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ERISA Fiduciary Duties Archives

"Clear that Aetna's goal was to deny the plaintiff's claim."

A recent ruling issued by a federal court in Philadelphia illustrated a number of issues relevant to disability insurance claims brought under ERISA.  In Charles v. UPS Long Term Disability Plan, 2015 WL 6600399 (E.D. Pa. October 29, 2015), after first finding the plaintiff was limited to part time work and thus unable to work at an occupation that would generate an income equal to 60% or more of pre-disability earnings, Aetna shifted gears and denied benefits.  The claimant had been a delivery driver for UPS who became disabled on account of a seizure disorder and could no longer qualify for a commercial driver's license based on the condition and the prescribed anti-convulsant medications which cause sedation and fatigue.  The plan's insurer, Aetna, had the file reviewed by doctors and vocational consultants who issued findings that Charles could work full time and that there were occupations he could perform that would generate the requisite wages.  The court overturned that finding in a harsh ruling that included the quotation that is the title of this blog.

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