Unum Life Insurance Company is facing a new wrongful disability claims denial lawsuit, from a former Quintiles Transnational Corporation employee.

The policyholder had filed a claim for disability insurance benefits after becoming unable to work and determining she met Unum’s long-term disability requirements.

Plaintiff Tina P. had worked as a full time employee as a Medical Sales Representatives for Quintiles and was a part of the company’s long-term disability plan. When she filed her claim for disability insurance benefits, she was and still is disabled under the terms and requirements of long-term disability plan and is entitled to the disability benefits, the Unum lawsuit says.

Overview of Unum Claim Denial Allegations

Under Unum’s long-term disability benefits plan, Tina would have ideally been provided benefits if she had fallen ill or had become injured in a way that would have prevented her from performing her occupational duties.

In summary, if she became unable to work due to either an unexpected injury or illness and suffered at least a 20 percent loss in her indexed monthly earnings from this condition, she would be eligible for long-term disability benefits.

Additionally, after 24 months of payments, Tina would have to prove that she is unable to work in a similar occupation that would have earned her sufficient income.

These terms and conditions were in effect when Tina became disabled on Nov. 4, 2013, due to severe cervical radiculopathy, chronic shoulder pain, and sleep apnea. Due to these health conditions, Tina was unable to continue her duties as a sales representative or any occupation she is qualified for, she claims in the claim denial lawsuit.

According to the Unum lawsuit, Tina had filed her claim for disability insurance benefits within the designated deadline made by Unum. Despite meeting all requirements to receive long-term disability benefits under her insurance plan, Unum terminated her disability benefits on April 9, 2015.

The insurance company stated that she no longer met the definition of disabled under the long-term disability plan. Tina appealed this decision and submitted additional medical evidence to prove she needed the long-term benefits.

In her first disability claim, she had submitted medical testimony from her doctor that stated she would be unable to work due to her injuries. When she appealed, Tina also submitted vocational evidence that showed she would be unable to perform work required by her former job or any similar occupation.

Despite all the additional evidence further establishing that Tina was qualified to receive disability benefits, Unum ultimately denied the appeal in a letter dated Nov. 18, 2015.

At this point, Tina has exhausted all administrative remedies to claim her disability benefits and has resorted to filing legal action against Unum Life Insurance Company.

Tina’s disability insurance lawsuit alleges that Unum denied her benefits based on unreliable or insufficient evidence, and that the insurance company acted in its own best interest.

Tina is seeking to recover all disability benefits she is entitled to, along with any other punitive damages.

The Unum Disability Claims lawsuit is Case No. 5:15-cv-05644-RMW, the U.S. District Court of Northern California.