By Tamara Burns  |  February 13, 2017

Category: Consumer News

disability insurance denialA new Provident Life lawsuit has been filed in Pennsylvania federal court against the Life & Accident Insurance Company by a woman who claims she was improperly denied disability benefits from the company.

Plaintiff Karen L. is a Pennsylvania resident who held an employer-sponsored disability benefits from Provident Life, and has been covered under the plan since 1992.

Karen alleges the insurance was issued in bad faith and is demanding attorney fees, punitive damages and reinstatement of her disability benefits per the Pennsylvania insurance bad faith statute.

In her Provident Life lawsuit, Karen states that she was totally disabled beginning in July 2015 and is entitled to monthly benefits in the amount of $4,020 from July 2015 up to the present, totaling more than $72,000 at the time of filing of the lawsuit.

In addition to the benefits over the last 18+ months, Karen is also seeking compensatory damages and future long-term disability benefits that are anticipated.

The legal action also qualifies under ERISA, the Employee Retirement Income Security Act, according to Karen’s Provident Life lawsuit. “ERISA invokes federal question jurisdiction and supersedes any and all related state laws…” the complaint reads.

In her most recent employment, Karen states that she was unable to perform many of her expected duties, even though she had a number of accommodations already made by her employer.

Her physical therapist and medical team continued to scale back on the amount of activities Karen was allowed to perform due to her physical issues.

The plaintiff stated she suffered from a number of conditions including intersection syndrome, thoracic outlet syndrome, back sprain and Morton’s neuroma. She was later also diagnosed with fibromyalgia.

Karen stated that her conditions caused a variety of physical and cognitive impairments.

Karen’s Provident Life lawsuit goes on to detail all of the times she worked with various physicians and healthcare providers regarding her physical and cognitive issues that interfered with her performing her regular work duties.

Karen was denied benefits on multiple occasions and appealed the denials until she had exhausted all of her administrative remedies, according to the Provident Life lawsuit.

Karen has brought forth a two allegations against Provident Life including breach of contract and bad faith. Karen says that Provident Life’s refusal to pay the benefits to which she was entitled is considered a breach of the terms of her policy.

In her allegation of bad faith, Karen states that Provident Life misrepresented policy provisions, failed to acknowledge communications, failed to properly investigate claims, misrepresented contract provisions related to coverage, failed to promptly investigate claims, refused to pay claims without having conducted a reasonable investigation and did not attempt to fairly settle claims.

“Accordingly, Plaintiff is entitled to a judgment in the amount of back benefits and prospective long-term disability benefits and compensatory damages, as well as punitive damages, interest, attorney’s fees and costs,” Karen’s Provident Life lawsuit concludes.

The Provident Life Lawsuit is Case No. 2:17-cv-00361, in the U.S. District Court for the Eastern District of Pennsylvania.

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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