California plaintiff Kristen L. is suing Unum Life Insurance Company of America for allegedly denying her disability benefits. Kristen claims that Unum had denied her claim under bad faith insurance circumstances, because the company did not have probable cause.

Kristen had a premium insurance coverage policy with Unum, which she signed up for on April 25, 1994. This policy would reportedly pay her several thousand dollars in the case of injury or illness that was not a pre-existing condition. To be eligible for coverage through her insurance policy, the impairment would have to prevent her from working sufficient hours, cause severe loss in her income, and would prevent her from finding a similar occupation.

Confident in her disability coverage and all required premiums, Kristen had been the president and CEO of a successful investigation resource company that was contracted by insurance companies. As the head of the company she had many duties, including sales and marketing, presentations, talking on the phone, negotiating contracts, and managing the day-to-day operations of the company. She had run her business as a tight ship for years until she recently became disabled, which eventually led her to file this Unum lawsuit.

Unum is the oldest and largest disability insurance provider in America, and provides the most disability insurance in the world. The company currently insures more than 17 million Americans, but has garnered a reputation for wrongful claim denials. Unum has reportedly denied countless insurance claims for insufficient reason, which has resulted in numerous rejected policyholders filing legal action for bad faith insurance. By definition, bad faith insurance is when the insurance company denies a claim for either false or insufficient reason to avoid providing coverage to the policyholder. This conduct is illegal, as insurance companies are required to act in the best interest of their policyholders.

Overview of Unum Claim Denial Allegations

In April 2013, Kristen became disabled after suffering a variety of adverse symptoms, including shortness of breath, fatigue, memory loss, nerve pain, and exhaustion. She was eventually diagnosed with vitamin deficiency, anemia, compromised immune system, and deficient metabolic system. These conditions prevented Kristen from working full-time, cutting her work hours down to only a few hours a week.

The plaintiff’s physician recommended that she cease working due to her deteriorating health. Additionally, her physician stated that she would not be able to work in a similar field, or sufficiently work in a similar occupation. After receiving this news, Kristen submitted a disability claim to Unum explaining the circumstances and symptoms of her disability, focusing on her work impairment and her physician’s medical testimony.

Despite meeting Unum’s requirements and submitting all required paperwork and testimony, her claim was denied several months after it was sent. In the denial letter, Unum stated that she was not eligible because her physician had not identified an exact diagnosis for her condition. Kristen filed an appeal to the company, once again following all administrative procedures, but was met with the same rejection on Nov. 12, 2014.

At this point, Kristen has exhausted all administrative options and has had to resort to legal action against the company. Kristen states that Unum had wrongfully denied her claim under bad faith insurance circumstances, claiming that the company denied her claim for the sake of their best interest. She is suing for all missed payments and any other punitive damages.

This Unum Wrongful Claim Denial Lawsuit is Case No. 8:15-cv-00542-DOC-JCG, in the U.S. District Court for the Central District of California.