Facts

Plaintiff Terrance Gill, a former project manager at Union Bank, filed suit against Defendant First Unum Life Insurance Company (erroneously sued as Unum Life Insurance Company of America) to recover further long-term disability (LTD) insurance benefits under a policy governed by the Employee Retirement Income Security Act of 1974, after First Unum discontinued Plaintiff's LTD benefits after twenty-four months based on the policy's mental illness limitation.

PLAINTIFF'S CONTENTIONS: Plaintiff contended Defendant wrongfully denied him distribution of continued disability benefits because the policy's mental illness limitation was inapplicable to him as his disability was caused by mild cognitive impairment, which is a physical, rather than a mental non-psychiatric condition.

DEFENDANT'S CONTENTIONS: Defendant denied Plaintiff's contentions and argued that Plaintiff's disability was due to mental illness and that the policy limited LTD benefits for such disabilities due to mental illness to 24 months, which Plaintiff had already received. Therefore, Plaintiff was not entitled to further benefits under the clear and express terms of the policy.

Result

Following the parties' cross-motions for judgment and hearing, the court ruled in favor of Defendant First Unum finding that Plaintiff did not meet his burden of establishing entitlement to further benefits as the preponderance of the evidence supports the conclusion that Plaintiff's cognitive impairments were caused by his mental illness -- such that he was not entitled to further benefits under the policy beyond the 24-months he had already received.