What Are the Most Common Reasons Unum Gives for Denying a Disability Claim?

Unum is among the largest suppliers of incapacity insurance coverage within the nation, providing each short-term and long-term protection. Nevertheless, it has additionally gained a repute for incessantly denying legitimate claims, usually leaving claimants annoyed, confused, and financially strained.

In case your incapacity declare has been denied by Unum, you’re not alone. 1000’s of policyholders face denials annually—lots of that are based mostly on standardized, strategic justifications designed to guard Unum’s backside line. On this submit we’ll stroll you thru the commonest causes for declare denials. Information is step one towards preventing again successfully and getting the advantages you deserve.

1. Lack of “Goal Medical Proof”

Considered one of Unum’s most typical causes for denial is claiming that your incapacity isn’t supported by goal medical proof. In different phrases, they argue that your medical information don’t comprise sufficient diagnostic assessments, scans, or measurable knowledge to show you’re unable to work.

This may be significantly irritating for individuals with circumstances like power ache, fibromyalgia, migraines, or psychological well being issues—the place signs are sometimes subjective and never simply measured by lab outcomes or imaging. Even when your physician confirms that you simply’re unable to work, Unum could reject the declare in the event that they imagine the proof isn’t “conclusive” sufficient.

What you are able to do: Complement your declare with detailed medical information, purposeful capability evaluations, and narrative letters out of your treating doctor that specify how your situation impacts your every day functioning.

2. Claiming You Don’t Meet the Coverage’s Definition of Incapacity

Each Unum coverage features a particular definition of what qualifies as a “incapacity.” Some insurance policies are own-occupation, that means you’re disabled in case you can’t carry out your particular job. Others are any-occupation, which units a a lot larger bar—you’re solely thought of disabled in case you can’t carry out any job that matches your training, coaching, or expertise.

Unum could deny your declare by arguing that whilst you can’t do your present job, you may nonetheless work in one other discipline, even when it’s at a decrease pay scale or outdoors your profession path.

What you are able to do: Work together with your doctor and presumably a vocational professional to obviously present how your situation prevents you from performing the fabric duties of any job outlined underneath your particular coverage.

3. Counting on Inner Medical Reviewers Who By no means Examined You

Unum usually makes use of in-house docs or employed medical consultants to overview claims. These people usually don’t meet with you or study you in individual—they merely overview your file and difficulty an opinion that usually favors denial.

Any such “paper overview” could also be used to override the opinions of your treating doctor, even if in case you have an in depth medical historical past that helps your incapacity.

What you are able to do: Insist on the credibility of your treating docs and supply supporting documentation that challenges Unum’s in-house medical assessments.

4. Alleging Inconsistencies in Your Declare

Unum incessantly combs by your declare for inconsistencies. This would possibly embody:

• Discrepancies between your signs and your every day actions
• Conflicting statements between you and your physician
• Social media posts that recommend you’re extra lively than reported
• Gaps in remedy historical past or failure to observe prescribed care

Even small contradictions can be utilized as grounds for denial.

What you are able to do: Be constant in the way you report signs and limitations. Keep away from posting something on social media that could possibly be taken out of context. Guarantee your physician totally understands your purposeful limitations.

5. Claiming You Can Carry out Sedentary Work

In lots of circumstances, Unum will deny a declare on the premise that you may nonetheless do “sedentary work,” even when that’s removed from sensible. They could argue that sitting at a desk or performing gentle duties is inside your capabilities, ignoring the ache, fatigue, or cognitive points that make even primary duties tough.

What you are able to do: Present documentation of how even sedentary work can be not possible resulting from your medical situation. Useful evaluations and vocational assessments may help reinforce your limitations.

6. Use of Surveillance or On-line Monitoring

Unum is understood to make use of personal investigators and social media monitoring to collect details about claimants. In the event that they discover a video or picture of you strolling, attending a social occasion, or partaking in bodily exercise, they might argue that you simply’re not as disabled as claimed.

Even regular actions taken out of context can be utilized towards you.

What you are able to do: Be aware of what you share publicly. A five-minute stroll or a smile at a marriage doesn’t imply you’re not struggling. Hold a document of how lengthy, painful, or exhausting such actions are and focus on them together with your physician.

7. Denial As a consequence of Technical or Procedural Errors

Missed deadlines or incomplete varieties can lead to a declare denial—even when your case is powerful. Unum could not give you an opportunity to right the problem earlier than denying your declare outright.

What you are able to do: Keep organized. Hold copies of all varieties, letters, and medical submissions. Seek the advice of a incapacity lawyer early that can assist you handle deadlines and keep away from procedural traps.

How Darras Legislation Can Assist You Battle Again

Unum has a long time of expertise denying claims—you want a regulation agency with simply as a lot expertise preventing them. At Darras Legislation, we’ve helped 1000’s of purchasers nationwide efficiently enchantment denials and recuperate the advantages they deserve. From declare opinions to courtroom advocacy, we’re right here to face up for you—and we don’t cost a charge except we win.

When you’ve obtained a denial letter from Unum, contact our Unum denial attorneys at the moment for a free coverage or declare analysis. We’ll make it easier to perceive your rights, strengthen your enchantment, and struggle to safe the advantages you labored onerous to earn.