Unum Disability Claim Denials

Receiving a denial letter from Unum for your long-term disability (LTD) claim is more than frustrating; it is destabilizing. You paid for protection. Now, when you need it most, the insurance company is refusing to uphold its end of the agreement.

Unum, a dominant force in the disability insurance market, has a well-documented history of rejecting potentially valid claims. It has faced widespread disputes over claim denials, rescissions, and other bad faith practices.

At Sandstone Law Group, we understand how important these benefits are when your health, career, and stability hang in the balance. Our attorneys are deeply familiar with Unum’s denial strategies and know how to counter them with sharp, focused legal action. If you have been denied, this is not the time to go it alone.

Unum’s Legal History

As one of the largest and most profitable insurance companies in the world, Unum has built its empire on the trust (and premiums) of working Americans. Through its vast network of subsidiaries, Unum collects billions each year in disability and life insurance payments.

Unum has come under intense scrutiny for its handling of long-term disability claims over the past two decades. The company’s practices led to widespread investigations by state insurance regulators across the United States in the early 2000s. These investigations culminated in a landmark multi-state regulatory settlement agreement in 2004, which required Unum to re-examine over 200,000 previously denied long-term disability claims and pay significant fines. Regulators found that Unum had engaged in systemic practices to improperly deny and delay claims, prioritizing profits over policyholder obligations. The regulatory settlement agreement is still in force today and limits the ways that Unum can deny claims.

This pattern of behavior led to numerous class-action lawsuits and individual litigation. Policyholders and regulatory bodies have consistently held Unum accountable for:

• Unreasonable claim denials based on its own improper reading of policy language.
• Systematic practices to delay or deny claims to reduce payouts.
• Failing to deliver on promises marketed to consumers about disability coverage.
• Using biased medical reviews and vocational assessments to justify denials.

Unum also expanded its reach by acquiring other disability insurers, including Provident Life and Accident Insurance Company, Paul Revere Life Insurance Company, and the disability operations of Principal Financial Group. While these acquisitions broadened Unum’s market share, they also meant Unum inherited the policies—and sometimes the associated claim disputes—of these companies. Therefore, a denial on a policy originally issued by Provident or Paul Revere is now often handled under Unum’s claim administration.

Tactics Unum Uses to Deny Disability Claims

Unum, like other major insurers, carefully manages LTD claim approvals and payouts as part of its overall cost-control efforts. Most policyholders do not have the resources or knowledge to fight back effectively, something that insurers like Unum are very aware of.

Here are some of the most common strategies insurers like Unum employ to avoid paying LTD benefits:

1. Questionable Independent Medical Exams (IMEs): Unum frequently sends claimants for so-called "independent" medical exams. However, many of these physicians are not specialists in your specific condition and often work routinely with insurers. Their findings can be biased, incomplete, or dismissive, despite extensive documentation from your treating providers. Unum is particularly known for using IMEs with generalists who may fail to grasp the nuances of complex medical conditions or specialized occupational demands.
2. Repetitive Requests for Information: Unum may continually ask for documents you have already submitted—pay stubs, physician letters, treatment notes—causing confusion and delay. This paperwork fatigue can lead claimants to give up or miss critical deadlines.
3. Delayed Decisions Beyond Legal Time Limits: Under federal ERISA rules (for group plans) and state laws (for individual policies), insurers must follow strict timelines for claim decisions. Claimants have complained that Unum often drags its feet, creating stress and financial strain while violating your legal rights.
4. Ignoring Favorable Evidence: Policyholders have reported that during claim reviews, Unum may place greater emphasis on certain medical findings while giving less weight to supportive opinions from treating physicians, vocational experts, or specialists. When an insurer selectively interprets medical evidence, it can make it more challenging for claimants to receive a fair and accurate assessment of their disability. Unum has a history of controlling the narrative, which means fair outcomes disappear.
5. Lowball Settlement Offers: Rather than honor your full benefits, Unum may attempt to settle your claim for a fraction of its value, especially when you are financially vulnerable. These offers are rarely in your best interest.
6. Biased Consultant Reviews: Unum will have its in-house consultants, nurses and physicians alike, review sometimes incomplete medical records and render unfavorable opinions, which are then used to support the denial of claims. Much like IMEs, the physicians sometimes lack the appropriate specialization to evaluate the medical conditions they evaluate. 
7. Downplaying Your Medical Evidence: Even with comprehensive medical documentation, Unum may dismiss key findings or suggest you are still capable of working, despite the overwhelming evidence to the contrary. Unum has been particularly noted for denying claims based on “subjective” pain or fatigue symptoms, even when these are thoroughly documented and debilitating. Unum knows better than to fail to evaluate a “whole person” and yet it often does this by failing to consider how all of your medical conditions impact functionality. 

If you have experienced any of these tactics, you are not alone. Sandstone Law Group has seen these patterns before, and we know how to fight back. Let us help you take the power back from Unum.

How to Appeal an Unum Disability Claim Denial

If Unum has denied your LTD claim, your next steps are critical, and they depend heavily on the type of policy you have.

Understand Your Policy Type:

• Group or employer-sponsored LTD plans are often governed by ERISA, a federal law that imposes rigid rules on how claims and appeals must be handled.
• Individual policies are often governed by state law, not ERISA, and offer broader legal remedies.

Appealing a Unum Disability Denial Under ERISA (Group LTD Policy) - If you obtained your policy through an employer or a professional group plan that is ERISA-governed, your claim likely falls under ERISA (Employee Retirement Income Security Act of 1974). If your policy is covered by ERISA, you must file an internal appeal with Unum before taking any legal action in federal court. This is not a step you can afford to take lightly and working with an experienced ERISA lawyer can greatly improve your chances of success.

• Your One Opportunity: This is your critical opportunity to submit all supporting evidence. Once Unum issues a final denial, any lawsuit you file will likely be based solely on the information you provided during the appeal. No new documents or testimony can typically be added later. If you do not submit a medical record, physician letter, or vocational assessment during your appeal, it likely will not be considered by the court.
• Working Against the Clock: Federal law requires that appeals be submitted within 180 days of receiving the denial. Missing this deadline can permanently bar your claim.
• Unum Will Not Tell You the Whole Truth: Unum will not explain the strategic importance of the appeal or the long-term legal consequences of submitting an incomplete file. In fact, many denials are issued with the hope that claimants will not fully understand their rights or the stakes.
• Discretionary Authority: To make matters worse, many ERISA policies grant Unum discretionary authority, which means a court will uphold the denial unless it was found to be “arbitrary and capricious.” That standard gives the insurer the benefit of the doubt unless your appeal is meticulously airtight. It’s important to review your policy and consider the state in which the policy was issued, among other factors, to determine discretionary authority. For example, California has banned discretionary clauses, whereas other states, such as Arizona, have not. 

Appealing (or Suing) Under an IDI Policy with Unum - If your policy was purchased independently and is not tied to an employer (or is specifically exempted from ERISA), it likely falls outside of ERISA. That is advantageous, because state laws in Arizona, California, and many other states provide far stronger protections than ERISA.

• Direct Litigation Potential (No Exhaustion Requirement): You may be able to sue Unum directly without appealing first, depending on your policy terms and individual case considerations.
• Broader Remedies: You may be able to pursue damages for breach of contract, bad faith, and even punitive damages – all remedies that are off-limits under ERISA.
• Jury Trial and Discovery: You have the right to a jury trial, a broader discovery process, and a far more level playing field.

While some IDI policies still contain internal appeal language or other procedural hurdles, a careful review of your specific policy and the applicable law is essential to moving forward. Unum will sometimes mislead you on the governing law, so it is important to consult with a law firm before deciding how to proceed. 

We Are Ready to Take Your Case to Court

Insurers, like Unum, count on you giving up. On accepting their denial. On not knowing your rights. But at Sandstone Law Group, we prepare from day one as though your case will go to court.

Under ERISA, we understand how to challenge “abuse of discretion” reviews, build airtight administrative records, and push for favorable rulings in the federal courts, including the Ninth Circuit. For IDI denials, we leverage every available legal remedy state law allows, including for bad faith if applicable to your case, with the support of an experienced insurance bad faith lawyer.

Why Choose Sandstone Law Group to Fight Unum?

When Unum denies your long-term disability benefits, it can feel like a betrayal. At Sandstone Law Group, we fight to restore not only your income, but also your peace of mind, your dignity, and your sense of control.

We understand that our clients would give anything to feel well again, to return to work, to regain normalcy. But when Unum refuses to honor its promises, we step in with conviction, clarity, and relentless legal resolve.

• We Know Unum’s Tactics: Unum has a well-documented pattern of denying claims that should have been approved through tactics like:
  • Discrediting treating physicians.
  • Downplaying symptoms using biased reviewers.
  • Exploiting surveillance footage out of context.
  • Misapplying policy language to limit or terminate benefits.
  • Denying claims based on “subjective” pain or fatigue symptoms.
• We Have Seen It All: Our attorneys have successfully challenged these strategies across both ERISA-governed and IDI policies. We handle every stage of the process, including:
  • Appealing internal denials with robust medical and legal documentation.
  • Challenging biased IMEs, peer reviews, and vocational assessments.
  • Litigating Unum denials in federal or state court.
  • Using procedural violations and bad faith conduct to shift leverage in your favor.
• We Are Courtroom-Ready: While many firms quietly settle or avoid litigation, we take the opposite approach: we prepare a case as if it will go to court. That mindset forces insurers like Unum to take our clients seriously, and it shows in our track record.
• We Win Because We Care: We do not treat cases like files or numbers. We treat them like the deeply personal battles they are. Our clients are people whose lives have been upended by disability and corporate denial, and we treat their stories with the respect and legal firepower they deserve.

Our team brings a rare combination of legal aggression and personal compassion. We have seen the damage done by disability denials, and we take the fight personally.

How Our LTD Insurance Claim Denial Lawyers Can Help

When Unum denies your long-term disability (LTD) benefits, you are left facing an uphill battle against a multibillion-dollar insurer armed with its own legal and medical teams. Our attorneys understand that behind every denial is a person whose life has been upended.

• We Will Listen: You will not be rushed through an intake form or handed off to a faceless case handler. At Sandstone Law Group, our attorneys, Erin and Kyle, listen deeply. We want to understand the full story behind your disability, the obstacles Unum has placed in your path, and what this denial has cost you. From there, we build tailored, legally sound strategies based on your lived experience, your medical realities, and your long-term goals.
• We Will Lead the Unum Appeals Process: For claims governed by ERISA, your appeal is your one and only chance to present the evidence that may ultimately decide your case in court. We take that responsibility seriously. Our team prepares each appeal with meticulous attention to medical records, expert opinions, functional assessments, and any other materials that can reinforce the legitimacy of your claim. If your policy falls outside of ERISA, such as with an individual disability insurance plan, we assess the most strategic path forward, which may include appeal or immediate litigation, depending on the circumstances.
• We Will Take Your Case to Court: Our attorneys have extensive experience litigating LTD denials in both federal and state courts. Whether the standard is de novo review or abuse of discretion, we are prepared to present a compelling case backed by facts, law, and a deep understanding of insurance company tactics. If your case involves potentially bad faith on an IDI policy, we are ready to ask a jury to make you whole and deter Unum’s conduct. 

You do not have to fight this alone. Let Sandstone Law Group fight for you aggressively, relentlessly, and without compromise.

Contact Sandstone Law Group Today

If Unum has wrongfully denied your long-term disability claim, or you are experiencing frustrating delays and confusing communications, it is time to seek legal guidance. Such actions by insurers are not merely administrative hurdles; they are a profound betrayal of the financial security you carefully planned for, often stripping you of the dignity and assistance you justly deserve.

At Sandstone Law Group, we are not intimidated by dominant insurers like Unum or the complex legal challenges they present. We take on cases that others may shy away from, prepared to fight relentlessly to hold these companies accountable when they fail to honor the long-term disability plans you purchased.

Contact us today at (602) 615-0050 to schedule a consultation. Let us uncover the truth, enforce your rights, and make sure your insurer delivers the protection they promised.