Suryadevara v. Unum Group

U.S. DISTRICT COURT
EASTERN DISTRICT OF NEW YORK
Insurance Law

New York Law Journal

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Judge I. Leo Glasser

Suryadevara obtained a disability policy from Unum's predecessor in 1992. He began behaving "erratically" in 1996 during a fellowship at Harlem Hospital. His medical license was revoked in June 2004 following a 2003 diagnosis of paranoid schizophrenia after presenting symptoms preceding overt psychotic behavior during his fellowship. In 2004 Suryadevara was diagnosed with borderline personality and obsessive compulsive disorders. Asserting contract breach and unjust enrichment Suryadevara sought a declaration that he suffered from two disabilities and was entitled to benefits greater than those currently received under Unum's policy. Absent expert testimony, the court could not determine whether Suryadevara's condition from 1996 through 2002 continued thereafter, or whether he was afflicted with a separate psychiatric condition in 2003. Because Suryadevara offered a plausible basis for finding that he suffered from two separate mental illnesses, he pleaded facts sufficient to survive dismissal. As to Unum's affirmative defenses of equitable estoppel and fraud, the court concluded that every alleged misrepresentation was grounded either on Suryadevara's reliance on psychiatric diagnoses, or his interpretation of Unum's policy.

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