Aluisi
Aluisi v. Elliott Manufacturing Co.
Opinion
Opinion
Ishii, J.
FINDINGS OF FACT AND CONCLUSION OF LAW
ORDER DIRECTING THE CLERK OF THE COURT TO ENTER JUDGMENT FOR DEFENDANTS
FINDINGS OF FACT
1. Defendant Elliott Manufacturing Co., Inc. (“Elliott”) is a California Corporation incorporated in 1929.
2. Elliott had an employee welfare benefit plan, which included a group long term disability plan (the “Plan”).
3. The Plan provides benefits through Unum’s Group Insurance (“Unum”) Policy No. 505313 001 (“the Policy”). Unum issued the Policy to Elliott Manufacturing, Inc., effective March 1,1996.
4. The Certificate Section of the Policy states that “[w]hen making a benefit determination under the policy, Unum has discretionary authority to determine your eligibility for benefits and to interpret the terms and provisions of the policy” (Administrative Record, bates pages U/A/ 26.)
5. Unum acts as the claims review fiduciary for long term disability claims under the Plan, and Elliott is the Plan Administrator (26, 50).
6. The terms of the Policy provide that, “You are disabled when UNUM determines that:
You will continue to receive payments beyond 24 months if you are also:
7. The maximum period of payment is to age sixty-five. However,…