Cee-Cee, like millions of Americans, had money deducted from her pay check for years to pay into their long term disability insurance policy. Not for a moment was she worried that, heaven forbid one day she got sick, Cee-Cee would have to rely on Unum. Unfortunately she is one of countless seriously ill Americans that has been "cut loose" from her long term disability benefits and denied an appeal; others have been denied disability altogether--a corporate strategy that is obviously designed for one purpose - to boost profits.
"Back in 2004 I had two emergency surgeries, both life-threatening," says Cee-Cee. "The last one really messed me up because a wire was cut out of my intestine (part of Kugel Mesh) that was inserted in 2003. Needless to see I had numerous complications including bowel blockages and bladder infections; I had a tumor removed as well as my ovaries and fallopian tubes. I've been through the wringer.
I had an Unum Provident policy through my employer and had to fight for my benefits. They finally paid me and I was awarded both short term and long term disability-- I got $1,803 per month. But I was awarded the long term disability after two appeals and one visit in front of the administrative law judge—I was a 'favorable disability decision' on April 26, 2006.
The also had to go back to September 24, 2004 to make my benefits retroactive—the date I left work. My policy also stipulated that I would be paid until I was 65 years old. That policy isn't worth the paper it is written on…
Unum Provident reviewed my case the following January and said that it would cover the next six months. Within that time frame I submitted a statement from my surgeon saying I needed another stomach operation. They deliberately overlooked this document and cut me off. It didn't matter that I was disabled pending another operation and my body had to heal—I wasn't strong enough to undergo the recommended surgery.
Unum claimed I was no longer disabled under their guidelines. Yet I was disabled according to social security. On November 9, 2007 I got a letter saying my benefits were terminated because I was no longer disabled.
They never sent me to their independent doctor, but they did give my the right to appeal. I sent them the upcoming surgery date (Feb 2008) and I had a CAT Scan showing three incarcerated intestines. When I had the surgery, my doctor found 5 incarcerations and had to put the mesh back into my stomach. I had abdominal adhesions and the presence of a tumor on my left kidney. My doctors sent this information to their independent medical examiner and he said I wasn't disabled—he never even saw me! Then they had the nerve to tell me I had exhausted my appeals status.
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When this insurance company cut me loose, I was in shock, I went to pieces. My own doctors have told me that I will never be able to work again, including my gastroenterologist. I have all my medical records but what's the point? I have been told that I have a 5-year statute of limitations, however a lawyer explained that they can only ask for the benefits I was due, if I was still eligible from November, 2007 until the present. And it will likely be a long litigation so I am hopeful that there is a class action lawsuit against these insurance companies—I am sure there are many other people in the same situation."