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MIAMILAW1127, Lawyer
Category: Employment Law
Satisfied Customers: 755
Experience:  Founding Partner at Moises Law, P.A.
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My husband and I found out in April of 2014 that he had a

Customer Question

My husband and I found out in April of 2014 that he had a life threatening disease. So I made sure to get a job with all benefits in May of 2014. Yes, I waited until November to sign up so the pre-existing condition would kick in when it started in January of 2015. So, I did this with my boss at the computer. He was at the controls. I watched him. He did everything I told him to do.I can see it all right now in my minds eye! Well, this was about the ultimate in crappy jobs. All new to me-selling phones at a call center... Hey, I needed this job Quick! We waited for our various policies for our health, dental, and life insurance. In January or February, I believe, the Chinese had broken into the healthcare providers computer system (Anthem). It didn't really matter to me at the time. I have not had too many jobs.The ones I did have I trusted. The medical stuff was always great. So I was getting everything taken out of my check, so I'm thinking, cool. Well, not my husband, he could not understand why he couldn't access our health insurance on line with the code they gave me on an email. Now you have to understand something about this place I worked at. We all had computers but we weren't allowed to print anything, have pens, phones or your purse at your desk. When I was training, I was signing alot of paperwork. So naturally I asked for copies. My Trainer would just laugh and say "Sure Dawn, no problem!". I knew I probably wouldn't be receiving them--I was right. In March I finally called Anthem. It turned out (after about 10 days of waiting) I had coverage for health but Glenn did not!!! They tried to tell me I NEVER added him and that someone had accessed my account on line like 9 times! I told them NO WAY, and that their system was not user friendly enough for us to checkout. I asked about what they were taking out of my check. Just my health insurance, NOT Glenns', everything else I had signed up for. So the battle began. Me emailing, conference calling at human resources (I don't capitalize that department cause they don't deserve it!!) to the home office of North America. "Gee Dawn, is Glenn Sick?" I did not think that was any of their business so I lied and said no. Well fighting with them was a long dragged out thing, Glenn seemed as good as he was the year before. I was still trying to get them to do something in the last part of May, early June. All of a sudden Glenn was falling, barfing and pooping all the time. He looked (through the eyes) like my dad did before he died. He was using a walker now. I bought some insurance from an agent. The coverage could not take effect until the 1st of August. Glenn had to have a wheelchair in the mid part of July. When we went into the hospital for a consultation from a PA, she started crying. She knew what I had thought in June...He ended up having to be checked in to the hospital 10 days before the coverage kicked in. He eventually went in and out of the hospital three times. The last time I demanded to take him home, there was nothing left for them to do. With the help of Hospice,(I had taken a leave of absence) I had the privilege of taking care of my best buddy for the last time. Glenn passed on August 31, 2015. He was only 55. We were together for over 30 years. I still feel lost. After I told work I was not returning, they made a big deal about his life policy. Some company named UNUM. They were constantly calling me. So I finally made the claims with my sisters' help. My former employer, Farmers, had a great benefit that paid me within 10 days. Just to rub salt in my wounds, UNUM denied Glenns' life insurance. I really think these two Companies are just rotten. My former employer, Qualfon, as well. That's my story. What do you think?--Dawn(###) ###-####
Submitted: 1 year ago.
Category: Employment Law
Expert:  Asad Rahman replied 1 year ago.

I am so sorry for your loss. I think you might have the basis for a claim based on your employer entering in the information incorrectly. However, it will be very difficult to say that was the cause of youru husband's passing under a wrongful death claim. I would suggest contacting an attorney who specializes in employment law or insurance matters.

Customer: replied 1 year ago.
I do not believe that my boss wrote the wrong thing.I was watching everything he did, like a hawk! Why in the world would I have EVER worked there if not for the insurance for Glenn? I thought maybe you would have understood that when Anthem was broken into, they (Anthem) probably found out his condition and took him off. Is that not evil or what? And what about them not paying the stupid 25k life policy? Even a company on the back of a matchbook would have paid that! So, yeah, I wish I could talk to you on the phone but, I guess it wouldn't do any good. I have got to start dinner now. so we will talk later-OK-Dawn
Expert:  Asad Rahman replied 1 year ago.

It is very possible, but it will be very hard to prove. I'm happy to talk to you by phone and figure out how to proceed. We do not take clients on for representation but we can give general info as to legal issues.

Customer: replied 1 year ago.
Wow, I am disappointed.
Expert:  Asad Rahman replied 1 year ago.

I can opt out and perhaps another expert can help you.

Customer: replied 1 year ago.
There has to be some kind of answer. Especially about how they can give a denial on a life policy. I need a expert please.
Customer: replied 1 year ago.
Thank you Asad. I can't help but feel that my email was not seriously read...
Expert:  MIAMILAW1127 replied 1 year ago.

Hello. I am going to be assisting you with your question today.

Please note: This is general information and is not legal advice. No specific course of action is proposed herein, and no attorney-client relationship or privilege is formed by speaking to an expert on this site. By continuing, you confirm that you understand and agree to these terms.

I can tell you that you definitely can sue UNUM for breach of contract for failing to provide the benefits of the life insurance proceeds. I can't see a reason why they would deny the life insurance benefits.

However, the health insurance is a little bit trickier. You would really only be able to sue your previous employer for negligence (potentially) for not properly signing your husband up for the health insurance as you had requested. If you are sure that they did, then your only cause of action would be against the insurer, but if they never took premiums for you, they can argue with ease that they were never supposed to provide coverage for your husband (unless of course, you have copies of the application along with proof that it was submitted to the insurance company).

I hope I have answered your questions. If I have not, please feel free to ask any follow-up questions you may have. Also, please do not forget to rate my response at your earliest convenience.

Thank you.