Disabilities can have different effects on different lines of work. For chiropractors, a physical injury or illness can seriously hamper their practice if it prevents them from performing physical manipulation on their patients.

Yet some chiropractors in that position have had their claims for long-term disability benefits denied by Unum Life Insurance Company or one of its subsidiaries.

Since many chiropractors are self-employed, the disability insurance policies they purchase as individuals tend to fall under state law, which provides claimants better protection against bad faith insurance denial. Policies that employees get through their employers are generally covered by the federal Employee Retirement Income Security Act, or ERISA.

One noted case involved a chiropractor from California, Joan H., who had to stop working due to a shoulder injury. Unum paid her disability benefits for two years, but then stopped paying when an Unum examiner decided Joan was able to return to work.

Joan challenged Unum’s denial in court. Even though she was self-employed, Unum tried to argue that her disability insurance policy was an employer-provided policy – which would have made it subject to a set of laws much more favorable to Unum.

But the court didn’t buy Unum’s argument. The judge ruled that her disability insurance policy was an individual policy, covered by state laws that would allow Joan to collect not just back payments but also compensatory damages. In 2002, Joan went on to win a verdict worth more than $7 million, a verdict that was upheld on appeal.

Unum Investigated

Around the same time Joan won her Unum lawsuit, Unum was under investigation by authorities in several states for allegedly improper practices. California Insurance Commissioner John Garamendi said that for several years Unum had an internal policy of canceling insurance policies that were already in place.

More recently, a Florida chiropractor settled his Unum lawsuit in exchange for a single lump sum payment. Dr. G., who ran his own chiropractor practice in Miami, had purchased an individual disability insurance policy from National Life of Vermont. That company was later purchased by Unum.

Performing physical adjustments on over 200 patients per week eventually took its toll on Dr. G.’s own joints. He eventually developed a torn rotator cuff in his shoulder and degenerative arthritis in his knees, wrists and hands. These disabilities ultimately caused Dr. G. to stop performing manual adjustments on patients and file a claim for long-term disability benefits.

Unum began paying benefits in the short term, but after several rounds of paperwork the company determined Dr. G. was not totally disabled and ceased making payments. With help from the insurance agent who originally sold him the policy, Dr. G. got Unum to review its decision and consider new evidence. But after that review, Unum only affirmed the denial.

It wasn’t until Dr. G. hired an Unum attorney to represent him that Unum finally became willing to negotiate. Dr. G. filed an Unum lawsuit, and after several weeks of negotiation Unum agreed to a confidential settlement in which Dr. G. exchanged the policy for a single lump sum payment.