A new Employment Retirement Income Security Act (ERISA) disability lawsuit was filed in U.S. District Court, Western District of Wisconsin on December 14, 2017.

The ERISA disability lawsuit was filed by plaintiff Michael C. against Unum Life Insurance Company of America. Michael claims he is owed benefits under an ERISA-governed employee disability insurance policy.

The plaintiff is a resident of the State of Wisconsin where this complaint is filed, and the Unum Life Insurance Company is authorized to do business in this state as well.

According to the narrative of this ERISA disability lawsuit, Michael was employed by Jeweler’s Mutual Insurance Company or its affiliate, Jeweler’s Mutual, as early as 2007.

Because of this employment, he could participate in the Jeweler’s Mutual Insurance Company plan. This plan supposedly provides disability income benefits if he were to meet the definition of being totally disabled at any time during his employment.

The plan was funded and managed by Unum Life Insurance Company, the named defendant in this ERISA disability lawsuit. Unum was the claims adjuster and fiduciary, making all benefit determinations and deciding which claims would be covered.

The Nature of Plaintiff’s Job

Michael was employed by Jeweler’s Mutual Insurance Company to market commercial insurance for the sellers, manufacturers, and owners of jewelry from sources of loss.

The company tended to focus on providing this type of insurance until they decided to expand into providing personal jewelry coverage in 2013. When this expansion happened, Michael was promoted into a lead role as director of the personal lines sales department in January 2014.

According to the ERISA disability lawsuit, this promotion came with the expectation that he travel to various trade shows and make key contacts to expand the personal lines end of the business.

This expectation involved preparing presentations, setting and tearing down marketing booths, and standing and giving presentations for long hours on his feet.

Michael’s Disability

The plaintiff says he experienced a transient ischemic attack (TIA) in his office on April 27, 2015. This incident was followed by a stroke two days later. He applied for long-term disability benefits through Unum shortly afterwards, and his claim was approved.

Benefits began to be paid on July 26, 2015, but he was subsequently warned in a letter of October 26, 2016 that the definition of total disability would change as of July 26, 2017—two years after benefits began.

The letter said that instead of not being able to meet the major expectations of his job to maintain disability status, Michael would have to not be able to meet the major expectations of any position for which he was qualified at the company.

Under this new definition, it was believed that the plaintiff would no longer qualify for his benefits by that midsummer deadline. In fact, his benefits ceased even earlier—by letter dated March 27, 2017.

Michael C. has tried all administrative methods for handling this denial of claim. He now asks for his ERISA disability benefits as allowed him by law for the period from March 27, 2017 through July 26, 2017. He is also asking for a return of attorney and other legal fees and costs.

The ERISA Disability Lawsuit is Case No.  3:17-cv-00935-slc in U.S. District Court, Western District of Wisconsin.

Do YOU have a legal claim? Fill out the form on this page now for a free, immediate, and confidential case evaluation. The bad faith insurance attorneys who work with Top Class Actions will contact you if you qualify to let you know if an individual lawsuit or Unum class action lawsuit is best for you. [In general, Unum bad faith lawsuits are filed individually by each plaintiff and are not class actions.] Hurry — statutes of limitations may apply.

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