Riemer Hess Obtains Total Victory Against Unum for Disabled Physician

Riemer Hess is proud to announce a major litigation victory in Glickman, M.D., v. First UNUM Life Insurance Company, 1:19-cv-5909-VSB-SDA (S.D.N.Y. Jun. 8, 2023), filed in the Southern District Court of New York.  The outcome represents a total win for Dr. Glickman.

Plaintiff Laurence T. Glickman, M.D., a doctor experiencing limitations in his ability to do his work following surgery for prostate cancer, filed this action against First UNUM Life Insurance Company alleging failure to pay out long term disability benefits within the meaning of an insurance policy subject to the Employment Retirement Income Security Act of 1974 (“ERISA”), 29 U.S.C. §§ 1001–1461.

Riemer Hess filed the lawsuit on Dr. Glickman’s behalf after UNUM decided to recalculate the monthly benefits it owed to Dr. Glickman, who Unum had already conceded was disabled.  Unum did so in a manner that incorrectly under-calculated Dr. Glickman’s pre-disability earnings, resulting in a lower monthly benefit than Unum had initially determined it owed to him.

The entire dispute boiled down to the plain meaning of the long term disability plan.  Specifically, the issue before the Court was whether the plan required Dr. Glickman to have experienced “a 20% or more loss in . . . indexed monthly income” during the 90-day elimination period before he became eligible for disability benefits.  If the answer was yes, then Dr. Glickman did not become eligible for disability payments until 2017, which would lead to benefit payments tied to his higher 2016 income.  If the answer was no, then Dr. Glickman became eligible for disability payments in 2016, which would lead to benefit payments tied to his lower 2015 income.

Applying a de novo standard of review, the Court analyzed the plain meaning of the plan and determined that Dr. Glickman’s reading of the plan was most logical and in line with the overall provisions of the plan.  The court found that the plan's elimination period required the Dr. Glickman to continuously satisfy both the "Limitation Requirement" (being limited from performing duties due to sickness or injury) and the "Income Requirement" (having a 20% or more loss in indexed monthly earnings due to the same sickness or injury) for the duration of the 90-day period.

The Court rejected Unum’s argument that the plan only required satisfaction of the Limitation Requirement during the elimination period.  The Court found that Unum’s interpretation raised more questions and did not give effect to the entire plan.  The Court concluded that Dr. Glickman’s interpretation of the plan, which did not require the exclusion of any words or provisions, was preferable.

Even if the Court found both interpretations reasonable and the plan ambiguous, the Court made it clear that any ambiguity would be construed against the party that drafted the language, which in this case was UNUM. For these reasons, the Court granted Dr. Glickman’s motion for summary judgment and denied Unum’s motion.

If you are looking for an attorney to represent you in an ERISA matter, Riemer Hess can help.  With so much at stake for you, your family, and your future, we understand how important your case is.  The experienced attorneys at Riemer Hess will fight the insurance companies for you.

Riemer Hess can assess your situation, explain your legal rights and options, and answer any questions you have about long term disability insurance.  To schedule your free consultation, call Riemer Hess today at 212-297-0700 or select the button below.