Moser
Moser v. Trans-General Life & Casualty Group, Inc.
Opinion
Lead Opinion
MEMORANDUM **
In our previous disposition filed July 24, 2000, we held that Susan Moser became disabled within the disability benefits period and was therefore eligible for long term disability benefits under her employer’s ERISA plan (the “Plan”). We found no need to remand the case back to the Plan administrator “for a subsequent determination of eligibility” and ordered the district court to enter judgment for Moser. It now appears we could have and should have been more precise.
On remand, disputes remained concerning the appropriate amount of the judgment, due to provisions in the Plan that limit disability benefits based on mental disorders and that require a showing of full disability from all jobs after twenty four months of disability. The district court felt that regardless of the merits of the Plan’s arguments, we had tied his hands, “reformed the insurance contract” and that he was required to award full benefits without respect to any other limiting language in the Plan. Our earlier disposition, however, was only meant to govern the issue of liability for some form of disability benefits, and not issues pertaining to the amount or duration of such benefits. We…