New York Presbyterian Hospital Employee With Knee Problems Sues First Unum Life Insurance Company For Denial of Disability Insurance Benefits

Recently, one disabled employee of the New York – Presbyterian Hospital filed a lawsuit against the First Unum Life Insurance Company for wrongful termination of long term disability benefits under the Retirement Income Security Act (ERISA).

New York disability Attorney sues Unum in the United States District Court for the Southern District of New York.

In Joanne Mercado vs the First Unum Life Insurance Company, administrator of the New York Presbyterian Hospital Long Term Disability Plan, the plaintiff, Joanne Mercado, through a New York disability attorney, filed a civil suit against the First Unum Life Insurance Company at the District Court of the Southern District of New York. The plaintiff filed the lawsuit in an attempt to secure disability benefits due to the wrongfuly denial of benefits by First Unum.

The plaintiff was formerly employed by New York – Presbyterian Hospital working in various capacities starting in October of 1992. Because of her employment, she was covered under the New York – Presbyterian Hospital Long Term Disability Plan administered by the First Unum Life Insurance Company which was effective on the day she was hired and has been renewed continuously.

On January 4, 2008, her doctors deemed her to be permanently disabled due to severe arthritis in her right knee, a meniscal tear in her right knee, constant re-injuring of that knee due to daily activities, and inability to sit and stand for long periods due to the knee. Because of this injury and her disability status, she stopped working.

Disability Insurance Terminated By Unum After Receiving Payments for More Than 2 Years

Due to the evidence presented, the Social Security Administration awarded the plaintiff Disability Insurance Benefits starting on July 14, 2008 under the Social Security Act. This same evidence was presented to First Unum who initially payed Long Term Disability Benefits to the plaintiff. However, on November 12, 2010 the plaintiff received a letter from First Unum stating that her disability benefits were being terminated due to the fact that she was no longer considered disabled. The time period in which Unum denied disability benefits is consistent with a change of the disability definition from “öwn occupation” to “äny occupation”.

The plaintiff then filed an ERISA appeal with First Unum asking them to reconsider their denial of disability benefits. In the appeal, the plaintiff’s physician, Dr Wetz, included an additional letter of support stating that she was still completely disabled due to her ongoing medical complications. In response, First Unum stated that they don’t consider her disabled so they denied her appeal. They also stated that the plaintiff had exhausted all of her options to appeal.

Disability Lawsuit Filed Against Unum

After all ERISA appeals were denied by Unum, the plaintiff and her New York disability lawyer filed a federal lawsuit against Unum. Despite medical support and an approval of social security disability benefits, Unum refused to pay long term disability benefits. In the lawsuit that was filed, the Plaintiff seeks payments of all past due disability benefits, reinstatement of her disability benefits, attorney fees, interest, cost, and any other relief that the courts believes is applicable.