Searching over 5,500,000 cases.


searching
Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.

Bales v. Hartford Life & Accident Insurance Co.

United States District Court, S.D. Mississippi, Northern Division

January 24, 2018

GARY BALES PLAINTIFF
v.
HARTFORD LIFE & ACCIDENT INS. CO. DEFENDANT

          ORDER

          CARLTON W. REEVES, UNITED STATES DISTRICT JUDGE

         The parties have filed cross-motions for summary judgment. On review, the plaintiff's motion will be denied and the defendant's motion will be granted.

         I. Background

         Six months after commencing employment at Weyerhaeuser, Gary Bales became unable to work and sought the benefit of his company's disability policies. Short-term disability benefits were provided; long-term disability benefits were denied. Aggrieved, Bales filed this lawsuit against the disability insurer, Hartford. The present motions followed.

         II. Legal Standard

A plan administrator abuses its discretion where the decision is not based on evidence, even if disputable, that clearly supports the basis for its denial. We reach a finding of abuse of discretion only where the plan administrator acted arbitrarily or capriciously. A decision is arbitrary only if made without a rational connection between the known facts and the decision or between the found facts and the evidence. Our review of the administrator's decision need not be particularly complex or technical; it need only assure that the administrator's decision fall somewhere on a continuum of reasonableness-even if on the low end.

Holland v. Int'l Paper Co. Ret. Plan, 576 F.3d 240, 246-47 (5th Cir. 2009) (quotation marks and citations omitted).

         III. Discussion

         The insurance policy reads, in relevant part:

Pre-Existing Conditions Limitation: Are benefits limited for Pre-existing Conditions?
We will not pay any benefit under The Policy for any Disability that results from, or is caused or contributed to by, a Preexisting Condition, unless, at the time You become Disabled:
1) You have not received Medical Care for the condition for 90 consecutive day(s) while insured under The Policy; or
2) You have been continuously insured under The Policy for 365 ...

Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.