LAW OFFICES

JAMES P KOCH

Representative Insurance Law Cases: 

Valerie Watson v. UnumProvident Corp., 185 F. Supp.2d 579 (D. Md. 2002)

        Plaintiff was a 56-year old woman with end stage congestive heart failure. Her treating cardiologist had repeatedly certified that she was totally disabled, even that she was at risk of sudden death on the job if she attempted to work. Prior to terminating her benefits, the insurer, UnumProvident Corp., asked the cardiologist to send all of plaintiff's medical records for review. After legal proceedings had commenced, James P. Koch, plaintiff's attorney, discovered that her cardiologist had mistakenly sent the insurer the records of another patient. When deciding to terminate plaintiff's disability benefits, the insurer apparently failed to notice that plaintiff's file contained the wrong patient's medical records.

        The court ruled that the UnumProvident Corp., the country's largest provider of long term disability insurance, had acted in an "unprincipled, if not fraudulent" manner when it terminated our client's long term disability insurance benefits. The court ordered the insurer to reinstate plaintiff's benefits immediately, retroactive to the date that benefits had been terminated. 

        This case was decided under the Employee Retirement Income Security Act (ERISA). 

           Click here to read read a report in the Wall Street Journal which cites this case as an example of UnumProvident's abusive disability insurance claims practices.