A lawsuit has been filed against Unum Life Insurance Company alleging the disability insurance provider failed to properly pay a client’s eligible claim for disability benefits.

Plaintiff John D. was employed by Westcon Group North America Inc. at the level of Vice President.

As part of the employee benefit package provided to him by his employer, John held a Group Long Term Disability Plan underwritten by Unum.

As a vice president, John was required to travel both domestically and internationally up to 25% of the time to perform his duties related to management, training, collaborating and more

Under the terms of his plan, John said that Unum agreed to pay him 60% of his monthly income, up to a total of $10,000, if he became disabled during the time his insurance policy was in effect.

In order to obtain the benefits of his disability, he was required to provide medical documentation of being under a physician’s care, satisfy the elimination period associated with the policy and meet other terms.

John’s disability is defined as “severe chronic premature coronary artery disease caused by metabolic syndrome characterized by low HDL cholesterol and high triglycerides.” He suffered his first myocardial infarction at age 39, and has been under medical care ever since.

His treatment for coronary artery disease has included “many medical interventions, including multiple percutaneous coronary intervention (“PCI”) procedures, coronary artery quintuple bypass grafting (with two failed bypass grafts”, and aggressive medical and pharmaceutical therapies.”

The lawsuit also states, “despite these interventions, [John’s] coronary artery disease continues to progress and his overall health continues to deteriorate.

In addition to his coronary artery disease, John suffers from secondary conditions as well, including depression and posttraumatic stress disorder. He also has a secondary diagnosis of ischemic systolic heart failure.

Unum Denies Claim for Disability Benefits

John filed his claim for disability benefits with Unum after a failed catheterization took place. His doctor wrote a supporting note that he was placing John on various restrictions, which included for him to stop working indefinitely beginning August 21, 2015.

Initially, Unum granted John his disability benefits after he filed his first claim for disability benefits with the company, with the benefit starting August 22, 2015. However, in January 2016, Unum sent him a letter stating that the company would no longer provide benefits to him after December 23, 2015.

The company stated that there was no support for John’s ongoing restrictions and limitations, even though his personal physician said otherwise. Upon receiving a denial for the claim for disability benefits, John filed an appeal with the company. He was later informed that his appeal was not successful and that his benefits would be terminated.

John attempted a second level appeal with Unum, but was again denied, saying that he no longer met the definition of “disability” as defined by his policy. After exhausting all of his appeals, John filed his lawsuit.

John has raised a single claim of violation of 29 U.S.C. § 1132(a)(1)(B) and seeks recovery of benefits, pre-and post-judgment interest, attorneys’ fees and costs and any additional relief.

The Unum Denied Claim for Disability Benefits Lawsuit is Case No. 1:16-cv-02838, in the U.S. District Court for the District of Colorado.