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Surgeon Wins $31 Million in UnumProvident Suit

UnumProvident • Consumer Complaints • Reader Comments News: • UnumProvident Agrees to "Sweeping Reforms" • In Settlement with NY, Unum Agrees to Review Denied Disability Claims • Unum Class Action Filed • $31 Million Jury Verdict • Georgia Fines Unum $1 Million

January 27, 2003
A California jury's $31.7 million verdict against UnumProvident, the nation's largest disability insurer, is just one of a number of legal problems the company faces. More than 2,500 policyholders have sued the company accusing it of fraud and breach of contract, there is at least one class-action suit pending and regulators in two states are conducting inquiries.

On Jan. 24, a jury in Marin County returned a $31.7 million damage verdict against UnumProvident after a three-month trial. The jury found in favor of Dr. Randall Chapman, a Novato, Calif., eye surgeon. He sued in 2001 after the UnumProvident refused to pay the $11,600 monthly benefit called for in a long-term disability policy Chapman had purchased during the 1980s.

Chapman said he had developed a phobia that caused him to shake, making him unable to perform eye surgery. The company's doctors disagreed with the diagnosis and terminated his benefits in September 2000 after making payments for only three months.

Many of the policyholders suing UnumProvident are doctors, lawyers and small business owners who, like Chapman, wanted to protect themselves and their families if they became disabled and unable to work. Many bought policies that could not be canceled with premiums that could not be raised.

Last year a federal judge in San Francisco upheld a jury's $7.67 million verdict against the company in a case filed by former Berkeley chiropractor Joan Hangarter. U.S. Magistrate James Larson upheld the verdict, said the company had engaged in a wide range of questionable activity to avoid paying legitimate claims and ordered it to "obey the law."

In 2001, a federal court jury in Florida ruled in favor of John Tedesco, a former ophthalmologist who said the company denied his disability claim even though he had been diagnosed with Parkinson's disease and a herniated disc. In that case, Tedesco was awarded $36.7 million.

A class-action suit filed in New York last year charges that UnumProvident operates "disability denial factories," wrongly denying disability claims by its policyholders. The class action alleges that UnumProvident "has illegally victimized, and continues to victimize, many thousands of disabled Americans." It seeks unspecified damages and asks the courts to order the company to re-evaluate all of the claims it has denied in recent years.

State insurance regulators in Tennessee and Georgia says they are presently reviewing policyholder complaints against the company.

The company issued a statement saying it insures 25 million people and has a complaint rate below the national average. It says it denied "only 1.5 percent" of 421,000 disability claims filed last year.

UnumProvident was created in 1999 through the merger of The Provident Companies, based in Chattanooga, Tenn., and the Unum Corp. in Portland, Maine. It has about 5,700 employees in the two cities.

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