Case: Health Care & Benefits/Long-Term Disability Benefits (D. Conn.)

A federal district court in Connecticut entered summary judgment in favor of First Unum Life Insurance Company of America and affirmed its decision denying a clinical nurse’s claim for continued long-term disability benefits under its plan governed by the Employee Retirement Income Security Act. Unum denied her application because she reached the maximum duration of coverage for mental health conditions, while she contended that she actually suffered from a physical condition—post-concussive syndrome. The court found that substantial evidence, including peer review opinions and thousands of pages of medical records, supported Unum’s decision. Thus, Unum’s decision wasn’t arbitrary or capricious, the ...