If an insured is making a claim under a disability insurance policy that he or she is unable to perform the duties of their occupation, does the policy require a showing that the claimant is unable to perform all of the job duties or is a showing of an inability to perform any material job duty sufficient. That was the question presented in Chaudhry v. Provident Life and Acc.Ins.Co., 2014 WL 3511529 (N.D.Ill. July 16, 2014), which involved a claim submitted by a psychiatrist who sought total disability benefits when a vision impairment significantly limited him from practicing in his field. There were a number of complicating issues, including the doctor's guilty plea to one count of Medicare fraud, which caused the insurer to question his claimed pre-disability income. However, the major issue in the case turned on whether Dr. Chaudhry needed to show he could not perform any aspect of his prior practice. Judge Amy St. Eve of the U.S. District Court for the Northern District of Illinois, analyzed the issue in the plaintiff's favor.
A recent court ruling from Pennsylvania involving ERISA Discovery permitted depositions to be taken in an ERISA disability insurance case, but applied a rationale that raises concerns about a misuse of administrative law procedures that attorneys and disability insurance claimants should be aware of.
In evaluating disability insurance claims, determining the insured's pre-disability occupation is often a complicated task. Many individuals derive their income from a variety of sources; and courts use two primary approaches in determining whether a person is disabled from performing their own occupation as the following discussion of a recent court ruling decided by a federal court in Michigan shows: