Jones v. Unum Provident Corp.
(8th Cir., March 1, 2010)
A disability insurance carrier denied coverage based on the plan’s pre-existing condition clause. The dispute was whether the prior carrier’s plan would have been paid if it had remained in force. The Circuit Court agreed with the insurer that the prior policy lapsed when the participant stopped working full-time, even after her benefits were denied, despite that she started working again a few months later. The court held that when the plaintiff quit work, contrary to her physician releasing her to work full-time, she was no longer a full-time employee and no longer eligible for benefits. The Court further stated that the plaintiff failed to provide evidence that her employer had requested continued coverage during the time she was not working.
For a complete copy of the Eighth Circuit’s decision, click here
Kimberly Whistler