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ERISA Disability Insurance Claims

9/15/2009
Ben Glass
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First UNUM Finally Loses 15 Year Old Disability Case

First UNUM finally lost a disability insurance claim case that has been going on for the last 15 years. John McCauley filed for disability all the way back in 1994 and has finally been awarded the ruling he was looking for. After UNUM first denied his claim in the mid-90s McCauley was forced to return to work for financial reasons but was only able to fight through his debilitating pain for 8 months. UNUM claimed this period meant that McCauley could not recover benefits because he had worked more than 6 months. The court was able to determine that UNUM's denial forced the client into work and that UNUM was using that work to deny benefits was an "unconscionable" practice and that the 6 month clause was to be ignored because of it.

Courts can ignore portions of contracts that they see as "unconscionable" or "so grossly unreasonable or unconscionable in the light of the mores and business practices of the time and place as to be unenforceable according to its liberal terms."  The court did this and remanded the case to determine just how much UNUM owes in back benefits to McCauley.

For the entire opinion follow this link to my disability insurance book site.

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