Unum Claim Denial Lawsuit Filed by Surgeon

By Sarah Mirando | January 9, 2013

Category: Pharmaceuticals

By Andrea Gressman

On July 11, 2011, a general surgeon filed a Unum lawsuit. It has been claimed that the defendant failed to uphold the insurance provider’s obligation to provide the appropriate benefits to the policy holder. Provident Life was also listed as a defendant along with Accident/UNUM. And like so many other Unum policy holders that have been unjustly denied disability benefits, the surgeon had had to file a Unum lawsuit in order to receive the compensation he deserves.

The physician filed his Unum lawsuit in the United States District Court of the Middle District of Florida, Tampa Division. It is the request of the plaintiff that Unum provide full compensation to the physician that he is entitled to including the following:

Attorney’s fees
Consequential damages
Disability benefits
Emotional distress damages
In addition to other damages

The plaintiff requested a jury by trial in his Unum lawsuit per Fed. R. Civ. P § 38 (b).

General Surgeon Files Unum Lawsuit for 3 Separate Unum Policies

The doctor began his work as a general surgeon in 1973. Since that time he took out 3 separate Unum policies. Each of the Unum policies contained terms and conditions for benefit payments if the doctor were to ever become disabled which resulted in his inability to perform as a general surgeon. The Unum lawsuit goes on to mention the history of Provident Life.

Provident Life is a Unum subsidiary and both insurance providers are duty-bound to meet any and all obligations that are mentioned in the policies sold both before as well as after their affiliation to each other. The following statement was issued in the Unum lawsuit by the Unum attorney representing the plaintiff: “During the time from 1995 forward, defendants instituted a number of practices intended to manage claims on Provident individual disability insurance policies to avoid full payment of benefits due.”

The Unum lawsuit goes on to explain that when Provident Life merged with Unum the doctor’s disability insurance policy would continue to be under the management of that particular insurer and that Unum has continued to attempt to avoid providing the benefits that the doctor is rightfully entitled to.

Plaintiff Experienced Disability But Still Received Unum Claim Denial

In January 2000 the doctor was given a diagnosis of renal disease at which time he filed a disability claim with the insurer. The short-term disability payments were honored. In 2001 he was able to go back to work as a gastroenterologist part time. However, he was never able to return to his work as a general surgeon.

The surgeon was then a part of a Unum class action lawsuit against both Unum and Provident life for a previous litigation matter which involved duplicity. In 2005 the surgeon asked Unum to reassess his benefits claim so that he could receive his full disability benefits as he found out some of his previous benefits were concealed by Unum. He complied with each of Unum’s requests throughout the reassessment process but Unum still failed to pay the benefits owed to the plaintiff. This is what led the plaintiff to file a Unum lawsuit on the grounds that Unum breached the contract between him and the disability insurance provider.

Unum has had a long history of legitimate claim denials and sadly one of the only ways to receive compensation is to file a Unum lawsuit. If you feel you may be eligible to file your own Unum lawsuit due to a claim denial visit the Unum/UnumProvident Disability Insurance Claim Denial Class Action Lawsuit Investigation page to speak with a Unum lawsuit lawyer and receive your free legal review.