Disability Insurance Blog

UNUM Abused Discretion In Terminating Claim


Tuesday, March 22nd, 2011

A Federal District Court judge has found UNUM to have abused its discretion in terminating long term disability insurance benefits to a claimant, who was on a disability claim for orthopedic difficulties following a motor vehicle accident. The Court determined that UNUM failed to adequately consider the nature of the claimant’s occupational duties, instead simply focusing upon the physical demand requirements of a generalized occupational class. This is a common technique employed by long term disability insurance companies, who focus only upon a physical functional capacity to perform work generally, rather than appreciating the actual work requirements, or considering the non-physical, cognitive requirements of a particular occupation.

The Court noted that UNUM rested its decision solely upon the results of a Functional Capacity Evaluation, a test that only is able to provide general overall functionality, and not any type of occupation specific abilities. Another troubling aspect of UNUM’s claim handling was its selective embrace of portions of the report, while ignoring other aspects that were favorable to the claimant. UNUM also sought to impugn the claimant’s credibility, another commonly seen approach by long term disability insurance companies. The Court rejected these efforts, noting that the subjective complaints of a claimant must be considered in connection with a long term disability claim.

Soucy v. First UNUM Life Ins. Co.