After a Dozen Years, Unum Insurance Lawsuit Finally Settled


. By Gordon Gibb

An Unum long-term disability insurance case involving a complaint over unpaid benefits dating back 14 years appears to finally be resolved. According to a recent issue of Leagle Inc., the dispute was between Unum and a urologist who claimed he could no longer perform the duties necessary to his profession.

The plaintiff in the matter submitted a claim to Unum in 1996, identifying himself as a "Urologic Surgeon-Urologist" and a long-term disability policyholder with Unum. Due to ankle pain that prevented him from standing for long periods, the plaintiff was no longer able to perform open urologic surgeries. He submitted a claim for total disability, which Unum denied.

The urologist sued.

After winding its way through the courts for some years, a jury at trial finally concluded that the plaintiff was entitled to residual disability benefits exceeding one million dollars for the period between October 1, 1996 and December 1, 2004. The amount—$1,006.380—was reduced by $114,000 and a figure that represented, in the jury's view, funds that had already been paid.

The plaintiff, however, disputed the amount representing $114,000. It was later found that the jury had erred, based on the incorrect belief that the defendant had already paid that amount prior to terminating the surgeon's benefits. However, it was later found that the amount paid was actually $83,474—a figure later subtracted from the full jury award.

The amount of disability benefits owed was adjusted to $922,906. The Court subsequently added $47,358.15 to the final tally based on a "waiver of premium" benefit contained in the policy, representing the time period that the jury concluded the plaintiff was disabled under the terms of the Unum long-term disability policy.

The plaintiff was further awarded prejudgment interest in the amount of $498,340 on his residual disability claim, together with a further $28,810 representing the return of premium benefits.

Various motions asking for a new trial and a declaration of a mistrial were denied.

Unum has been swimming against a tide of discontent over several years of alleged misdeeds surrounding a systematic denial of legitimate claims, in an apparent effort to cut costs and increase performance values for shareholders. Various media and former employees have reported numerous examples of bad faith practices when dealing with claimants who maintained their Unum insurance policies in good faith, only to be stiffed when it came time to collect under the stated provisions of the policy.

Unum continues to develop and grow its business and was recognized as recently as June 14 by the National Business Group on Health for its commitment to promoting a healthy workplace and encouraging its workers and families to support and maintain healthy lifestyles. However, it is not known if Unum continues to pursue unsavory tactics as in previous times.


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