Schwartz Law formerly known as Quadrino Schwartz has dealt a blow to First Unum and obtained a long-awaited trial victory for its client. The jury found in favor an orthopedic surgeon who could no longer perform surgery due to multiple injuries he sustained.
Based upon the verdict, the doctor will be awarded overdue disability benefits and interest in the sum of $1,750,000. First Unum will also be required to pay him $12,000 a month for the rest of his life. One theme of the trial was First Unum’s all-too-familiar technique of terminating a claimant’s disability claim after admitting the ongoing existence of the disability by paying the benefits for a substantial period of time. The claim denial in this case was part of First Unum’s pattern of terminating legitimate disability claims, as evidenced by the recent government settlements in which First Unum, UnumProvident and its affiliates must reassess thousands of terminated and denied claims. Schwartz Law demonstrated to the jury how First Unum pretended to have reasons for changing its initial claim decision and actually constructed an entire phony set of documents in its file. First Unum’s scheme, however, is sophisticated and subtle and required Schwartz Law to fight back hard to overcome the ploys, tricks, and maneuvers attempted by First Unum.
Another theme of the trial centered on the view of Schwartz Law that “own occupation” disability insurance insures against a loss of identity – a loss of the ability to perform in an occupation that a person has worked so hard to develop. First Unum, UnumProvident, and other insurers have tried to shift the focus away from the real purpose of these policies, due to their own financial considerations. The trial team of Schwartz Law explained the true nature of this insurance to the jury, and the jury agreed. Even though the client received $900,000 of income each year during the first two years of his disability, continued to work, and received similar large amounts of income in the years thereafter, the jury understood that his income was irrelevant to the determination of whether he could perform the “substantial and material duties” of his former occupation.
First Unum’s defense centered upon the testimony of Ernest Smith, an accountant who worked for First Unum, UnumProvident, and more than 15 other disability insurance companies for many years. Mr. Smith prepared numerous reports attempting to recast the doctor’s former occupation, while completely ignoring the important aspects of his former life as a surgeon in a teaching hospital. The evidence at the trial exposed multiple errors by Mr. Smith and First Unum. By rendering its verdict in Plaintiff’s favor, the jury rejected First Unum’s misguided financial approach to “own occupation” disability insurance.
Evan S. Schwartz
Founder of Schwartz, Conroy & Hack
833-824-5350
[email protected]
