Dental Disability Claim Lawyer

Dentists and Disability Insurance Claims

When selling disability insurance policies to Dentists and other dental professionals, such as Oral and Maxillofacial Surgeons, Endodontists and Periodontists, insurance companies frequently highlight the fact that 1 out of 4 Dentists will become disabled long enough to collect benefits at some point before retirement. They claim that Dentists should “prepare for the worst” by buying disability insurance.

But after paying thousands of dollars in insurance premiums each and every year, should Dentists also “prepare for the worst” when having to submit a disability insurance claim? The answer is an unqualified “Yes!”

When a sickness or injury prevents, or threatens to prevent, your ability to work in the profession that you love, the highly experienced and respected attorneys at Pillsbury & Coleman, LLP are here to help you navigate the tricky claims process, so that you understand the terms of your policy, understand your rights, and obtain the benefits you are owed. We have decades of experience representing all types of dental professionals, including General Dentists, Oral Surgeons, Endodontists, Periodontists, and Dental Hygienists. We have beaten every major disability insurance company in the United States, including Unum and its affiliated companies Paul Revere Life Insurance Company, Provident Life and Accident Insurance Company, Unum Life Insurance Company of America, and General American Life Insurance Company; Protective Life Insurance Company; Ohio National Life Assurance Corporation; Standard Insurance Company; MONY Life Insurance Company; and Guardian Life Insurance Company and Berkshire Life Insurance Company. And we have deep knowledge of the rigors and demands of clinical dentistry and the common disabling conditions that necessitate a claim submission.

How We Help Dentists and other Dental Professionals

From beginning to end, the attorneys at Pillsbury & Coleman help Dentists and other Dental Professionals obtain the disability insurance benefits they are entitled to.

• Before Any Claim Is Submitted: Our attorneys consult with you to help you understand the coverage that you have purchased. We talk with you and review your medical records to help you understand how your insurance company may react to a future claim for benefits and how best to present a claim to improve the chances that it will be accepted by your insurer.
• During A Claim: Often, something happens during the course of a claim that causes concern. Perhaps your insurer has asked for voluminous financial records or procedure codes without explaining their relevance; perhaps they are slow to accept your claim or act adversarially towards you; perhaps they have requested an in-person interview or medical examination. Our attorneys assist dentists and other dental professionals to prevent a claim denial. Sometimes this involves simply assisting behind-the-scenes. Other times, we become directly involved advocating on your behalf with the insurer. Insureds are entitled to a full and fair review by their insurance company, which is obligated to treat them fairly and in good faith. We help make sure that insurance companies abide by the terms of their policies and comply with the law.
• After A Claim Denial: If benefits are denied, we carefully review your coverage, medical records and other documents, and we scrutinize the insurer’s denial. Sometimes, we can overturn denials without the need for litigation. Other times, a lawsuit is necessary. Our attorneys are recognized as among the top trial attorneys in the country, and we have the track record of success to prove it.

Our Decades of Success Representing Dental Professionals

Pillsbury & Coleman has a proven track record of success representing Dentists and other Dental Professionals whose disability insurance claims have been denied or terminated. Our successes include:

• Bennett v. Ohio National Life Assurance Corporation. Our client is a former Marin County oral surgeon who had to sell his practice after he suffered radial and ulnar nerve injuries in his retractor hand after being thrown from a horse. Under his policies, Ohio National promised to pay lifetime benefits for a disability due to “injury,” but only to age 65 for a disability due to “sickness.” Although his disability clearly stemmed from his horseback riding accident, Ohio National terminated benefits when Dr. Bennett turned 65. We filed suit, alleging that Ohio National’s termination of benefits was not only wrong, but was done in bad faith. So far, we have obtained Dr. Benefits. Ohio National recently reinstated benefits. Further, our court has rejected Ohio National’s attempt to throw out our claims for insurance bad faith and punitive damages, writing: “An insurer is not permitted to rely selectively on facts that support its position and ignore those facts that support a claim; doing so may constitute bad faith. (Mazik v. Geico Gen. Ins. Co. (2019) 35 Cal.App.5th 455, 470. Internal citations omitted.) When sufficiently egregious, an insurer’s intentional disregard of facts supporting a claim also meets the standard for punitive damages. (Ibid.). In viewing the facts set forth by Plaintiff under a substantial evidence standard, a reasonable finder of fact could determine that Defendant’s conduct was sufficiently egregious, and that Plaintiff is entitled to punitive damages.” Read the Order here. Trial is set for March 2025.
• Inong v. Protective Life Insurance Company. Our client was a Stockton, California, general dentist, disabled due to Thoracic Outlet Syndrome. Two insurance companies accepted her disability claim and paid benefits. One insurance company, however, Protective Life, denied benefits, even though the coverage was issued through the American Dental Association, which claims that its insurance plan is specifically designed to protect disabled dentists in their time of need. We sued Protective for bad faith. In the course of litigation, we determined that it was important to take the deposition of the claims manager at Protective responsible for the denial of benefits to obtain evidence of the company’s wrongdoing. Protective refused to have its representative deposed, requiring us to go to Court permitting the deposition. Our Court not only agreed that we could take the deposition, it also threatened to impose judgment against Protective if it failed to have its claims manager appear for deposition. Read the Order here. We cross-examined the claims manager over the course of a full day, and the case was successfully settled on a confidential basis just 4 days later.
• Wall v. The Canada Life Insurance Company. We represented a Stockton, California, oral surgeon, who suffered herniated discs in a boating accident. Following the accident, he attempted to keep working, but his condition progressed, and he sought disability insurance benefits. Under Dr. Wall’s policy, Canada Life promised to pay monthly benefits for life for a disability due to “injury,” but only to age 65 for a disability due to “sickness.” Although his disability clearly stemmed from his boating accident, Canada Life internally coded his claim as a “sickness,” and when Dr. Wall was about to turn 65, it sued him federal court, asking the court to declare that he was not entitled to further benefits. Canada Life sued its own policyholder. Canada Life did this because it wanted to try to obtain a federal court venue, where it believed it stood a better chance of beating Dr. Wall. We immediately filed a separate lawsuit for breach of contract and insurance bad faith in state court against Canada Life, convinced the federal court to dismiss the action that Canada Life had filed, and prepared Dr. Wall’s case for trial. Canada Life tried to have our state court lawsuit dismissed, but we had gathered substantial evidence of Canada Life’s wrongdoing and Dr. Wall’s entitlement to punitive damages. Our court ruled: “[T]he insurer’s unreasonable classification of a disability as caused by ‘sickness’ rather than ‘injury’ (so as to deny or limit benefits) may breach its implied covenant of good faith and fair dealing with the insured. In this case, plaintiff presents substantial evidence that the accident ‘triggered’ the injury, he is entitled to lifetime benefits, and Canada Life ignored this information in an attempt to limit plaintiff’s benefits.” Read the Order here. Pillsbury & Coleman obtained a confidential settlement shortly before jury trial on bad faith and punitive damages.
• White v. Unum Group. We represented a San Diego dentist who had to sell her practice after experiencing debilitating symptoms from Thoracic Outlet Syndrome. Our firm has particular expertise litigating claims against Unum Group and its subsidiary insurance companies, including Paul Revere, Provident Life, and Unum Life. Our firm obtained a landmark $32 million jury verdict, including $30 million in punitive damages, against Unum in Chapman v. UnumProvident, where the evidence showed that Unum targeted Dr. Chapman’s claim for denial in order to meet quarterly denial targets. In White v. Unum Group, we obtained evidence that Unum still targeted claims for closure years later. After obtaining a confidential settlement for Dr. White, Unum tried to keep the evidence that we gathered secret, so that no one else could learn how Unum contributed to distribute monthly and quarterly “expectations” to its claims staff of the number of claims they were expected to close. We fought to keep that information public and prevailed. The trial court in San Diego denied Unum’s request to keep the evidence secret. Read the Order here. Because of our work in this case, not only did our client obtain justice, but we have been able to share our evidence with other attorneys nationwide.
• Womack v. General American, Protective Life Insurance Company, and The Paul Revere Life Insurance Company. Our firm was asked to take on this case by other counsel in light of our expertise in disability insurance. Dr. Womack, a Southern California general dentist, had to sell his practice after a boating accident in which he suffered compression fractures in his thoracic and lumbar spine. His recovery was compromised by severe osteoporosis, and he later suffered a ruptured tibial tendon necessitating major reconstructive surgery that failed and left him with permanent nerve damage and Complex Regional Pain Syndrome. Amazingly, Unum terminated benefits. Pillsbury & Coleman quickly worked the case up for trial, including a full week of depositions at Unum’s home office that revealed the outrageousness of its denial. We presented that evidence in court and obtained a summary judgment order from the federal district court holding that “a reasonable jury could find Plaintiff’s evidence to be clear and convincing proof of malice, fraud, or oppression. Read the Order here. We achieved a successful settlement for Dr. Womack shortly thereafter.

Hire a Dental Disability Claim Lawyer Today

If you’re a dentist or dental professional facing a disability insurance claim, it’s crucial to have experienced legal support on your side. At Pillsbury & Coleman, LLP, we understand the unique challenges that dental professionals face when illness or injury threatens their ability to work. With a proven track record of securing benefits for clients, we are here to help you navigate the complexities of your claim, ensuring that you receive the compensation you deserve.

Don’t let the insurance companies stand between you and your rightful benefits. Contact us today for a consultation and take the first step toward protecting your future.