A man has filed a long-term disability benefits lawsuit against Unum Life Insurance Company of America under the Employee Retirement Income Security Act of 1974, commonly referred to as ERISA.

Plaintiff Alex L. brought forth this long-term disability benefits lawsuit in order to recover benefits under the terms of his employee benefit plan, as well as to clarify and enforce its rights under the plan.

Alex was employed with QRS Corporation while he was living in Francisco County in California. While employed with QRS, he was covered under a long-term disability plan managed by Unum as the plan insurer and claims administrator.

In his long-term disability benefits lawsuit, Alex states that he became eligible for his disability benefits beginning in June 2003, as he suffered a disability that was covered under his plan. Alex was granted his long-term disability benefits and was paid until April 21, 2016. At that point the payments stopped.

After being denied benefits at that time, Alex says he submitted a timely appeal to Unum on July 18, 2016. Following his appeal, Unum contacted him and asked him to comment on the evidence he provided within his appeal, and gave Alex an Oct. 1, 2016 deadline to provide that information.

On Sept. 1, 2016, Alex says, he was contacted again telling him that he had until Oct. 1, 2016 to present the requested information related to the evidence to the company. On or about Sept. 28, 2016, Alex responded to Unum.

In response, Unum contacted Alex’s counsel the following day to acknowledge that the response was received. Unum stated they would review the information and respond appropriately.

According to Alex’s long-term disability benefits lawsuit, more than 90 days past since his appeal and later submission of a response to the evidence presented. Due to this time lag, based on the terms of the plan, Alex’s “claim is ‘deemed exhausted’ as he has exhausted his administrative remedies,” according to the long-term disability benefits lawsuit.

As a result, Alex became eligible to file a long-term disability benefits lawsuit against Unum since he exhausted all of his administrative remedies.

Alex alleges that Unum breached the terms of the plan by failing to pay the appropriate benefits, by failing to render a decision on his appeal within 45 days after submission or within 90 days after exceptional circumstances, for failing to provide reasons of denying his benefits, failing to say what additional material was necessary after denying the benefits, and failing to appropriately investigate and review his claim.

In addition to being denied his benefits, Alex states that he has also incurred attorneys’ fees and costs as a result of having to pursue legal action against Unum in order to reinstate his long-term disability benefits.

“The wrongful conduct of Unum has created uncertainty where none should exist, therefore, Plaintiff is entitled to enforce its rights under the terms of the LTD Plan and to clarify his right to future benefits under the terms of the LTD Plan,” the long-term disability benefits lawsuit states.

Alex is seeking relief “including but not limited to payment of the correct amount of benefits due to him under his plan, prejudgment and postjudgment interest, reinstatement to the benefit plan at issue herein, and attorneys’ fees and costs.”

The Unum Long-Term Disability Benefits Lawsuit is Case No. 4:17-cv-01880-DMR, in the U.S. District Court for the Northern District of California.