Disability insurance giant Provident Life is facing a new claim denial lawsuit from a Georgia man for allegedly wrongfully denying his disability benefits.

According to his claim denial lawsuit, Plaintiff Miles D. is severely disabled and needs the disability insurance from Provident Life to fund his care.

Even though Miles claims he met the requirements of Provident Life to receive full disability benefits, the insurance company allegedly denied him on insufficient grounds.

Miles applied for full disability benefits in December 2012 from a Provident Life policy he signed up for on Jan. 01, 2003. Under this specific policy, if Miles’ condition became so severe that he could not perform certain daily tasks then he could qualify for ‘catastrophic’ disability insurance.

Miles suffers from crippling type-1 diabetes, hypoglycemia, and osteoarthritis, which caused him to become totally disabled on Feb. 22, 2013.

On the same date he became totally disabled, Provident Life classified him as eligible to receive catastrophic disability benefits after confirming he could not perform daily tasks that included basic personal care.

According to Provident Life, Miles had to be unable to perform daily tasks to take care of himself including: bathing, dressing, toileting, getting out of bed, bowel and bladder control, and eating.

Miles states he is in constant pain and will continually need his wife’s help to eat, prepare food for consumption, and to dress himself on a daily basis.

Provident Life Claim Denial Allegations

While Provident Life did initially provide disability insurance, the company stopped on Aug. 23, 2013 after declaring Miles did not meet the catastrophic disability coverage requirements.

Provident Life stated that Miles only needed help dressing and therefore did not qualify for catastrophic disability insurance, which allegedly contradicts the claim Miles filed.

Miles promptly filed an appeal to Provident Life, following all administrative procedures and submitting all documentation required to reiterate his need for the disability benefits, according to the claim.

However the appeal was denied on March 16, 2016, with Provident Life also denying Miles’ request for a review of the claim on April 07, 2016.

At this point, Miles has exhausted all administrative remedies and has had to resort to legal action to claim his disability benefits.

According to his claim denial lawsuit, Miles is seeking compensation for all the missed monthly benefit payments of $1,771.00 from Provident Life since Aug. 24, 2013.

He is also seeking to file additional penalties against the company for failing in their contractual responsibility, and for wrongfully denying his claim.

This Provident Life Claim Denial Lawsuit is Case No. 16-1-3104-99, in the Superior Court of Cobb County, Georgia.