Rhode Island plaintiff Michael L. is suing Unum Life Insurance Company of America for allegedly using bad faith insurance practices to withhold his disability benefits. Michael claims that the company has been wrongfully denying him his long-term disability (LTD) benefits, along with his life insurance waiver premium (LWOP) benefits.

According to the disability benefits lawsuit, the plaintiff is entitled to both sets of benefits under his employee benefit plan from Boston Scientific Corporation. For years, he worked as a full-time employee at Boston Scientific Corporation doing various work tasks in his occupation. It is important to note that the plaintiff’s job required full use of his back and legs, being a fairly active job.

Unfortunately, Michael was forced to suddenly cease working on Sept. 3, 2010, when he collapsed after suffering a sudden pain in his lower back and legs. Sometime after this episode, Michael was diagnosed with transverse myelitis, a spinal cord inflammation condition that disrupts neurological and sensory functions. Medical experts explain that patients who suffer from this condition often experience symptoms like numbness or tingling, pain and discomfort, and bladder dysfunction.

Michael had also suffered from myelopathic pain syndrome, chronic fatigue, gait disorder, mental cloudiness, memory loss, and weakness, numbness and spasticity in his left arm and left leg from this condition. Initially believing it would only be a temporary injury, Michael applied and was approved for short-term benefits by Unum on Oct. 19, 2010, after the insurance company determined him to be disabled. However, when his condition worsened he applied for long-term disability benefits. He was initially approved to receive them by Unum on April 19, 2011.

Michael was also later approved to recover his premium life insurance waiver from Unum on Dec. 20, 2011, after Unum determined him to be disabled and unable to perform the duties of his occupation at Boston Scientific, or any other company. However, trouble started brewing for Michael in August 2012 when Unum referred him to assistance in filing a claim for Social Security Disability Insurance (SSDI) benefits.

Several months later, Unum notified Michael that the disability qualifications would change in his plan starting March 24, 2013, from an “own occupation” standard to an “any gainful occupation” standard. Due to this change, Unum stated that it would review Michael’s claim to determine if he was still disabled under the company’s definition.

Overview of Unum Claim Denial Allegations

Despite the notification, Unum’s decision to terminate Michael’s benefits came as quite a surprise to him, when he was officially cut-off in February 2013. These benefits were allegedly terminated without proper review or consideration, with Unum completely disregarding medical evidence. Without the assistance of counsel, Michael appealed Unum’s decision to deny his benefits in March 2013, which was initially overturned April 29, 2013.

However, Unum demanded that the plaintiff undergo a neuropsychological examination on July 9, 2013 and July 19, 2013, despite declaring him disabled multiple times. Moreover, the Social Security Administration had also officially declared Michael disabled on Nov. 1, 2013, further justifying the need for his benefits. Despite the massive amount of medical evidence and previously approving him multiple times, Unum ultimately denied Michael his long-term disability and premium life insurance waiver benefits on March 13, 2014 and March 19, 2014, respectively.

Michael filed an appeal of Unum’s decision on Sept. 8, 2014, in accordance with Unum’s procedures. Despite submitting all required paperwork, medical testimony, and vocational evaluation, the insurance company still denied him benefits. Currently, Michael reportedly remains completely disabled due to his chronic back pain and other symptoms caused by his condition.

Therefore, Michael is filing this claim denial lawsuit against Unum for allegedly practicing bad faith insurance. He is seeking compensation for all missed payments, along with any other punitive damages.

This Unum Lawsuit is Michael L. v. Unum Life Insurance Company of America, Case No. 1:15-cv-00119-S-PAS, in the U.S. District Court for the District of Rhode Island.