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Taylor v. Fortis Benefits Insurance Co.

IN THE UNITED STATES DISTRICT COURT FOR THE WESTERN DISTRICT OF PENNSYLVANIA


August 6, 2008

C. RICHTER TAYLOR, JR. PLAINTIFF,
v.
FORTIS BENEFITS INSURANCE COMPANY AND TITUS & MCCONOMY LONG TERM DISABILITY BENEFITS PLAN, DEFENDANTS.

The opinion of the court was delivered by: David Stewart Cercone United States District Judge

Electronic Filing

MEMORANDUM ORDER

AND NOW, this 6th day of August, 2008, after de novo review of the record and upon due consideration of [34] the magistrate judge's supplemental report and recommendation filed on May 1, 2008, and plaintiff's objections thereto, IT IS ORDERED that the Defendants' Motion for Summary Judgment (Doc. No. 16) be, and the same hereby is, granted. The supplemental report and recommendation as augmented herein is adopted as the opinion of the court.

Plaintiff's objections are without merit. The difficulty in this case is not the shape of the pegs at play. It is this: even if one looks beyond the prejudice created by the untimeliness of plaintiff's claim, the record still reflects a lack of sufficient evidence to meet plaintiff's undeniable burden to establish that defendant's decision was arbitrary and capricious under the applicable heightened standard of review. It is fairly clear that the symptoms from plaintiff's bipolar disorder had begun to surface by his claimed onset date of November 30, 1995, and may upon retrospective examination have meaningfully impacted his ability to perform the material duties of his occupation. But that does not show that Union Security violated ERISA when it determined that plaintiff had not proved he was disabled during the Ninety-day Qualifying Period for a variety of reasons, including the lack of pertinent restrictions or limitations on his abilities to perform the duties of his occupation, the conflicting information about the degree to which plaintiff was under Dr. Scott's care and attendance at the time and plaintiff's subsequent work record for a number of years following his departure from Titus & McConomy. Its determination was supported by substantial evidence and reflected a logical and reasoned assessment of all the available information. Consequently, it cannot be overturned notwithstanding the lack of an exclusion barring the presentation of claims based on conditions that can have a delayed onset.

20080806

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