Was the plaintiff’s required benefits too rich for Unum?
According to legal documents attached to the Unum disability insurance lawsuit, the plaintiff in the case is identified as John A. Calcagno, MD, a pediatrician who maintained a practice through Calcagno Pediatrics, PC in which Calcagno was also a partner. The lawsuit suggests that the plaintiff’s long-term disability (LTD) policy is an employee welfare benefit plan within the jurisdiction of the Employee Retirement Income Security Act of 1974 (ERISA), with Calcagno Pediatrics, PC serving as the sponsor and Plan Administrator.
Calcagno’s Unum disability lawsuit asserts that on, or about March 1 of last year the plaintiff was no longer able to undertake his own occupation and specialty as a pediatrician. The disability was such that Calcagno was required to leave his practice.
Calcagno submitted a claim for Unum disability together with what the lawsuit describes as ample medical evidence supporting his disability claim. Unum, it is noted, duly provided the plaintiff with disability payments for a period of months under reservation of rights, only to deny his claim in April of this year – some seven months after the plaintiff submitted his claim.
Through his Unum long term disability insurance attorney, Calcagno appealed Unum’s denial in August of this year, together with the submission of additional medical evidence and documentation supporting his disability claim.
In October, Unum responded with a denial of Calcagno’s appeal.
Unum was happy to accept premiums, until it came time to pay up
READ MORE UNUM LEGAL NEWS
The Unum disability lawsuit is John A. Calcagno, MD v. Unum Life Insurance Company of America, Case No. 3:17-cv-1890 filed November 27 2017 and brought under ERISA in the US District Court for the District of Oregon, Portland Division.