Berg v. New York Life Ins. Co.

Federal 7th Circuit Court
Civil Court
Insurance
Citation
Case Number: 
No. 15-1410
Decision Date: 
July 27, 2016
Federal District: 
N.D. Ill., E. Div.
Holding: 
Reversed and remanded

Dist. Ct. erred in granting defendant-insurance company’s motion for summary judgment in action alleging that defendant wrongfully denied plaintiff’s request for total-disability benefits arising out of condition of plaintiff’s hand that prevented him from working as pit broker at Chicago Mercantile Exchange. Defendant based its denial of plaintiff’s claim for full benefits on its interpretation of phrase “requires and receives regular care by Physician” as establishing that plaintiff’s “total disability” condition occurred only as of date that plaintiff first sought treatment for his disabled condition. Said interpretation was improper, since there was no temporal element in relevant policy language. As such, trial was required because onset of plaintiff’s could have occurred prior to date plaintiff sought treatment for his hand condition at time when plaintiff would have been eligible for full disability benefits.