A federal judge has ordered Unum Life Insurance Company of America to pay Dr. Nicholas Grosso $1,045,045.35 in lost long-term disability benefits, finding the insurer mishandled his claim.
Senior U.S. District Judge Richard D. Bennett of the U.S. District Court for the District of Maryland entered the judgment Oct. 16 after a bench trial. Judge Bennett ruled for Dr. Grosso on two of the three counts in his second amended complaint and for Unum on the third.
The claim fell under a group long-term disability policy that Unum issued to The Centers for Advanced Orthopaedics. The court declared that Dr. Grosso was entitled to coverage from Feb. 17, 2022, the date Unum approved his claim, through the end of his benefit period on Dec. 7, 2026.
The court found that Unum breached its duty to properly administer the claim in four ways:
- It set his disability date in 2021, although he did not suffer the required earnings loss until 2022.
- It then treated 2020 as the tax year just before his disability.
- It left his corporate income out of the calculation of his pre-disability earnings.
- It counted nonclinical income toward his disability earnings.
Unum must also pay prejudgment interest on the award at 6% a year. The order is the final judgment and directs the clerk to close the case.
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