Latest Unum Lawsuit – January 2022 Update
As we’ve discussed before, Unum is one of the insurance companies that gets sued the most for mishandling disability insurance cases. Unum was also the target of a multi-state conduct exam in 2004. This exam identified several inappropriate claims handling practices, including excessive reliance on in-house medical staff, unfair evaluation of attending medical examiner notes, failure to evaluate the totality of the claimant’s medical condition and placing an inappropriate burden on claimants to justify their eligibility for benefits.
Despite an estimated settlement cost to Unum of around $120 million, we still see them implementing these claims handling practices in an effort to deny legitimate claims. One such example is the recent case of Gary v. Unum, discussed below.
Prior to her disability, Alison Gary was an associate attorney at a law firm. Gary was diagnosed with Ehlers-Danlos syndrome (EDS) Type III, an incurable connective tissue disorder. Common symptoms include joint hypermobility and chronic musculoskeletal pain. In addition, she was subsequently diagnosed with cervicomedullary syndrome, a condition where pressure on the brain stem causes neurological problems. In Gary’s case, she suffered cognitive problems, weakness, impaired coordination, bladder problems, numbness, tingling, and other sensory disturbances. After this diagnosis, her doctor ordered her to stop working immediately (both due to cognitive and physical impairments), which Gary did on December 1, 2013.
Given her symptoms, including her severe neck pain, headaches, cognitive changes, word-finding issues, weakness, sensory loss, and imbalance (among others), a neurosurgeon recommended surgery. The doctor stressed that the surgery would “not offer a panacea for all her problems” and would only take care of some of her issues. On October 6, 2014, Gary underwent suboccipital decompression, reduction, and occipitoaxial fusion-stabilization surgery.
Prior to surgery, the doctor estimated that results may take 6 months. Despite the fact that Gary did not fully recover in 6 months, Unum denied benefits after April 6, 2015. The Court found that Unum abused its discretion because there was “over-whelming post-surgical medical evidence that anticipated a longer recovery.”
We’ve often seen Unum try to force claimants back to work after surgery—despite limited or insubstantial recovery, based solely on recovery predictions (often made by the insurance company’s own doctors). In reviewing Unum’s conduct, the Court noted that Unum did not conduct an Independent Medical Examination or hire and EDS specialist; instead, Unum relied on hired consultants to conduct a paper review of Gary’s records. These consultants specialized in orthopedic surgery, family medicine and psychology.
Unum also cherry-picked from the medical evidence. For example, they ignored statements in medical records that indicated that the surgery would not be a “panacea”. While there were statements in her records that some of Gary’s conditions had improved after surgery, there were also numerous statements in the records that explicitly explained that Plaintiff was not yet able to return to her employment as an attorney.
When this case was initially heard before the District Court of Oregon, the Court actually found in favor of Unum as it applied a moderate level of skepticism to its abuse of discretion review of Unum’s actions. However, after being appealed, the Ninth Circuit Court of Appeals remanded the case, stating that the district court should apply a heightened level of skepticism in determining whether Unum abused its discretion. Under this heightened level of skepticism, the Court found in favor of Gary.
This case highlights that Unum is one of the most aggressive companies in the industry that appears to be reverting back to their old ways. Other disability insurance companies may follow suit and begin implementing similar practices into 2022, as in the past we’ve seen Unum act as a bellwether of sorts for the industry.
Every claim is unique and the discussion above is only a limited summary of the court’s ruling in this case. If you are concerned that your insurer is using any of the tactics above to evaluate your claim, an experienced disability insurance attorney can help you assess the situation and determine what options, if any, are available.
 Gary v. Unum Life. Ins. Co., No. 3:17-cv-01414-HZ, 2021 WL 5625547 (D. Or. Nov. 29, 2021)
 NIH Genetic and Rare Disease Information Center, Hypermobile Ehlers-Danlos syndrome, https://rarediseases.info.nih.gov/diseases/2081/hypermobile-ehlers-danlos-syndrome
 Gary v. Unum Life Ins. Co. of Am., 831 Fed.Appx. 812, 814 (9th Cir. 2020)