District Court Permits Unum to Countersue Claimant for Recovery of Overpaid Disability Benefits Due to Claimant’s Receipt of Social Security Disability Benefits

In Radle v. Unum Life Insurance Company of America, No. 4:21CV1039 HEA, 2023 WL 8449084 (E.D. Mo. Dec. 6, 2023), Missouri Eastern District Judge Henry Edward Autrey denied Plaintiff’s motion to dismiss Unum’s counterclaim for recovery of overpayment due to Plaintiff’s award of Social Security Disability Insurance (SSDI) benefits, finding that Unum had adequately pled a claim for relief under ERISA and the applicable long-term disability (LTD) Plan.

Most LTD plans include offsets for SSDI benefits a claimant receives. Many LTD plans insured by Unum contain the following language:

Unum will subtract from your gross disability payment the following deductible sources of income: …  The amount that you, your spouse and your children receive … as disability payments because of your disability under: – the United States Social Security Act.

…

Unum has the right to recover any overpayments due to: … – your receipt of deductible sources of income.

Plaintiff brought this ERISA action against Unum claiming it had failed to adequately consider the facts and circumstances regarding his disability claim under the applicable LTD Plan when it discontinued Plaintiff’s disability benefits after 24 months. Unum sought leave to file a counterclaim against Plaintiff after it learned of Plaintiff’s award of SSDI benefits, asserting pursuant to the LTD Plan that Unum is entitled to recover as overpayment the amount it paid Plaintiff while he received SSDI benefits. Roberts Disability Law has previously analyzed the court’s decision granting Unum’s motion for leave to file the counterclaim here.

In this most recent decision, Plaintiff next moved to dismiss the counterclaim for failure to state a cause of action. Plaintiff urged dismissal because: (1) he no longer has the funds for which Unum is seeking to be repaid; and (2) Unum failed to detail in its counterclaim where and how the funds are specifically separated from his other assets. The Court denied Plaintiff’s motion finding that Unum’s counterclaim adequately set out that it was seeking equitable relief to recover the overpayment, that the LTD Plan provides that Unum is entitled to reimbursement of overpayments, and that Unum had sufficiently pled a claim for equitable relief. The court further noted that Plaintiff’s concerns regarding whether the funds can be identified could be raised after discovery.

If Unum or your disability insurer has denied or terminated your disability insurance claim, contact us for assistance.