Silver

Silver v. Executive Car Leasing Long-Term Disability Plan

Good Law
457 F.3d 982·2006 WL 2241536·2006 U.S. App. LEXIS 20153
United States Court of Appeals for the Ninth CircuitAugust 7, 200604-55747California4,474 words

Opinion

Opinion

Fletcher, J.

Marc Silver claims that he is disabled due to the deteriorating condition of his heart. He argues that, as a result of his disabling heart condition, he is entitled to benefits under an insurance policy issued by the UNUM Life Insurance Company of America (“UNUM”). UNUM claims that Silver recovered from his disability and that under the terms of the policy he is therefore not entitled to benefits. Following a bench trial, the district court upheld UNUM’s decision to deny Silver’s claim. We now reverse.

I. Factual and Procedural Background

Since 1974, Executive Car Leasing has provided coverage for its employees under a long-term disability insurance policy (“Policy”). The Policy is administered by UNUM and governed by the Employee Retirement Income Security Act (“ERISA”), 29 U.S.C. §§ 1001 et seq. It provides benefits to Executive Car Leasing employees who suffer a loss of earning’s due to disability. To qualify as disabled under the Policy, a claimant must demonstrate that “because of injury or sickness ... [he] cannot perform each of the material duties of his regular occupation.” Also, because the Policy covers only long-term disabilities, it establishes a 90-day “elimination…

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