Wilkerson

Wilkerson v. Riffage.Com Disability Income Protection Program

Good Law
303 F. App'x 408
United States Court of Appeals for the Ninth CircuitDecember 10, 2008No. 06-16415California289 words

Opinion

lead Opinion

*409 MEMORANDUM *

Appellant Elizabeth Wilkerson appeals the district court’s Conclusions of Law denying benefits under a pre-existing condition exclusion in the Sun Life Long-Term Disability (“LTD”) Plan. We affirm. Because the parties are familiar with the factual and procedural history of this case, we need not recount it here.

I

The district court correctly held that the Sun Life LTD Plan could apply its preexisting condition exclusion to Wilkerson’s disability, despite her other later, non-disabling conditions. A pre-existing condition exclusion is valid, and bars recovery, if: (1) the provision is conspicuous; and (2) the “pre-existing condition substantially contributed to the disability.” McClure v. Life Ins. Co. of N. Am., 84 F.3d 1129 , 1135 (9th Cir.1996). So long as the pre-existing condition substantially contributed to the disability, the insurer may deny benefits even if a later condition is shown to be “the predominant or proximate cause of the disability.” Id. at 1136.

The policy’s pre-existing condition exclusion here is conspicuous. Furthermore, Wilkerson acknowledges that her primary disabling condition is multiple sclerosis and that multiple sclerosis…

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