After an extended legal battle and Insurance Trial, we obtained an important ruling from a New York appeals court against disability insurer First Unum. The client kept the faith over the years and has now obtained true justice after years of bad faith litigation by First Unum.
First Unum stopped paying monthly benefits to our client, a former dental hygienist who suffered from carpal tunnel syndrome in both wrists and other nerve damage in her arm. First Unum’s own doctors and an independent physician both agreed that she had the conditions and that they were indeed disabling, despite the fact that an invasive nerve test did not show positive results. A second nerve test would not have changed the diagnosis, but First Unum insisted upon it and terminated the benefits as a strong-arm tactic, believing that it could force the client into doing things that were unfair, unwarranted, and irrelevant.
We vigorously fought back on her behalf, seeking to not only establish her disability but to set and enforce the ground rules to be followed under disability insurance contracts. After a trial without a jury, the judge believed that the client should have undergone the test, but he repeatedly failed to indicate what the consequences should be and refused to render a verdict as to the ultimate issue of disability. We disagreed with the ruling and pressed forward with an appeal in the Appellate Division of the Supreme Court.
The appeals court found that First Unum acted unreasonably and was breach of the contract of insurance. The court also noted that First Unum could not terminate or suspend benefits, in breach of the contract’s terms, and then, while it was in breach, make demands upon its client, the insured disabled person. And then, in an unusual move urged by us, the court decided to not send the disability issue back to the trial judge. Instead, the appeals court decided that the client was so obviously disabled based upon all of the evidence at the trial. First Unum was ordered to pay all of the long overdue disability benefits, plus interest on the overdue amounts over the years.
Evan S. Schwartz
Founder of Schwartz, Conroy & Hack
800-745-1755
ESS@schwartzlawpc.com