J. Gary Kerns v. Northwestern Mutual Life Insurance Company
Published: Mar. 26, 2011 | Result Date: Nov. 30, 2010 | Filing Date: Jan. 1, 1900 |Case number: 2:08-cv-02016-GEB-KJM Bench Decision – Defense
Court
USDC Eastern
Attorneys
Plaintiff
Defendant
John T. Burnite Jr.
(McDowell Hetherington LLP)
Experts
Plaintiff
Leroi B. Gardener
(medical)
Defendant
Henry M. Alba
(medical)
Facts
J. Kerns signed a request for disability benefits from Northwestern Life Insurance Co. on Oct. 3, 2006, under two disability insurance policies effective in 1972 and 1973.
Kerns stated he was disabled from his occupation as an insurance agent starting February 2006 due to neck and head pain from accidents from sporting incidents in September 1987 and July 2001. Northwestern evaluated the claim and denied coverage.
Contentions
PLAINTIFF'S CONTENTIONS:
Kerns filed suit against Northwestern, alleging breach of its insurance contract. He contended that two disability insurance policies Kerns maintained with Northwestern entitled him to coverage for a lifetime disability benefit.
DEFENDANT'S CONTENTIONS:
Northwestern contended that the denial was valid, because the alleged disability was a result of sickness, not accident, and that under the policies Kerns was entitled to a limited amount of disability benefits if his disability was the result of sickness. Northwestern alleged that Kerns's degenerative arthritis of the spine was due to his age, and that his accidents in 1987 and 2001 had no causal connection to the pain beginning in February 2006.
Damages
Kerns sought damages for breach of insurance contract as well as a declaration that he is entitled to lifetime benefits.
Result
The court found that Kerns' disability was the result of sickness, rendering a verdict for the defense.
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