A physician is suing Unum for allegedly denying his doctors disability benefits claim in error.

Plaintiff Paul R. is a medical doctor who says he used to practice as a small-town family physician in Texas. Back in 1984, he says, he purchased disability insurance for himself from defendant The Paul Revere Insurance Company, a subsidiary of defendant Unum Group Corporation.

More than thirty years later, Paul finally made a claim on that doctors disability benefits policy.

He says trouble started manifesting around 2003 with a decline in productivity. Then in April 2008, he began to suffer from back pain so severe he could no longer practice as a physician. He says he was diagnosed with normal pressure hydrocephalus.

Paul also began suffering from severe headaches. An imaging study of his head revealed dilation of the ventricles inside his brain, which his doctor determined was secondary to cerebral atrophy. He says he eventually required surgery to have a shunt put into his brain to drain the excess fluid.

These conditions were severe enough to stop him from practicing medicine, he claims, and he continues to be unable to work today.

Doctors Disability Benefits Wrongly Denied, Says Plaintiff

When Paul submitted his claim for doctor’s disability benefits to Unum, he made sure Unum had a copy of the April 2008 imaging studies. He also included a letter from his own doctor, Dr. Torres, describing Paul’s alleged disabilities.

In that letter, Dr. Torres determined that the symptoms caused by Paul’s normal pressure hydrocephalus were what had prevented him from practicing medicine since 2008. Dr. Torres included among those symptoms a decline in Paul’s cognitive abilities, in addition to his physiological symptoms.

The Paul Revere Insurance Company denied Paul’s claim for doctors disability benefits in February 2015, he says. He then requested a review of the decision directly from Unum.

Paul says in his request for review he submitted a letter from his daughter, who had worked for him as a physician’s assistant from 2003 to 2011.

She confirmed that Paul was unable to perform the duties of his work since 2008, describing occasions on which she had to tend to his patients for him while he had to lie down in his office because of his pain. When he could work at all, she says, he could only see a few patients per day.

Nevertheless, in March 2016, Unum upheld its denial of the doctors disability benefits.

Paul argues that Unum ignored the fact that it had already found him totally disabled in 2009 when it approved his claim for residual disability benefits.

He also says Unum’s own neurologist was wrong to conclude that the 2008 diagnosis of normal pressure hydrocephalus was unsupported, even though that neurologist never examined Paul in person.

Paul now accuses Unum of failing to acknowledge undisputed evidence of his disabilities and of creating pretextual reasons for denying his claim.

He says Unum failed to conduct the reasonable investigation required by the Texas Insurance Code. He says Unum misrepresented his insurance policy by making false statements regarding material facts and by failing to make legally required disclosures.

Paul’s Unum lawsuit raises claims for multiple violations of the Texas Insurance Code and the Deceptive Trade Practices – Consumer Protection Act, plus other claims under Texas common law.

He seeks an award of payment of back benefits plus interest at the statutory 18 percent rate, plus reasonable attorneys’ fees.

If you paid for disability insurance benefits from The Paul Revere Insurance Company, Unum, or one of Unum’s subsidiary companies, and had your claim unfairly denied or terminated, you may have legal claim.

The Unum Lawsuit is Case No. 1:16-cv-02221 in the U.S. District Court for the Southern District of Indiana.