Here are the main points to take away from the case:
- The firm’s client is a liver transplant surgeon who had purchased an individual, own occupation insurance policy from Ameritas;
- The insurance policy was meant to ensure the client’s medical specialty;
- When the client’s disability prevented him from performing liver transplants, Ameritas denied his claim for total disability benefits because he continued performing other job duties; and
- Dabdoub Law Firm argued a liver transplant surgeon who cannot perform liver transplants is totally disabled from that medical specialty occupation; and
- This case is a huge win for physicians covered under a specialty own-occupation disability insurance policy.
Continue reading to learn more about the case and how the firm defeated Ameritas’s attempt to deny total disability benefits to their client, a surgeon.
Since 1994, Dr. Michael Millis worked as a liver transplant surgeon at the University of Chicago Medicine. He was one of four liver transplant surgeons at UChicago, performing between 10 and 12 liver transplant surgeries per year.
After suffering an injury to his wrist in 2019, he was no longer able to perform liver transplant surgery, but he continued performing other operations on the liver as well as maintained his teaching appointment at the university hospital that employed him.
By its nature, liver transplant surgery does not occur every day. Thus, it is customary that a liver transplant surgeon performs other duties, such as abdominal surgeries including hepatobiliary surgery. It is also customary for a physician at a teaching hospital like the University of Chicago to hold a professorship. However, a liver transplant surgeon’s medically recognized specialty is that of a liver transplant surgeon, regardless of the other types of surgeries or duties they perform.
As a result of his inability to perform his specialty occupation as a liver transplant surgeon, Dr. Millis submitted a total disability insurance claim to his individual disability insurance carrier, Ameritas Life Insurance Corporation.
Ameritas denied his total disability claim on the basis that liver transplant surgery was not his only occupation. According to Ameritas, his pre-disability occupation included liver transplant surgery, hepatobiliary surgery, and professor. Ameritas claimed he has three occupations in all—liver transplant surgeon, hepatobiliary surgeon, and professor—and that he was not totally disabled because he could continue working in two of the three.
Dr. Millis then filed a lawsuit against Ameritas in federal court for breach of contract for failure to approve and pay his total disability claim.
After reviewing the parties’ cross-motions for summary judgment, the court issued an order in favor of Dr. Millis. The court found that Dr. Millis’s pre-disability occupation was that of a liver transplant surgeon and that his other duties—hepatobiliary surgery and professorship—were part and parcel of the customary duties of a liver transplant surgeon. They were not separate occupations.
This case is a huge win for physicians covered under a specialty own-occupation disability insurance policy. Insurance companies are quick to deny physician claims, especially when a physician continues working in another area of medicine and, but for their illness or injury, can no longer work in their own specialty.
Dabdoub Law Firm specializes in disability insurance law representing clients across the nation. The firm was built for the sole purpose of representing disabled people against their disability insurance carrier. Edward Dabdoub and his team of attorneys have successfully represented physicians against major disability insurance companies getting paid disability benefits.
Help from a Lawyer with Expertise in Disability Insurance
Disability insurance law is complex. Hiring an experienced disability attorney is important. Because all disability lawyers at this law firm focus on disability insurance claims, we have expertise in disability insurance law.
That means we have:
- Experience with every major disability insurance company;
- A proven track record of success in winning major disability lawsuits;
- Recovered millions of dollars in disability benefits for clients;
And, we never charge fees or costs unless our clients get paid.
The firm can help at any stage of your disability insurance claim, including:
- Submitting a disability insurance claim;
- Appealing a long-term disability denial;
- Negotiating a lump-sum settlement; or
- Filing a lawsuit against your disability insurance company.
Because federal law applies to most disability insurance claims, our lawyers are able to represent clients across the country.Call to speak with an experienced disability attorney. Consultations are free.