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An Unum claim denial lawsuit was filed by a North Carolina radiologist who alleges that he was able to obtain disability benefits from three companies but one refused to do so despite several expert psychiatric assessments.
The disability insurance lawsuit says fellow employees noticed a decrease in productivity and gave him less work to do as a radiologist in an attempt to help him keep his job. After a blip of success, things deteriorated until June 2011, after which he applied for benefits with records from two doctors indicating that he suffered from attention deficit disorder and obsessive compulsive disorder.
Even though he submitted documentation noting his inability to “focus and and concentrate to an acceptable degree with his current job,” Unum reportedly denied his claim. The defendant’s own expert, Dr. Catherine Clodfeldter, noted that the plaintiff was “very impaired” but decided that he was not trying hard enough.
That alone, the man’s lawyer argues, means Unum insurance violated North Carolina state law because it states “when the patient’s health is in question, an insurer shall give greater weight to the opinion of a physician who has examined the patient[.]” In addition, other psychiatrists, some using the same techniques as Clodfeldter came to the same conclusions regarding his cognitive issues.
Unum Insurance allegedly still did not find the evidence compelling enough to provide benefits from the disability insurance policy. With the new information, the company instead issued a second insurance claim denial. Clodfelter used much of the same information as in the first, issued in 2012. The result, according to the Unum disability benefits lawsuit, is an alleged violation of state law requiring insurers to not “[refuse] to pay claims without conducting a reasonable investigation based upon all available information.”
The Unum Claim Denial Lawsuit is Robert Edward Shepherd v. Unum Group, et al., Case No. 14-cv-00427 in the U.S. District Court for the Middle District of North Carolina.
In general, Unum lawsuits are filed individually by each plaintiff and are not class actions.
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