Green
Green v. Sun Life Assurance Co.
Opinion
Lead Opinion
*44 MEMORANDUM **
Green appeals the district court’s finding that Sun Life properly denied his claim for disability benefits.
A district court’s interpretation of a contract is reviewed de novo. See Lamantia v. Voluntary Plan Administrators, Inc., 401 F.3d 1114 , 1118 (9th Cir.2005). We “interpret[] terms in ERISA insurance policies in an ordinary and popular sense as would a person of average intelligence and experience.” Babikian v. Paul Revere Life Ins. Co., 63 F.3d 837, 840 (9th Cir. 1995) (internal quotations and citation omitted). “[A]mbiguous language is construed against the insurer and in favor of the insured.” McClure v. Life Ins. Co. of N. Am., 84 F.3d 1129 , 1134 (9th Cir.1996).
Under Green’s policy, during the elimination period and the subsequent 24 months, the period at issue, a claimant is “totally disabled” if “because of Injury or Sickness, [he] is unable to perform the Material and Substantial Duties of his Own Occupation.” In interpreting this provision, the district court adopted Sun Life’s “functionality test,” requiring that Green leave work because of a specific condition and that this specific disability last throughout the elimination period. This…