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REAGAN v. FIRST UNUM LIFE INS. CO.

March 18, 1999

LUTHER C. REAGAN, PLAINTIFF,
v.
FIRST UNUM LIFE INSURANCE COMPANY, DEFENDANT.



The opinion of the court was delivered by: Richard Mills, District Judge.

OPINION

The ERISA plan administrator's decision to discontinue Reagan's monthly long term disability payments was neither arbitrary nor capricious.

Therefore, the Court must affirm his decision.

I. BACKGROUND*fn1

Luther C. Reagan began working for Foreign Credit Insurance Association ("FCIA") as a senior marketing representative in 1987. As part of its employee benefits package, FCIA provided its employees with a group long term disability plan.*fn2 FCIA's group long term disability plan was underwritten and provided by First UNUM Life Insurance Company ("UNUM"). This group long term disability plan provided in relevant part:

  "Disability" and "disabled" mean that because of
  injury or sickness:
  1. the insured cannot perform each of the material
     duties of his regular occupation; and
  2. After benefits have been paid for 24 months, the
     insured cannot perform each of the material duties
     of any gainful occupation for which he is
     reasonably fitted by training, education, or
     experience;. . . .

The group disability plan provided long term disability benefits for eligible employees who met the plan's requirements:

  When the Company receives proof that an insured is
  disabled due to sickness or injury and requires the
  regular attendance of a physician, the Company will
  pay the insured a monthly benefit after the end of the
  elimination period. The benefit will be paid for the
  period of disability if the insured gives to the
  company proof of continued:
  1. disability; and

2. regular attendance of a physician.

  The proof must be given upon request and at the
  insured's expense.

On November 2, 1987, Reagan completed a disability benefits application in which he stated that he was a marketing representative, disabled due to a heart condition. On November 5, 1987, Dr. Karl Laping filled out a doctor's statement in support of Reagan's application for disability benefits.*fn3 Therein, Dr. Laping diagnosed Reagan as suffering from angina pectoris, cardiac arrhythmia, chest wall pain, anxiety attacks, depression, and shortness of breath. Dr. Laping indicated that Reagan was incapable of performing any work but that he expected a fundamental change in Reagan's condition in the future. In addition, Dr. Laping noted that Reagan's current occupation could be modified to allow him to perform his work with his impairments. Finally, Dr. Laping ...


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