A New Jersey dentist denied disability benefits has filed a lawsuit against insurance giant Unum and its provider, Paul Revere.

With evidence showing she is unable to perform her duties as a medical professional, she alleges that her claim for long-term disability benefits was unfairly denied.

NJ Dentist Denied Disability Benefits

Plaintiff Bernadetta M. graduated from dental school in 1992. At the age of 26, she was offered an individual disability income insurance policy by Paul Revere. Unum Group acquired Paul Revere in 1997.

Bernadette understood that her Unum disability policy would entitle her to benefits if she were to become disabled and unable to perform her tasks as a dentist.

This policy was issued on January 9, 1992 and was non-cancellable and guaranteed renewable until she reached the age of 65 as long as she continued to pay the premiums.

She worked as a self-employed dentist and in 1999, she formed a dental group with her husband. Bernadette worked full time performing orthodontic dental work 40-50 hours a week, seeing about 15-25 patients a day.

However, by 2008 she began experiencing cardiac health symptoms such as chest pain and left arm pain. Regardless of her healthy problems, she continued to work full time.

In 2012, Bernadette’s symptoms worsened to include shortness of breath, chest pain, irregular heartbeat, left arm pain and palpitations. She was under the care of several cardiologists.

Late that year, she underwent an MRI to determine the source of left arm and shoulder pain. The MRI revealed AC joint arthropathy with bone marrow edema with posttraumatic osteolysis.

Throughout the next two years her symptoms increased and she visited the ER several times. Unfortunately by September of 2013, she became unable to continue to perform tasks as a dentist.

She became unable to use her left hand or lift her left arm. The next month, she called Unum to report her disability claim.

Even after physical therapy and close watch by her primary care physician and a rheumatologist, Bernadette still could not perform her duties as a dentist.

Unum, as a result of her claim, conducted an investigation of Bernadette and her injuries. After the investigations, surveillance and research, Unum concluded that she indeed was unable to perform her tasks as a dentist.

An Unum doctor confirmed that Bernadette was fit for her disability insurance claim in March 2014 and Unum approved her claim the next month. However, in January 2015, another Unum doctor recommended that Bernadette undergo a vocational review.

The results of that vocational review, according to Unum, was that workplace accommodations could be made in order for her to continue working. A roundtable meeting occurred at Unum to evaluate her pending claim in order “to come up with ways to deny, terminate or limit defendant’s exposure to paying benefits on their policies.”

In essence, after Bernadette’s claim had been approved, a meeting took place whose purpose was to find ways that the approved claim could either be denied or limited.

In July 2015, Bernadette received a letter terminating her disability benefits.

Bernadette’s dentist denied disability benefits lawsuit claims that even though she cannot return to work, Unum refuses to pay her the benefits to which she is entitled. She is under the care of 2 board certified surgeons to care for her, and still is unable to perform her dental tasks.

She explains, in her dentist denied disability lawsuit, that Unum has breached their contract and failed to provide the financial security promised her. Unum also, allegedly, has a corporate culture that incentivizes claim personnel to meet targets and goals for claim closures.

In her dentist denied disability benefits lawsuit, she accuses Unum of terminating her policy without evidence, violating their own claim manual procedures, relying on biased medical reviews, bad faith practices and engaging in unfair and deceptive acts and practices.

The Dentist Denied Disability Benefits Lawsuit is Case No. 2:16-cv-04123 in New Jersey District Court, Bergen County.