Insurance companies like Unum promote long-term disability (LTD) coverage as financial protection for professionals who become unable to work due to illness or injury. Policyholders are told that if they pay their premiums and meet the policy’s requirements, benefits will be there when they are needed most. The reality is often very different.
Even for a company widely known for aggressive and wrongful denials of long-term disability claims, Unum’s attempt to terminate monthly benefits for a Physician Assistant (PA) represented an unusually troubling example of claims handling driven by financial pressure rather than medical reality. In this case, Unum’s conduct crossed the line from bad judgment into a deliberate disregard of its fiduciary obligations to its insured.
Newfield Law Group successfully challenged and overturned Unum’s termination, restoring our client’s benefits and exposing the financial motivations underlying the insurer’s decision.
A Sudden and Unjustified Termination of Benefits
Our client is a hardworking 58 year old Physician Assistant who attempted to continue working despite severe, progressive pain affecting all four quadrants of her body. Like many dedicated healthcare professionals, she pushed herself beyond reasonable limits, trying to remain productive even as her medical condition worsened.
She had been receiving long-term disability benefits for 2 years when Unum terminated her claim. Nothing about her medical condition had improved. In fact, her degenerative conditions and associated symptoms had worsened, and her treatment providers continued to support her inability to work. But her frequency of visits lessened and her therapy was replaced by home care.
UNUM seized upon this. Prior to engaging our firm, from the claimant’s perspective, the termination made no sense. From our perspective, however, the explanation became clear very quickly – meeting goals and targets.
After years of litigating and appealing claims against Unum, Newfield Law Group has seen this pattern before. When a claim represents significant long-term financial exposure – particularly one involving high monthly benefits payable for life – Unum frequently looks for a way to shut it down.
Financial Exposure Drives Claims Decisions
Unum’s refusal to recognize our client’s ongoing disability was not based on medical evidence. It was driven by financial considerations and the company’s first priority: to protect shareholder returns at the expense of insured individuals.
Under the terms of her policy, our client was entitled to receive monthly disability benefits for the remainder of her life. From Unum’s financial perspective, that represented a substantial and ongoing liability. Rather than honoring its contractual obligations, Unum chose to terminate the claim.
The Financial Pressure Driving Long-Term Disability Insurers Claims Decisions
The long-term disability insurance sector has faced mounting financial pressure in recent years. Rising unemployment has caused many workers to lose employer-provided benefits, cutting off premium payments to insurance companies. At the same time, claim costs have increased, particularly for high-earning professionals with significant benefits.
As one of the largest LTD insurers in the country, Unum has been among the hardest hit. Public reports indicate that the company has cut into its financial reserves, highlighting the strain it has experienced in maintaining profitability.
When an insurer faces declining revenue and increasing claim costs, it responds in predictable ways. Cost-cutting measures follow, and those measures include more aggressive claims handling practices. Applications are denied at higher rates. Existing claims are scrutinized more harshly. Terminations increase. Claimants become the collateral damage of these financial decisions.
Cutting Costs by Cutting Claims
Unum has acknowledged in its own financial disclosures that it has implemented “better claims-management practices” in response to financial pressures. In theory, that phrase suggests efficiency and accuracy. In practice, it means denying and terminating legitimate claims to improve loss ratios and earnings.
The conflict of interest inherent in this system is well documented. Unum has the dual role of both evaluating claims and pays benefits, creating a built-in incentive to deny claims whenever possible. What makes matters worse is how deeply that conflict is embedded within the company’s compensation structure.
Newfield Law Group has observed that Unum employees, including claims personnel and medical reviewers, receive corporate stock as part of their compensation. When stock price performance is tied to claims outcomes, the incentive to terminate high-value claims becomes evident.
Notably, we have observed a recurring pattern: significant increases in Unum’s stock price often coincide with periods in which a large number of disability claims are terminated. That correlation is not accidental.
A Strategic and Surgical Approach to Claims
Unum is especially known for its strategic, surgical approach to terminating claims. Rather than denying all claims indiscriminately, the company targets those with the greatest financial impact—claims involving high monthly benefits and long durations.
Our client’s claim fit that profile precisely.
Recognizing this, Newfield Law Group developed a comprehensive, two-pronged appeal strategy designed to prove disability and expose the financial motivations behind Unum’s decision.
A Two-Pronged Appeal That Forced Accountability
The first prong of our appeal focused on what should have mattered most from the beginning: the medical evidence.
We carefully documented our client’s medical history, the physical demands of her occupation as a Physician Assistant, and the clear reasons she could no longer perform those duties on a sustained basis. This included objective testing, treating physician opinions, and a vocational analysis.
The second prong addressed an issue insurers prefer to keep out of the spotlight: Unum’s financial condition and its direct relationship to claims handling decisions.
We conducted a detailed review of Unum’s corporate earnings reports, loss ratios, and operating income during the period in which our client’s claim was terminated. The results were telling.
Quarterly Earnings Reveal the Real Motivation
During the second quarter of 2025, when Unum terminated our client’s benefits, the company failed to meet its financial goals. Internal pressure on claims personnel increased as loss ratios worsened.
Unum’s own reports attributed its declining loss ratio to “lower recoveries in our long-term disability product line and higher average claims size.” In plain terms, Unum was paying out too much in disability benefits, particularly on large claims.
That same quarter, Unum reported a reduction in overall operating income of more than 18% — a substantial decline by any measure. These figures strongly support the conclusion that high-value claims, like our client’s, were targeted for termination to shore up earnings.
Given Unum’s documented investment losses in prior quarters, it is reasonable to conclude that the company attempted to make up for those losses by denying and terminating more disability claims.
The corporate earnings commentary from the first and second quarters of 2025 provides powerful evidence that Unum’s claims handling was driven by financial conflict of interest, permeating the organization from upper management down to individual claims staff.
Medical Evidence Clearly Proves the PA’s Disability
While Unum focused on its balance sheet, the medical evidence told a very different story.
Our client underwent a comprehensive Functional Capacity Evaluation (FCE) to assess her ability to perform work-related tasks. The results were unequivocal.
The evaluator concluded that the client was unable to perform full-time work in her occupation or any comparable occupation. She could not maintain the positional tolerances required for sustained work due to poor body mechanics that worsened with prolonged postures.
The evaluation further found that she was restricted to only occasional squatting, bending, twisting, and climbing, and limited to sedentary lifting on an occasional basis. These limitations alone are incompatible with the demands of a Physician Assistant’s job.
Objective observations during the evaluation strongly correlated with her reported pain levels. The evaluator noted worsened body mechanics, frequent changes between sitting and standing, reduced reach velocity, wincing, facial grimacing, and visible discomfort, including rubbing of her lower back and wrist.
These findings were consistent, credible, and medically supported.
The Physical Demands of Being a Physician Assistant
Unum’s termination ignored the realities of what it means to work as a PA.
Physician Assistants face significant physical demands. They spend more than 80% of their workday standing or walking. They must be capable of lifting up to 50 pounds, frequently bending, reaching, and using their hands for fine-motor tasks.
Physician Assistants also require substantial stamina. Long shifts, extended periods on their feet, and constant movement are standard. Full range of motion, coordination, and endurance are not optional; they are essential job requirements.
Our client had undergone cervical spine surgery, could not sit for more than ten minutes without severe pain, and could not stand for extended periods. These limitations alone made continued work as a PA impossible.
Being a Physician Assistant is not a light-duty occupation, and no amount of paper review or selective evidence could change that fact.
Newfield Law Group Forces Unum to Reverse Course
By presenting both overwhelming medical evidence and a compelling analysis of Unum’s financial conflicts, Newfield Law Group forced the insurer to confront the reality of its decision-making process.
The appeal succeeded. Unum overturned its termination and restored our client’s long-term disability benefits.
This case serves as a reminder that wrongful denials are often not about medicine at all. They are about corporate priorities that place profits ahead of people.
Standing Up to Unum Requires Experience and Strategy
Unum is a sophisticated insurer with vast resources and a long history of aggressive claims practices. Successfully challenging its decisions requires more than submitting medical records. It requires understanding how financial pressures influence claims behavior and knowing how to hold insurers accountable under the law.
Newfield Law Group has decades of experience representing disabled professionals against Unum and other major insurers. We know their playbook, and we know how to fight back.
If your long-term disability claim has been denied or terminated, you do not have to accept the decision at face value. With the right legal strategy, wrongful denials can be overturned—and justice can be restored.