If you've received an unexpected denial from Unum for your long-term disability claim, navigating the UNUM Disability Appeal process becomes crucial in reclaiming your rightful benefits. Unum, one of America’s largest insurance companies, has faced investigations into alleged unfair practices, particularly wrongful claim denial. Understanding the appeals process is a critical tool for effectively challenging the denial.
Understanding the Types of Disability
Before diving into the Unum Disability Appeal process, it's important to have a thorough understanding of Unum's disability coverage. Unum's policies cover two broad categories of disabilities:
- Physical Disability: This category includes conditions that impair a person's physical functionality, mobility, dexterity, or endurance. It encompasses a range of conditions, from spinal cord injuries to respiratory and cardiovascular diseases.
- Mental Health Disability: This category includes conditions that affect a person's cognitive processes, emotions, behavior, and overall mood. It covers a wide range of conditions, such as depression, anxiety disorders, bipolar disorder, and post-traumatic stress disorder (PTSD).
Each disability type presents its unique challenges when initiating a claim or appeal.
Unum's Disability Insurance Policies
Unum offers long-term disability insurance policies through various group companies, including Paul Revere and Provident. These policies aim to provide financial support in the event of a disabling illness or injury that prevents you from working. However, many policyholders have experienced claim denials by Unum without sufficient grounds.
Reasons for Claim Denial
Unum may deny your disability claim for various reasons, including insufficient medical evidence, opinions of medical or vocational experts hired by Unum stating that you are not truly disabled, or policy exclusions for your specific medical condition. It's important not to accept a denial letter from Unum at face value, as it may be incomplete, misleading, or outright wrong.
The Unum Disability Appeal Process
If your disability claim has been denied by Unum, you have the right to appeal this decision. The Unum Disability Appeal process involves the following key steps:
- File an appeal with Unum within 180 days of receiving the denial letter.
- Draft a detailed appeal in writing, preferably with the assistance of an experienced long-term disability attorney.
- Submit your appeal to Unum, which will review it within 45 days. They may request an additional 45-day extension for review.
- Unum will issue its decision after reviewing your appeal.
Strengthening Your Unum Disability Appeal
To increase your chances of a successful Unum Disability Appeal, it's crucial to compile and present persuasive evidence. This evidence can include:
- Comprehensive Medical Records: Gather all relevant medical examinations, treatments, and notes from your doctor. It's beneficial to have your physician draft a letter outlining your condition and its impact on your ability to work.
- Personal Narratives: Provide a detailed description of your daily life, highlighting the constraints and challenges you face due to your disability. This narrative can help illustrate the reality of your situation.
- Testimonials: Seek statements from friends, family members, and colleagues that offer additional perspectives on your condition and its effect on your life.
- Reports from Vocational Experts: Consider obtaining reports from vocational experts that provide an unbiased assessment of your capacity to work, taking into account your medical condition, educational background, skills, and labor market factors.
Choosing the Right UNUM Disability Appeal Attorney
Contesting a denial from Unum can be a daunting and stressful ordeal. However, with the guidance of an experienced long-term disability attorney, you can navigate the Unum Disability Appeal process more effectively.