Gonzalez

Gonzalez v. Guarantee Mutual Life Co.

Good Law
5 F. App'x 627
United States Court of Appeals for the Ninth CircuitFebruary 26, 2001No. 99-16818; D.C. No. CV-97-04213-SCCalifornia577 words

Opinion

Lead Opinion

MEMORANDUM *

Maria Gonzalez appeals from the district court’s findings of fact and conclusions of law following a bench trial on her claim for long-term disability benefits under an ERISA-governed insurance policy. Because the facts are familiar to the parties, we repeat them here only as necessary to explain our decision.

1. Gonzalez argues that we should not reach the issue of her non-compliance with the examination provision because her claim was not denied for that reason. The record reveals, however, that her non-compliance was a stated reason for Guarantee’s denial of her claim. On March 7, 1997, Guarantee informed Gonzalez that it had “no alternative but to uphold [its] original denial” of her claim for several reasons, including her refusal to comply with the examination clause, and in an October 3, 1997 letter, Guarantee stated that it would consider Gonzalez’s file closed for, among other reasons, her refusal to submit to requested examinations. So Gonzalez was, or should have been, aware that Guarantee conditioned its payment of benefits on her compliance with the examination clause and denied benefits in part for non-compliance with the clause.

2. We review de novo…

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