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Disabled Pediatrician Sues Unum for Denied Long Term Disability

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A pediatrician faithfully paid his Unum LTD insurance premiums. Then he became disabled. All he asks is for disability payments according to the terms of his policy. But Unum has denied him – twice.

Portland, ORA medical doctor who carried Unum insurance for long-term disability has launched an Unum lawsuit against the global supplier of LTD insurance after the insured’s benefits were abruptly stopped, and his LTD claim denied. The benefit to the plaintiff, according to claims made in the Unum disability claims lawsuit, amounts to $12,500 gross per month the plaintiff asserts is owed to him pursuant to the terms of his disability policy.

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
Having exhausted the appeals process with regard to his disability claim, Calcagno has initiated a Unum disability insurance lawsuit seeking monthly benefits retroactive to June 1, 2016 and continuing to the date of judgement. The plaintiff also seeks monthly disability payments of gross $12,500 per month, according to the terms of his policy, from the date of judgement going forward provided he remains disabled and entitled to benefits under the terms of his Unum disability policy, pursuant to ERISA. The plaintiff also seeks prejudgment interest, attorney’s fees and costs.

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.

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READER COMMENTS

Posted by

on
I Suffering not getting enough money for a long-term disability could you please look into it please over one doctor he lied

Posted by

on
Does the fact that he was under investigation by the medical board (subsequently resolved) have anything to do with his disability, or why UNUM picked him from the pack for denial?

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