In Hinchey v. First Unum Life Insurance Company, et al., No. 20-1342, __F.App’x__, 2021 WL 2153722 (2d Cir. May 27, 2021), a dispute over long-term disability benefits, Plaintiff-Appellant Joseph Hinchey appealed from the grant of summary judgment to Defendants-Appellees First Unum Life Insurance Company (“First Unum”) and Manhattanville College (“Manhattanville”). After Hinchey had heart surgery in 2010, First Unum began paying him long-term disability benefits but terminated his claim in 2016 after it determined he was no longer disabled. The Second Circuit determined that First Unum’s decision was not arbitrary and capricious because the medical records did not support Hinchey’s claim that he was unable to perform the job of a Security Director. The court also determined that Unum did not violate the ERISA claims-procedure regulation, 29 C.F.R. § 2560.503-1, which would justify a de novo standard of review. The court affirmed the district court’s decision.
The court’s opinion was short and did not contain much analysis. The court did not mention anything about whether Hinchey’s condition had improved since First Unum determined that he was disabled for at least five years. What this opinion highlights is that receipt of benefits for several years does not guarantee that the insurance company will pay you for the maximum benefit period. It is important that one’s medical records consistently reflect ongoing symptoms, treatment, and functional ability.
If Unum has denied your claim for long-term disability benefits, contact us before you submit the appeal on your own. We have helped many clients secure benefits from Unum.
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