• Is Unum Denying More Disability Benefit Claims Than Usual?
  • Unum / Provident / Paul Revere Long & Short Term Disability Claims (Ep. 13)
  • Unum Disability Denial & Appeal Tips
  • Deposition of Insurance Co. Employee in a Disability Insurance Benefits Denial Lawsuit (Ep. 19)
  • Did Disability Insurance Claims Examiner Understand A Physician's Job Duties? (Ep. 22)
  • What relationship does UNUM have with hired doctors in disability insurance claims?
  • UNUM Lump Sum Settlement / Disability Lump Sum Buyout
  • 24 Month Self Reported Symptoms Limitation in Unum Disability Policy Case Study
  • Tips About a Unum Medical Examination in a Disability Benefit Claim

Provident Life & Accident Insurance Company sued for denying lifetime disability benefits to former attorney

Recently, in the case of Steven J. Kravitz v Provident Life & Accident Insurance Company (Provident Life), an action alleging breach of a disability insurance contract and promissory estoppel was filed at the District Court of the Southern district of Florida by a disability attorney. This lawsuit deals with the issue of whether a disability was caused by an accident or sickness. In this case if the claimant can prove that his disability was caused by an accident, then he will be entitled to lifetime disability benefits.

Background of the Case

The plaintiff Steven J. Kravitz was a former leading real estate attorney who purchased a disability income insurance policy from Provident Life which had became effective on July 1st 1980. Under the terms of the policy, total disabilitycan result from an accident or sickness. The terms of the policy also indicated that if an insured was to suffer from a Sickness Total Disability prior to age 50, or an Accident Total Disability, the maximum period for which the disability benefits will be paid out will be the insured’s lifetime. For a Sickness Total Disability that occurred after age 50, the maximum period for the disability benefits to be payable will be until the insured’s 65th birthday. It was also stated that not less than 24 months of benefits will be paid out to the insured in the case of the second scenario.

In December 1996, the plaintiff received a flu vaccination which caused him to be totally disabled from his occupation due to chronic inflammatory demyelinating polyneuropathy (CIDP), a variant of Guillain-Barre syndrome (GBS). At the time when the plaintiff was diagnosed with CIDP, he was unaware that the flu vaccination was a rare cause of GBS. In 1998, due to further deterioration of his physical condition, the plaintiff was unable to work and submitted to Provident Life a claim for long term disability benefits. Provident Life determined that the plaintiff was totally disabled under the terms of the policy as of April 1st 1998 and approved the plaintiff’s claim for disability benefits. Since then, the plaintiff has remained totally disabled as defined under the terms of the policy.

Offer to buyout insurance policy by Provident Life

On April 1st 2005, Provident Life while in the administration of the plaintiff’s disability claim offered to buyout the plaintiff’s policy bundled with the plaintiff’s two other disability polices administered by Provident Life parent company, UNUM. In the letter dated April 1st 2005 informing the plaintiff of the offer, Provident Life also indicated that the plaintiff was entitled to receive lifetime benefits under the policy. Prior to this letter, Provident Life had never informed the plaintiff whether it was administrating the plaintiff’s disability claim under a sickness disability or an accident disability.

Because Provident Life had indicated that the plaintiff was entitled to a lifetime of benefits, he rejected the buyout offer made by Provident Life. Provident Life then informed the plaintiff on July 9th 2010 that his benefits under the policy would terminate on April 1st 2011 (at age 65 instead of lifetime benefits).

The plaintiff subsequently reminded Provident Life of its prior representation that the plaintiff was entitled to lifetime benefits. In addition, the plaintiff provided medical statements from his physicians that his disability was accidental due to the flu vaccination he received in December 1986. On October 14th 2010, the plaintiff filed a Civil Remedy Notice to the Florida Department of Financial Services about Provident Life’s refusal to pay lifetime benefits to the plaintiff under the policy.

Provident Life in response to the Civil Remedy Notice argued that its prior representation of lifetime benefits to the plaintiff was a “mistake” as a result of an “administrative error”. Although Provident Life’s internal medical review had also indicated that the plaintiff’s disability could had been caused by the flu vaccination, Provident Life still maintained that the plaintiff was disabled due to sickness and as such limited the payment of disability benefits to the insured until the insured’s 65th birthday. Subsequently Provident Life terminated the plaintiff’s benefits on April 1st 2011.

Judgment sought under the Lawsuit

In the action filed against Provident Life in the District Court, the plaintiff alleged that he had suffered damages due to the conduct by Provident Life. As such, the plaintiff is demanding from Provident Life:

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Questions About Hiring Us

Do you help Provident claimants nationwide?

We represent Provident clients nationwide and we encourage you to contact us for a FREE immediate phone consultation with one of our experienced disability insurance attorneys.

Can you help with a Provident disability insurance policy?

Our disability insurance lawyers help policy holders seeking short or long term disability insurance benefits from Provident. We have helped thousands of disability insurance claimants nationwide with monthly disability benefits. With more than 40 years of disability insurance experience we have helped individuals in almost every occupation and we are familiar with the disability income policies offered by Provident.

How do you help Provident claimants?

Our lawyers help individuals that have either purchased a Provident long term disability insurance policy from an insurance company or obtained short or long term disability insurance coverage as a benefit from their employer.

Our experienced lawyers can assist with Provident:

  • ERISA and Non-ERISA Appeals of Disability Benefit Denials
  • ERISA and Non-ERISA Disability Benefit Lawsuits
  • Applying For Short or Long Term Disability Benefits
  • Daily Handling & Management of Your Disability Claim
  • Disability Insurance Lump-Sum Buyout or Settlement Negotiations

Do you work in my state?

Yes. We are a national disability insurance law firm that is available to represent you regardless of where you live in the United States. We have partner lawyers in every state and we have filed lawsuits in most federal courts nationwide. Our disability lawyers represent disability claimants at all stages of a claim for disability insurance benefits. There is nothing that our lawyers have not seen in the disability insurance world.

What are your fees?

Since we represent disability insurance claimants at different stages of a disability insurance claim we offer a variety of different fee options. We understand that claimants living on disability insurance benefits have a limited source of income; therefore we always try to work with the claimant to make our attorney fees as affordable as possible.

The three available fee options are a contingency fee agreement (no attorney fee or cost unless we make a recovery), hourly fee or fixed flat rate.

In every case we provide each client with a written fee agreement detailing the terms and conditions. We always offer a free initial phone consultation and we appreciate the opportunity to work with you in obtaining payment of your disability insurance benefits.

Do I have to come to your office to work with your law firm?

No. For purposes of efficiency and to reduce expenses for our clients we have found that 99% of our clients prefer to communicate via telephone, e-mail, fax, GoToMeeting.com sessions, or Skype. If you prefer an initial in-person meeting please let us know. A disability company will never require you to come to their office and similarly we are set up so that we handle your entire claim without the need for you to come to our office.

How can I contact you?

When you call us during normal business hours you will immediately speak with a disability attorney. We can be reached at 800-682-8331 or by email. Lawyer and staff must return all client calls same day. Client emails are usually replied to within the same business day and seem to be the preferred and most efficient method of communication for most clients.

Dell & Schaefer Client Reviews   *****

Michael F.

Having had several lung surgeries including a wedge resection, lobe removal and pleurodesis as well as MAC lung disease, I was diagnosed with stage vi (end stage) COPD in October 2012. With my lung function at 23% it was becoming very difficult to manage my daily life let alone continue working in my management role at a large healthcare company. After meeting with my primary physician and my pulmonologist, it was agreed that I should stop working and submit a claim for disability. I was 52 at the time. My short term disability plan with Mutual of Omaha paid my claim for 3 months at which time it was converted to my long term disability plan with no issues. I continued to collect my LTD benefit from February 2013 until November 20th 2014 when I received a letter saying I could return to my previous position and there was nothing in my medical records to indicate disability. I was shocked to say the least, as my condition is chronic and progressive and in fact my condition had continued to decline. I didn’t know what to do and knew I did not have the knowledge or experience to appeal their decision. I was very afraid as we depended on this income to pay our bills, that’s why I held the policy for many years, to protect my family. I want to add that I applied for and was approved for Social Security disability benefits shortly after diagnosis.

I immediately started to search for attorneys that handle disability claims and found literally hundreds that handled SSDI claims, but few that handled employer/private policies. I found Dell & Schaefer and filled out their quick online form and almost immediately received a reply from Gregory Dell (yes, an actual person responded!) who let me know that he asked Rachel Alters to call me. I don’t think it was more than a half hour before I received a call from her. I immediately felt a sense of relief as she explained the process and what she would be doing for me.

From that day forward, I have been met with OUTSTANDING customer service from Rachel Alters and Kathleen Bordes. Any time I reached out with questions or concerns they were very responsive and always left me feeling satisfied that I had the best in my corner. The process took many months and a lot of leg work on Rachel and Kathleen’s part. When I was finally sent a draft of the appeal, I completely understood why it takes so long. The level of detail was unbelievable. I actually feel like I better understand my disease after reading it! The appeal was filed timely and my denial was overturned very quickly. When I learned it was overturned, I have to admit I had tears in my eyes. I want to add, that even if the appeal didn’t have the positive outcome that it did, I would feel exactly the same about the exceptional job done on my case. I’m not sure I can ever truly express how grateful I am, and how blessed I feel to have found Dell & Schaefer and especially Rachel and Kathleen!

***** 5 stars based on 202 reviews

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