This is an interesting long term disability benefit case that was litigated in the Washington Federal Court against Principal Life insurance. As we see with a lot of ERISA disability lawsuits, the insurance company denies a claimant’s long term disability claim when the definition of disability changes from OWN OCCUPATION to ANY OCCUPATION. In this case, Principal paid benefits during the Own Occupation phase (24 months) and then cut benefits when the definition of disability changed to any occupation. This Principal disability policy had an earning qualifier definition of disability during the Any Occupation period. The policy defined any occupation as a gainful occupation that allows you to earn equal to or greater than the income you were earning while working. This is not the usual definition of any occupation, which is defined as the inability to perform any occupation for which you have experience, education or training.
In this case, Principal determined that the truck driver claimant could do several jobs in the future that would pay at least as much as he was earning. The claimant argued that the Principal must look at what he can do right now and that a disability claim is a continuous real team determination of eligibility. A Washington Federal Judge determined that Principal’s evaluation and review of the claim was unreasonable. The court reversed the claim denial.
Our disability insurance attorneys have helped hundreds of Principal Life claimants nationwide. We did not handle this claim, but we track and report on every major disability case nationwide. Contact us for a free immediate consultation with a disability attorney.