Unum Cases In New York

Monday, December 29th, 2008

There is good news for people whose disability claims were terminated or denied by Unum. The Second Circuit’s decision in McCauley v. First Unum makes it easier to overturn Unum’s decisions in federal court.

The Second Circuit ruled that the Supreme Court’s decision in Metropolitan Life v. Glenn requires the district courts to apply a new standard of review to long term disability cases. Applying this standard, the Second Circuit found that the errors Unum committed in reviewing claims, and its conflict of interest as as claim administrator and payor, warranted reversal. The court asked rhetorically, what else could have caused Unum’s errors other than its conflict of interest.

The Second Circuit rejected Unum’s lip service argument that it considered all of the evidence in making its decision. Perhaps more importantly, the Second Circuit ruled that Unum’s cherry picking one medical report “to the detriment of a contrary report that favors granting benefits was … indicative of an abuse of discretion.”

The Second Circuit added that “Unum’s history of deception and abusive tactics to be additional evidence that it was influenced by its conflict of interest as both plan administrator and payor in denying McCauley’s claim for benefits.” McCauley means that any person whose disability claim was terminated or denied by Unum now has a better chance of winning in federal court. The same applies to other insurers with a history of biased claims administration, such as CIGNA, Hartford, and others who have hidden behind the old standard of review that favored them with an unlevel playing field prior to the Glenn decision.
Posted by The Law Offices of Jeffrey Delott at 6:45 AM

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