Cause or Symptom?

Best's ReviewVol. 106 Nbr. 11, March 2006

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Summary


While most group disability policies include a provision that limits benefits paid for mental and nervous conditions, insurers argue that the mental illness limitation applies to any disability in which the insured exhibits symptoms of anxiety or depression. However, in Lang vs Long Term Disability Plan of Sponsor Applied Remote Technology Inc, the 9th Circuit Court ruled the mental illness limitation did not apply to disabilities that include mental conditions resulting from physical disorders. Similarly, in Mongeluzo vs. Baxter Travenol Long Term Disability Benefit Plan, the 9th Circuit Court found that an insured with chronic fatigue syndrome who suffered from fatigue, headaches and muscle weakness and received treatment from a psychiatrist for depression and anxiety did not fall within the policy's mental illness limitation because the term was ambiguous.

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Extract


Cause or Symptom?

While most group disability policies include a provision that limits benefits paid for mental and nervous conditions, the definition of mental illness is often ambiguous. Policy limitations for mental illnesses typically limit benefits to 24 month...

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