An Unum disability insurance claim has led to a lawsuit.

Plaintiff James H. has named Unum Life Insurance Co. of America as the defendant in this legal action. The plaintiff is a citizen and resident of Texarkana, Texas and Unum is licensed to do business in this state.

According to the new Unum disability insurance claim, the complainant entered into a contract for disability income benefits thirty years ago. Since the inception of the contract, James says he has paid his premiums religiously and was never late in meeting his contractual obligations as the insured.

Nevertheless, the plaintiff alleges he became disabled in the last few years due to an accidental occurrence during surgery on his eye. He filed an Unum disability insurance claim because he could no longer perform his work duties as an interventional cardiologist.

The insurance company faithfully paid for two years-worth of disability wages based upon an evaluation of their in-house physician that the damage was caused either by sickness or another spontaneous event. James says this response was in line with the terms of the contract which states that, if a disability is brought on by sickness or spontaneous event, they will pay benefits for a two-year period only.

According to the complaint, all benefits ceased to be paid to James after 24-months despite the formal admission by the treating ophthalmologist that the eye disability was caused by a surgical accident. The plaintiff also says he had an independent medical evaluation which confirmed this conclusion.

Both of these sources were allegedly ignored by the defendant when James filed an Unum disability insurance claim for lifetime benefits and was denied. Lifetime benefits following disability were to be provided, according to the original contract entered into, in the event of a disability caused by an accident.

James responded to the denial of his Unum disability insurance claim for lifetime benefits by filing an appeal with the company. The appeal was, unfortunately, denied.

Following administrative protocol as required by the contract in question, the complainant filed a second appeal regarding his Unum disability insurance claim for lifetime benefits. This second appeal was purportedly also denied by the defendant.

The plaintiff has brought several causes of action against Unum Life Insurance Co. of America, including breach of contract and violation of Texas insurance laws.

James is seeking an award that involves actual damages equal to all back disability lifetime benefits due and continuing into the future, statutory treble damages, pre-judgment and post-judgment interest and all costs of litigation which include court and attorney fees. He hopes for additional compensation as seems fair to the jury upon review of the evidence.

The Unum Lawsuit is Case No. 5:18-cv-00065-RWS in the Eastern District of Texas, Texarkana Division.

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