A Urologist and esteemed Professor of Urology at a top university has filed a lawsuit against Provident Life alleging the company breached its contract to provide disability benefits.

Plaintiff Gary L. had to abruptly end his career as a surgeon when a previously placed intraocular lens in his right eye spontaneously dislocated, his Provident Life lawsuit states.

Despite continued treatment with surgeons for his own health issue, Gary claims he has suffered continued issues from the surgery itself, affecting his ability to perform his job as before.

Gary’s Claims Against Provident Life

Provident Life initially issued Gary disability insurance in August 1992. The lawsuit states that according to the policy terms, if Gary were to become totally disabled, he would be entitled to $8875 per month following a 90-day Elimination Period for the rest of his life.

In June 2013, Gary became disabled as per the terms of the policy when his previously placed intraocular prosthetic lens spontaneously dislocated, he states.

The next month, Gary underwent surgery to repair the dislocation but “suffered surgically induced damage to his eye causing retinal folding,” according to the claim.

In October 2013, Gary’s claim under Provident Life’s sickness provision of the policy was approved, the claim recounts.

The following year, in September 2014, Gary claimed Provident informed him that his benefits under the policy would be capped at 36 months because it fell under the sickness provision of the policy.

Upon receiving this news, Gary asserts that he had his treating physicians provide supporting documentation to Provident Life on his behalf and attempted to appeal the cap on benefits himself.

Following receipt of the documentation, Gary claims that Provident Life denied his appeal and said that the coverage would only be given under the sickness policy.

As a result of receiving the appeal denial, Gary decided to file a lawsuit against Provident Life to attempt to have the company provide him the disability benefits for life that he felt he qualified for under the disability insurance terms.

Gary alleges that Provident Life breached its good faith and fair dealing with respect to his disability insurance benefits. He accused the company of unreasonably failing to make payments, delaying payments, withholding payments, misrepresenting facts about the policy provisions, failing to investigate the claim for benefits, and failing to provide a basis for denial.

In addition to the count of breaching good faith, Gary also alleged that Provident Life breached its contract for disability benefits.

Gary is seeking damages for failure to provide benefits of the policy plus interest, general damages for emotional and mental distress, attorneys’ fees and costs, punitive and exemplary damages, and other relief as deemed just and proper by the court.

Filing a Disability Insurance Lawsuit

If you have exhausted your appeals to Provident Life or another disability insurance company but believe you should be entitled to continued benefits under the provision of your plan, you may be eligible to file a claim.

A disability insurance attorney can review your case at no charge to you and can inform you of your legal options.

The Provident Life Disability Insurance Lawsuit is  Case No BC616681, in the Superior Court for the State of California, County of Los Angeles.