Lacko v. United of Omaha Life Ins. Co.

Dist. Ct. erred in granting defendant-plan administrator’s motion for summary judgment in plaintiff-employee’s ERISA action alleging that defendant wrongfully denied her application for short-term and long-term disability insurance benefits based on plaintiff’s claim that she could no longer perform duties of her job or perform material duties of her regular occupation. Defendant labored under conflict of interest, where relevant insurance plans granted defendant discretionary authority to determine benefits and imposed on plaintiff obligation to pay such benefits when due. Moreover, defendant’s denial of said benefits was arbitrary and capricious, where: (1) plaintiff had previously qualified for Social Security Disability benefits; (2) physician who conducted mental residual functional capacity assessment found that plaintiff had understanding and memory limitations that precluded her from performing skilled work; (3) DOT title for plaintiff’s past relevant work and for her regular occupation required that plaintiff perform skilled work; and (4) plaintiff’s inability to perform skilled work qualified her for disability benefits under relevant insurance policies. Also, record lacked any evidence to cast doubt on conclusion made by said physician, and defendant otherwise merely considered only evidence that supported its denial of benefits.