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UNUM Policyholder – We Win On Appeal, Lifetime Benefits Are Reinstated

Tuesday, January 5th, 2010

A New Jersey doctor has been on residual disability with UNUM for over ten years as a result of a sickness that limited his ability to practice as an obstetrician/gynecologist. The language of his UNUM policy states that if he becomes totally disabled before age 65 because of an Injury, UNUM must pay benefits for the rest of his life.

Almost immediately prior to turning 65 the doctor became totally disabled based upon bi-lateral carpal tunnel syndrome. We immediately notified UNUM that the doctor was unable to perform any of the material and substantial duties of his occupation because he was totally disabled based upon an injury.

Not surprisingly, UNUM stopped paying benefits at age 65, stating that he was not totally disabled and furthermore, that carpel tunnel syndrome was not an injury.

Once again, a disability insurance company is trying to stop making payments. At over $20,000 a month, the doctor, has already received more than $2.4 million in benefits, based upon a sickness – not payable for lifetime benefits. Not hard to figure out why UNUM would want to cut him off.

Our firm was retained to represent him in an appeal, and with aggressive representation, we were successful. After performing extensive research, developing and attacking the underlying bases for UNUM’s position, and submitting an Appeal to UNUM addressing these issues, we were able to convince UNUM that carpal tunnel was an injury and not a sickness warranting benefits for life.

Now the doctor will receive full payment – over $20,000 per month – for the rest of his life.

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