Record failed to support Dist. Ct.’s finding in favor of plaintiff-insured in action under ERISA alleging that defendant-insurance company wrongfully denied plaintiff long-term disability benefits based on plaintiff’s back condition. Instant policy required showing that plaintiff was “regular” employee at least 60% of employee’s full-time schedule, and new trial was required, where record did not support Dist. Ct.’s finding that plaintiff’s coverage for said disability benefits extended beyond last day she performed work as attorney and eventually went on extended leave based on her back condition. Moreover, Dist. Ct. failed to pin down exact date of onset of plaintiff’s disability as defined under policy, when plaintiff could no longer practice law. As such, there was potential for finding that plaintiff was disabled prior to her application date, and thus was ineligible for coverage under policy terms.
Federal 7th Circuit Court
Civil Court
ERISA