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The Ninth Circuit reversed the district court's grant of summary judgment in favor of Sun Life and remanded the case for trial, holding that de novo review rather than deferential abuse of discretion review applies to the disability benefits denial.
Court Rules Employee Gets New Chance to Fight Disability Benefits Denial
Toni Feibusch worked for Integrated Device Technology and paid into the company's disability insurance plan through Sun Life Assurance. When Feibusch became disabled and applied for benefits, Sun Life denied the claim. Feibusch sued both the company and Sun Life, arguing the denial was wrong. A lower court initially sided with Sun Life without holding a full trial.
However, the Ninth Circuit Court of Appeals overturned that decision and ordered a new trial. The appeals court ruled that when reviewing disability benefit denials, courts should use a stricter standard called "de novo review" rather than simply checking whether the insurance company's decision was reasonable. This stricter standard means judges will take a fresh, independent look at all the evidence rather than giving the insurance company the benefit of the doubt.
This ruling matters for workers because it makes it easier to challenge wrongful disability benefit denials. When insurance companies refuse to pay legitimate claims, employees now have a better chance of winning in court since judges will review the case more thoroughly rather than automatically deferring to the insurance company's judgment.
This summary was generated to explain the ruling in plain English and is not legal advice.
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