Riemer Hess is proud to announce a major litigation victory in the case of Chung v. Provident Life and Casualty Insurance Company. The Honorable Alvin Hellerstein, an esteemed District Judge in the Southern District of New York, ruled in favor of Plaintiff, awarding him $818,865.98 in total disability benefits dating back to his date of disability, along with interest in the amount of $114,332.90, costs of $681.63, and approximately $375,000 in attorneys鈥 fees. The outcome represents a total win for our client.
The Plaintiff had a career as a high-profile mergers & acquisitions partner at one of the most prestigious law firms in the country. After nearly three decades of service, his career came to an early end due to progressive spinal difficulties.
Crucially, the Plaintiff held two insurance policies through his firm, both subject to ERISA regulations:
The policies were administered by Provident, a subsidiary of UNUM, the country's largest provider of disability insurance. Initially, the Plaintiff鈥檚 claims under both policies were approved by UNUM, and he received benefits for approximately two years. However, the situation took a turn when UNUM sent a letter threatening to terminate benefits under both policies. UNUM鈥檚 rationale was based on their so-called Independent Medical Examination (鈥淚ME鈥), which suggested that the Plaintiff could work part-time, even though no such requirement existed in his policies.
UNUM eventually backed down on the threat to terminate benefits under the group policy, but they ceased payment benefits under the supplemental IDI policy, even though both policies had nearly identical definitions of disability.
During the appeal, UNUM relied on the reports of non-examining medical reviewers and one 12-minute-long Defensive Medical Examination. The Plaintiff provided mountainous evidence with his appeal, including a fully favorable decision from the SSA for Social Security Disability benefits, an expert vocational assessment, and opinion letters from his treating specialists supporting his disability and refuting UNUM鈥檚 defensive examiner. Despite this, UNUM refused to overturn its adverse decision, thus leading to the initiation of the lawsuit.
In litigation, Riemer Hess successfully established that the Plaintiff could not even work part-time, let alone perform at full capacity, as UNUM alleged.
Key takeaways from this victory include:
The Court awarded Riemer Hess $374,754.13 in attorneys' fees, fully reflecting the requested amount, along with prejudgment interest at a beneficial 9% interest rate. This award is crucial in making the Plaintiff financially whole, as ERISA's fee-shifting provision ensures that plaintiffs are not burdened by legal costs when wrongfully denied benefits. This outcome not only aids in rectifying the Plaintiff's financial losses but also highlights the protective intent of ERISA regulations regarding legal expenses.
The favorable decision in Chung v. Provident demonstrates the importance of challenging outdated tools insurance companies use to justify unfair claim denials and providing strong, objective evidence of your condition. The outcome reflects Riemer Hess鈥 commitment to excellence and advocacy in representing individuals in need of assistance with their group and individual long term disability claims. It is also a testament to our reputation as the most aggressive long term disability litigators NYC has to offer.