Unum is one of the largest providers of group life insurance and accidental death coverage in the United States. Because Unum’s plans are deeply tied to employer systems, HR departments, and third party administrators, many denials stem from administrative breakdowns rather than anything the insured did wrong. Families are often shocked when a claim is rejected after years of payroll deductions and consistent coverage.
The encouraging news is that many Unum denials can be overturned with a structured, evidence driven approach.
This page explains why Unum denies claims, how beneficiaries can challenge those decisions, and what steps to take immediately.
How Unum Handles Life Insurance Claims
Unum administers a massive volume of employer sponsored life insurance plans. These plans often involve multiple layers of communication between HR, payroll, and Unum’s claims team. When information is missing or inconsistent, Unum frequently defaults to denial. Understanding how these systems interact is essential to reversing a wrongful decision.
Common Reasons Unum Denies Life Insurance Claims
Active Employment and Eligibility Disputes
Unum often denies claims by asserting that the employee was not eligible for coverage at the time of death. These denials frequently involve medical leave, reduced hours, or job transitions. Many of these decisions rely on incomplete employer data. Payroll records, attendance logs, and HR communications are often the key to overturning these denials.
Evidence of Insurability Failures
For supplemental or voluntary life insurance, Unum may claim that the employee never completed the required evidence of insurability. In many cases, the employer failed to notify the employee or failed to submit the form. Courts often hold employers and insurers responsible when the employee reasonably believed they had coverage.
Premium and Payroll Deduction Errors
Unum frequently denies claims by stating that premiums were not paid. These denials often involve payroll mistakes, missed remittances, or administrative confusion during medical leave. Many families discover that premiums were deducted or that the employer failed to forward payments. A detailed review of payroll history can reveal that coverage should have remained active.
Contestability Investigations and Alleged Misstatements
If the insured passed away within the first two years of the policy, Unum may conduct a detailed investigation. The company may allege that the insured failed to disclose a medical condition, medication, or lifestyle factor. To uphold the denial, Unum must prove that the alleged misstatement was material and that the policy would not have been issued if the truth had been known.
Accidental Death Denials Based on Exclusions
Unum denies accidental death claims at a high rate. The company often relies on exclusions involving intoxication, illness, drug use, or hazardous activities. These cases require a careful review of medical records, toxicology reports, and the exact policy language. Many AD&D denials collapse under scrutiny.
Beneficiary Disputes and Missing Forms
Unum may delay or deny payment if the beneficiary designation is unclear, outdated, or contested. These issues often arise after divorces, handwritten changes, or missing forms. When multiple people claim the benefit, Unum may delay payment or file an interpleader lawsuit.
What Beneficiaries Should Do After an Unum Denial
A denial letter is not the final word. Beneficiaries have strong legal rights, and many Unum denials can be reversed with a methodical approach.
Request the Complete Claim File
Unum must provide all documents, internal notes, medical reviews, and communications related to the denial. This file often reveals inconsistencies or missing information.
Review the Policy and All Related Documents
Beneficiaries should examine the full policy, including riders, amendments, summary plan descriptions, and employer provided documents. Many denials rely on selective interpretations of policy language.
Investigate Employer or Administrative Errors
Because Unum relies heavily on employer provided information, HR mistakes are common. Identifying these issues can be the key to overturning the denial.
Challenge Unsupported Findings
If Unum relied on incomplete medical records, incorrect assumptions, or flawed calculations, these findings can be challenged with evidence and expert review.
Prepare a Strong Appeal
A well prepared appeal can reverse a denial and secure full payment. For ERISA governed plans, the appeal is especially important because it becomes the entire record for any future lawsuit.
Why Unum Denials Are Often Reversible
Many Unum denials are based on administrative errors, incomplete investigations, or misinterpretations of policy language. When beneficiaries challenge these decisions with a structured, evidence based approach, they often succeed. Unum must follow strict legal standards, and when they fail to meet those standards, beneficiaries can recover the full benefit.
Get Help With an Unum Life Insurance Denial
If Unum has denied or delayed your life insurance claim, you do not have to navigate the process alone. A strategic review of the denial can uncover the path to recovery and protect your rights.