Court overturns disability decision based on psychiatric testimony, where insurer reviewer applied unduly high threshold of proof
In Hayden v. Martin Marietta, the Plaintiff sought to recovery disability payments based on anxiety and depression. The involved LTD insurer rejected Hayden's claim based on a physician review that essentially ignored the policy language. The reviewer did not apply the employee's "own occupation" definition and ignored the policy definition of "disability" in favor of a newly-created definition that would preclude any patient from proving disability based on anxiety or depression issues.
The Federal Appeals court remanded the case for entry of judgment in favor of the employee, after applying the standards and definitions that were contained in the actual policy language.