Apr 29, 2017

UNUM's Denial is "Incredible"


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11/17/2008
Brian S. King
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I've always felt that being described as "creative" is a good thing except in one context: a judge characterizing your argument. I've had a judge or two use that word to describe a particular argument I was making in a case and I've yet to do well in that situation. Similarly, in a case issued today, Silver v. Executive Care Leasing Long-Term Disability Plan, found here on the website for the U.S Court of Appeals for the Ninth Circuit, the court describes UNUM's position as "incredible." This may generally be a word you want to describe your performance. But it was not used in a positive sense for UNUM. The case involved Marc Silver, a man with chronic heart, pulmonary and circulatory conditions. He had an angioplasty on December 14, 2000, and his treating physicians, employer and disability insurer, UNUM, agreed that as of that date he was disabled. However, under the UNUM insurance policy he was not eligible for disability benefits until he had completed a 90 day "elimination period" being totally disabled. Only then would he be entitled to benefits. UNUM argued that at the end of that 90 days, which expired in mid-March, 2001, Silver could go back to work. The problem was that Silver's doctors disagreed and, more important, his medical treatment shortly thereafter showed that his condition had not improved to any meaningful degree. In May, 2001, he went in for another angioplasty. The court stated in unequivocal terms that UNUM's denial was wrong and ordered payment of disability benefits to the plaintiff.

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