Case: Health Care & Benefits/Long-Term Disability Benefits (5th Cir.)

The Fifth Circuit affirmed the decision of a federal district court in Texas denying a Situs Group employee’s claims for long-term disability benefits under an employer-provided ERISA plan, due to the application of a pre-existing condition exclusion. The employee was denied long-term disability benefits arising from her brain cancer and its treatment, despite misrepresentations at a benefits conference and on the enrollment form. The Fifth Circuit affirmed the district court’s grant of summary judgment and its subsequent ruling regarding estoppel under ERISA.