Diagnosis of insured’s medical condition after termination of employment does not preclude disability claim
Daniel J. Rochow, the former president of Arthur J. Gallagher & Co., was insured under Life Insurance Co. of North America’s disability plan. The Sixth Circuit affirmed that a disability insurer’s denial of benefits to a former employee who was terminated because his symptoms prevented him from performing his duties was arbitrary and capricious, even though the employee’s diagnosis was not made until after he stopped working.
Daniel Rochow began to experience short term memory loss and was demoted from President to a sales executive. Rochow was diagnosed with a rare form of herpes which causes brain trauma. Rochow sought long-term disability benefits through Gallagher’s Group Insurance Plan, which was administered by Life Insurance Company of North America (LINA). LINA contended that Rochow’s inability to function did not occur until his hospitalization after he stopped working.
Rochow challenged LINA’s denial of benefits under the Employee Retirement Income Security Act and the District court ruled that LINA’s denial was arbitrary and capricious. The Sixth Circuit affirmed, concluding that Rochow presented sufficient evidence to establish that he was disabled before he stopped working within the meaning of the plan.
See Daniel J. Rochow v. Life Insurance Co. of North America, No. 05-2100, 6th Cir.; 2007 U.S. App. LEXIS 7599.
About the author: Gregory Michael Dell is an attorney and managing partner of the disability income division of Attorneys Dell & Schaefer. Mr. Dell and his team of disability lawyers have assisted thousands of long-term disability claimants with their claims against every major disability insurance company. Attorney Gregory Dell is a nationally recognized disability insurance attorney and the author of a long-term disability insurance law book published by Thomson Reuters, which is a legal reference for attorneys and judges. For a free consultation, please call 800-828-7583 or use our contact page.
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