Where a man’s medical records showed he had a normal echocardiogram, had no heart symptoms, was walking three miles a day and had lost substantial weight, the long-term insurance provider did not err in concluding that he could return to his writer/editor position.
Background
Kevin Geiger sued Zurich American Life Insurance Company of New York, challenging Zurich’s denial of long-term disability, or LTD, benefits under the Employment Retirement Income Security Act. The parties cross-moved for judgment on the record, and the district court awarded judgment to Zurich.
Analysis
The court agrees that Zurich conducted a reasonable decision-making process. First, it approved short-term-disability benefits for March 2018 and extended them through September 2018 based on the medical records it had at that time. Then, after Geiger applied for LTD benefits, Zurich approved them. But Zurich cautioned that it would continue to require updates on Geiger’s progress and medical conditions.
Then, after Geiger moved from New York to Asheville, Zurich received Dr. Izzo’s records. While Dr. Izzo said that Geiger was disabled, his records belied that conclusion. Geiger had a normal echocardiogram, had no heart symptoms, was walking three miles a day and had lost substantial weight. To be disabled under the plan, an employee must be “unable to perform the material and substantial duties of [his] regular occupation due solely to [his] sickness or injury.” Zurich determined that, based on the...
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