A Tennessee OB-GYN surgeon is suing Unum Life Insurance and its subsidiary Paul Revere Life Insurance Co. for alleged improper denied disability benefits.

Plaintiff Barbara N. an obstetrician, gynecologist and surgeon who has practiced medicine for over 30 years sustained an injury to her finger in April 2015 when another physician accidentally cut her during an operation, which required immediate surgery.

After her injury, Dr. Barbara submitted a claim to Unum for disability benefits under the three policies she purchased.  Unum paid her claims through Oct. 15, 2015.

Dr. Barbara failed to recover from her injury, and as a result, was not able to serve as the lead surgeon for her patients’ surgeries.

She requested that Unum continue her benefits under the policies, providing a Functional Capacity Evaluation showing she continued to have difficulty performing required surgical movements.

Additionally, Dr. Barbara’s attending physician initiated a permanent work restriction prohibiting Dr. Barbara from any heavy gripping or suturing in the operating room.

But this was not enough for Unum and they require Dr. Barbara to undergo an Independent Medical Evaluation performed by one of their own doctors.

Unum’s doctor determined that even though Dr. Barbara suffered a significant loss of grip and pinch strength in her injured right hand, the Unum doctor concluded Dr. Barbara could return to work and that permanent work restrictions were not necessary “because she is not likely to re-injure her hand by returning to work”, and Unum

Despite despite numerous medical reports validating Dr. Barbara’s disability, Unum sided with their own doctor and denied disability benefits for Dr. Barbara in March 2016.

According to the denied disability benefits lawsuit, Dr. Barbara contends that her policies with Paul Revere and Unum, “the ability of the insured to return to work without exacerbating the injury is not listed as a factor in determining whether the insures is eligible for disability benefits.”

Dr. Barbara appealed Unum’s decision to denied disability benefits but Unum denied her appeal in June 2016, stating that her policies “provide benefits in the event she has an injury or sickness which prevents her from performing the important/substantial and material duties of her occupation.”

Unum stated that in determining whether Dr. Barbara qualified for those benefits, it relied on the opinion of their own doctor.

After exhausting her appeals over the denied disability benefits, Dr. Barbara is filing suit to recover the benefits she claims she is entitled to under her policies.

She is filing the Unum denied disability lawsuit on three counts: breach of contract, bad faith failure to pay under Tennessee code, and declaratory relief.  Dr. Barbara is seeking compensatory damages, attorneys’ fees and court costs, and an order requiring Unum to pay all benefits due.

Unum’s History of Denied Disability Benefits

Tennessee-based Unum, formerly known as Paul Revere, Provident, and then Unum Provident, is the world’s largest disability insurance provider. Unfortunately, UNUM has also gained a notorious reputation for denying qualified claims for long-term disability benefits.

Among tactics allegedly used by Unum to unreasonably delay or deny disability insurance claims:

• Arguing the policyholder had a pre-existing condition, even if that condition is not linked to the one being claimed
• Refusing to acknowledge certain disabilities
• Ignoring professional medical diagnosis or using biased experts
• Changing policies after a claim is filed
• Claiming a person is not disabled and can work, despite a medical diagnosis from a professional

Such tactics listed above fall under bad faith insurance, and if an insurer has committed bad faith insurance, policyholders whose claims have been improperly or unreasonable denied or delayed may be eligible to file a complaint against the insurance company.

Unum Lawsuits

Unum lawsuits filed against the insurance provider allege the company committed fraud and breach of contract.

Many Unum lawsuits stem from denial of legitimate Unum long-term disability insurance claims in which the insurance company allegedly unfairly and improperly fails to compensate the insured for a loss covered by their policy, or unreasonably delays making payments due under the policy.

If you or a loved one have suffered a serious disability while insured by Unum and have been denied disability benefits, you may be eligible to file an Unum lawsuit.

Dr. Barbara’s Unum Denied Disability Benefits Lawsuit is Case No. 3:16-cv-01984 in the U.S. District Court for the Middle District of Tennessee.