance denied Mondolo her disability benefits. Mondolo sued. The US District Court for the Central District of California ruled in favor of Mondolo, finding that Unum had abused its discretion in terminating the plaintiff’s benefits.
The denial on the part of Unum in the Mondolo case appears to mirror denials of other Unum disability claims historically, going back several years. To that end, the Court noted Unum’s history of biased claims administration.
Among other findings, the Court determined that Unum Group failed to properly determine just how much sitting the plaintiff could tolerate in association with carrying on regular administrative tasks, without incurring significant pain in the process.
The Court also took Unum Disability Insurance to task for failing to determine if alternative jobs the insurer claimed Mondolo was capable of undertaking were indeed appropriate for the claimant given her limited ability and mobility.
Unum, formerly operating as First Unum and Unum Provident before that, had insisted in defending its denial of Mondolo’s disability benefits that the plaintiff could sit between one-third and two-thirds of a work day. However, Unum was not able to prove beyond a reasonable doubt that Mondolo could perform the work the insurer insisted she was capable of performing.
The Court also noted the defendant, together with Unum disability reviewing physicians, failed to consider available psychological evidence, in spite of language in Mondolo’s policy that spoke to the due consideration of such evidence relative to the process of ruling on the appropriateness of benefits.
The Court ordered the insurer to immediately reinstate Mondolo’s Unum long-term disability insurance benefits, with interest. The Court also ruled that Mondolo’s attorneys could make a motion for costs and attorney’s fees.
Unum is one of the largest providers of insurance in the world. A Fortune 500 Company, Unum prides itself on contributing to charitable causes and not-for-profit initiatives. However, the insurer continues to suffer from a years-long reputation of unfair practices and accusations of bad faith insurance.
Such accusations are often tested in the courts with a Unum lawsuit. The Mondolo action is Mondolo v. Unum Life Ins. Co. of Amer., CV-11-07435 CAS (MRWx) (C.D. Cal. 2013).
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