In a recent Unum lawsuit, a doctor has sued the insurance company for allegedly wrongfully denying his long-term disability benefits.

The doctor’s bad faith insurance lawsuit called out Unum Life Insurance Company for its alleged bureaucracy and limitations it sets against its policyholders, and pointed out that these instances were all too common in the world of insurance claims.

According to the Unum lawsuit, plaintiff Dr. Albert M. had submitted a disability claim to Unum in August 1996, indicating that he was no longer able to perform the occupational duties required in his profession.

The claim described a searing pain in the Dr. Albert’s ankle, which prevented him from standing long enough to perform surgery; the doctor had been a professional Urologic Surgeon Urologist, and was in high demand for his capabilities.

Despite meeting all requirements for total disability under Unum’s policy, the insurance company still denied Albert his disability benefits.

Overview of Unum Claim Denial Allegations

The doctor claimed that due to Unum unreasonably denying him benefits for reportedly no legitimate reason, Albert is suing Unum for bad faith insurance, breach of contract, and other similar damages.

Dr. Albert’s bad faith insurance lawsuit indicated that he had followed all administrative requirements in submitting the claim, and had submitted all requested medical documentation, supporting his claim. Despite this, Unum denied Albert his disability benefits, without indicating a sufficient reason, according to the Unum lawsuit.

In 2009, the court had denied both cross-motions for summary judgment on Albert’s disability claim, finding issue of whether or not he could perform the necessary functions of his job, like major surgeries.

At the end of the trial, the jury had sided with the doctor after finding that he did meet the definition of total disability. The jury awarded Albert $892,380 in damages, to compensate all missed disability payments.

While Albert’s case was difficult, his struggle ended in success. Sadly, his allegations are all too common in the insurance world, according to legal experts.

In fact, Unum has been publically criticized for it’s long history of denying occupation-specific policies that are often held by doctors or other such professions. Claimants who are of lower-income positions are also vulnerable to claim denials, as Unum has its own appeal process to evaluate claims from policyholders.

Unum is the oldest and largest disability company in America, providing disability insurance policies to over 17 million Americans. Ideally, it would provide Americans disability insurance in the case they become unable to work due to unexpected injury or illness.

Unfortunately, Unum has gained a bad reputation of a systemic claim denial plant throughout the years, with bad faith insurance lawsuits such as Albert’s, not helping the company’s reputation.