Lawrence

FINDINGS OF FACT AND CONCLUSIONS OF LAW

This matter came before the Court on November 10, 2015 for a court trial on the administrative record. The Court now finds as follows.

FINDINGS OF FACT

1. Defendant Life Insurance Company of North America (LINA) issued a group long-term disability policy to a multiple employer trust; Plaintiffs employer, SCS Engineers, was a Participating Subscriber. (A.R. 309-338.)

Relevant Policy Provisions

2. The Policy provides: “The Insurance Company will pay Disability Benefits if an Employee becomes Disabled while covered under this Policy. The Employee must satisfy the Elimination Period, be under the Appropriate Care of a Physician, and meet all the other terms and conditions of the Policy. He or she must provide the Insurance Company, at his or her own expense, satisfactory proof of Disability before benefits will be paid. The Disability Benefit is shown in the Schedule of Benefits. The Insurance Company will require continued proof of the Employee’s Disability for benefits to continue.” (A.R. 320.)

3. The Policy provides for a ninety-day Elimination Period, which is defined as “the period of time an Employee must be *1142 continuously…