Valente v. UnumProvident Corp., Cal., San Francisco County Super. Ct., December 22, 2004
After years of hand pain, Dr. Valente, a dentist with her own practice, underwent hand surgery to remove a painful cyst. Following surgery she suffered bilateral hand pain and could no longer practice dentistry as she did in the past. Eventually, she sold her practice and retired from dentistry.
Dr. Valente was covered by an “own occupation” policy with UNUMProvident, and thus, submitted a claim stating that her hand condition prevented her from practicing dentistry in “a normal and continuous fashion.” The insurance company initially paid the claim, however, benefits were terminated after an in-house physician and two medical examinations concluded that she was not disabled.
Dr. Valente sued the carrier, alleging breach of contract and breach of the covenant of good faith and fair dealing. She alleged that UNUM’s denial of her claim was unreasonable and that she was misled during the course of the investigation. She further alleged that the claim denial was part of a pattern and practice to deny all “own occupation” disability claims because of their high cost to the company.
The insurance company argued that the dentist could not have been disabled because her earnings remained constant throughout the years she said she was in pain and that her retirement was a lifestyle choice.
The jury awarded Dr. Valente a total of $1.21 million, which included over $400,000.00 for the carrier’s breach of good faith and fair dealing.