A Kansas resident and orthopedic hand surgeon has filed a lawsuit against Unum Life Insurance Company of America, Provident Life, and Accident Insurance Company.
Unum Life Insurance Company, a Fortune 500 insurance company, is known to be the largest administrator of doctor’s disability benefits insurance in the United States.
According to plaintiff Anne R., she had purchased her doctor’s disability benefits policy while working as an orthopedic resident at the University of Pennsylvania in Philadelphia, Pennsylvania.
She had submitted the application to Unum and Provident Life and had also requested additional coverage of doctor’s disability benefits insurance.
According to the doctor’s disability benefits lawsuit, the policy had designated that if ever the plaintiff became disabled from “performing her former specialty as a hand surgeon through the life of the policy,” her benefits would be paid. She would also be covered through the age of 65.
Anne says she became “totally disabled” within the timeframe of the policy, and she continues to be disabled presently, according to the Unum lawsuit. This had allowed her to become entitled to receive doctor’s disability benefits.
Anne had sustained total disability when, according to the doctor’s disability benefits lawsuit, she was forced to not work due to the serious adverse effects of retinal vein occlusion.
Retinal vein occlusion, according to MedlinePlus, an online information service provided by the National Library of Medicine, states that it is “a blockage of the small veins that carry blood away from the retina. The retina is the layer of tissue at the back of the inner eye that converts light images to nerve signals and sends them to the brain.”
The symptoms of retinal vein occlusion include vision impairment, according to the doctor’s disability benefits lawsuit. Anne says that she had suffered from lack of visual clarity, loss of depth perception, double vision, central vision distortion, and blurred vision.
According to the doctor’s disability benefits lawsuit, the plaintiff was also diagnosed with vitreal detachment, retinal edema, parafoveal telangiectasia, and ocular migraines. Moreover, together with her physicians, she had attempted several different treatment plans, but nothing had provided her enough alleviation to enable her to go back to work.
Since she could no longer practice as a hand surgeon, she was forced to stop working in June 2014. She had filed her claim in July 2014, and the defendants approved her request in November 2014.
However, while the benefits were being paid, Unum had requested that she go see a physician and undergo “an in-person examination by a physician of their choice.” She was requested to go see Dr. Robert F., an ophthalmologist.
After her evaluation, he had concluded that, “if her definition of her occupation is that she is only a hand surgeon and nothing else, she may not be able to work on either a physical or on a functional basis.”
However, when asked for further clarification and when Unum had requested an addendum to his statement, the doctor reiterated that, “my impression was that she could function as an orthopedist, if not a hand surgeon.”
After receiving his addendum, the defendants put a stop to the plaintiff’s disability payments and it became effective in October 2015.
The doctor’s disability benefits lawsuit is currently being filed and has therefore ensued after the plaintiff filed an appeal to the claim denial.
The Doctor’s Disability Benefits Lawsuit is Case No. 4:17-cv-40064-TSH, in the U.S. District Court for the District of Massachusetts.
Do YOU have a legal claim? Fill out the form on this page now for a free, immediate, and confidential case evaluation. The bad faith insurance attorneys who work with Top Class Actions will contact you if you qualify to let you know if an individual lawsuit or Unum class action lawsuit is best for you. [In general, Unum bad faith lawsuits are filed individually by each plaintiff and are not class actions.] Hurry — statutes of limitations may apply.
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