A Unum disability claim denial lawsuit was filed by a New Jersey man with a history of heart disease.

Plaintiff Joseph M. of New Jersey filed the Unum claim denial lawsuit against Unum alleging the insurer denied him his disability benefits in bad faith. Bad faith is a legal term that means one party in a contract is trying to get out of its contractual obligations unfairly or illegally. In the case of insurance laws, it usually has to do with an insurance company avoiding paying a claim.

In this Unum lawsuit, Joseph states that he suffered from serious heart problems since 1996, when had surgical procedures to treat progressive single vessel disease. Since then, his health largely declined, and his cardiologist characterized Joseph’s status as “doing poorly.” The Unum lawsuit states that he frequently suffers from chest pain, along with lightheadedness and nausea associated with his episodes of chest pain. His doctor said only rest and nitroglycerine-based medications relieve the pain. Follow up from other cardiac specialists quoted in the Unum lawsuit state that Joseph’s heart problems are severe and uncommonly difficult to treat.

Joseph applied for disability benefits under his Unum insurance. However, Unum demanded additional information. Then, a Unum-paid physician re-evaluated the documentation and concluded that Joseph could perform sedentary work, the Unum lawsuit said. The Unum lawsuit points out that the Unum in-house physician never addressed the impact of workplace stress on his heart conditions. Despite several appeals, Unum maintained that Joseph could work, and terminated his benefits in January.

Under the Employee Retirement Income Security act (ERISA), policyholders may sue disability companies like Unum if they believe that they have had their disability benefits denied in bad faith. Under this law, a policyholder must first exhaust any internal appeals process before seeking civil action like a Unum lawsuit. ERISA was first created in response to notoriously-fraudulent pension plans, but the legislation also covers disability insurance policies and certain other financial tools.

The Unum Lawsuit is Joseph M. v. First Unum Life Insurance Company, Case No. 2:14-cv-04962-JD, in the U.S. District Court for the Eastern District of Pennsylvania.