Doctor Sues Provident Life For Denial Of Long-Term Disability Benefits

An Alabama disability attorney recently filed a federal lawsuit against the Provident Life And Accident Insurance Company. The Plaintiff worked as a self-employed board-certified physician of internal medicine for over 30 years in Birmingham, Alabama. Plaintiff had previously purchased two long-term disability insurance policies from Provident.

The Plaintiff filed a disability lawsuit to recover over $75,000 wrongly held by Provident according to the terms of a disability insurance policies purchased from Provident by the Plaintiff.

Facts Against Provident Life And Accident Insurance Company

Plaintiff worked as a physician and was self-employed as a board-certified practitioner of internal medicine. He worked a demanding schedule that called for 10-12 hour work days and seeing an average of 20 to 30 patients a day. He was also on call 24 hours a day, 7 days a week. Plaintiff also managed the operation of his business, including supervising four full-time employees and two contract employees.

Plaintiff purchased two disability insurance policies from Provident in the event that he became disabled, which would lead to disastrous financial consequences. One Policy was purchased in 1991, providing a monthly benefit of $8,340.00 per month for life. Another Policy was previously purchased in 1982 would provide up to $3,000.00 per month until at least age 65, and under some circumstances, for life. Plaintiff kept current on the substantial monthly premium payments for both policies.

Plaintiff had broken his neck in a car accident in 1978, leading to a fusion of his neck and a back surgery in 1994. This is a primary reason why he bought the two disability policies. Plaintiff had dealt with pain from these injuries for many years, but beginning in 2005, the pain began to grow worse. This pain began to radiate down his legs.

Plaintiff was diagnosed with spondylolisthesis and spinal stenosis, both of which could lead to paralysis if not treated. Plaintiff chose to have conservative treatments to deal with these conditions and was able to continue working for a time just using these conservative treatments.

During 2010, Plaintiff’s condition deteriorated significantly, including weakness in his legs. This was caused by pressure on his spinal cord. This pain prevented the Plaintiff from focusing on patient care, complete a day’s work, and perform rounds at the hospital.

After Plaintiff exhausted all other alternatives, he underwent a posterior lumbar interbody fusion surgery on November 9, 2010. Despite the surgery, pain still persists to the extent where the Plaintiff is limited in his ability to be an effective physician, requiring him to take frequent rest periods and affects his ability communicate effectively with his patients. A combination of the 1974 injury and surgery, the 1994 surgery, the 2010 fusion surgery, and other medical conditions have led to the Plaintiff’s present condition.

Plaintiff made a claim for benefits on November 17, 2010. His claim was approved on January 17, 2011 for the time period beginning on November 9, 2010. Plaintiff had paid all premium payments and provided all information requested by Provident.

Cessation of Provident Long-Term Disability Benefits

Without notice or warning, Provident abruptly terminated long-term disability payments on June 2, 2011.

Due to exhausting all administrative remedies, Plaintiff has filed this lawsuit against Provident.

Lawsuit Filed Against Provident By Alabama Disability Lawyer

According to the lawsuit, Plaintiff alleges that Provident failed to provide the following:

  • The continuation of long-term disability payments as stipulated by the Policy, despite knowing from the evidence submitted that Plaintiff is disabled according to the terms of the Policies
  • Terminating LTD payments for an appropriate reason based on the terms of the Policies
  • Failing to adequately investigate Plaintiff’s claims, including the requirements for fulfilling the obligations of a physician
  • Ignored the reports of Plaintiff’s treating physician as to Plaintiff’s current condition
  • Covenant of good faith and fair dealing
  • Failed to allow Plaintiff’s treating physician an opportunity to respond to requests for information regarding Plaintiff’s current condition

Plaintiff Seeks The Following Relief In Provident Lawsuit

Due to Provident’s actions, Plaintiff wants following relief from the Court:

  • More than $75,000 in damages, including actual, punitive, and compensatory damages
  • Injunctive relief against Provident
  • All attorney fees
  • All other relief that the Court deems to be proper and just