A lawyer in Orange County, California, has filed a lawsuit against Unum Life Insurance Company and subsidiary Provident Life and Accident Insurance Company, alleging the company breached their contract to provide disability insurance payments.

Plaintiff Michael G., a partner in his law firm, claims that his firm took out long-term disability group coverage through Provident Life and Accident Insurance Company effective Jan. 1, 1999. According to the disability insurance lawsuit, all premiums had been paid on the insurance.

On May 3, 2013, Michael suffered a heart attack, a medical situation that was allegedly covered under his policy. Michael returned to work, but in his Unum lawsuit described how he needed to perform his duties in a modified capacity to reduce the risk of another heart attack. This work reduction also led to a reduction in income.

Michael submitted a long-term disability claim to the Unum and included medical documentation that he was required to modify his work in order to avoid a future, and potentially deadly, cardiac event. He received a reply letter from Unum stating that the benefits were not payable and the company believed he was physically able to work full time.

According to the court documents, Michael “had made it clear that his claim was compensable due to his need to materially modify his law practice to reduce the risk of another cardiac event (modifications which in turn resulted in a loss of income), not his physical ability to perform his occupation if the risk of another cardiac event is ignored.”

The insurance company said in their denial letter that Michael’s policy was governed by the Employee Retirement Income Security Act (ERISA), however, Michael claims it is not.

In December 2014, Michel appealed the denial and provided additional medical documentation that said he needed to materially change the way he practiced law, providing medical journals and vocational evidence to support his claims. In April 2015, Michael’s appeal was denied.

After the appeal was denied, Michael filed his lawsuit alleging that Unum breached the insurance contract by denying his benefits.

Michael alleges that Unum and Provident withheld benefits when they knew he was entitled to them, did not provide a prompt and reasonable explanation for denial, and improperly said his claim was governed by ERISA when it was in fact covered by California law.

He also claimed that the companies unreasonably denied his benefits, failed to properly investigate the claim, improperly applied the policy to maximize their own profits, and forced Michael to litigate to resolve the situation.

Michael is requesting past, present and future benefits in excess of $2.5 million dollars, plus interest; $500,000 in general damages for emotional and mental distress; punitive and exemplary damages in excess of $5 million; and attorneys’ fees and the cost of litigation.

The Unum Bad Faith Insurance Lawsuit is Case No. 8:15-cv-01975-JFW-PJW in the U.S. District Court for the Central District of California.