Another Federal Court has adopted the approach of conducting a trial in an ERISA disability insurance benefits case, increasing the trend which only several years ago was unheard of.
A Court in West Virginia has determined that “because there are numerous genuine issues of material fact which conflicting inferences may be drawn from the evidence and reasonable men may reach different conclusions”, both parties’ motions for judgment were denied, and a bench trial is to be held.
This case presents many parallels to our firm’s case of Barber v. Sun Life where a Federal Judge in Connecticut has scheduled a bench trial with live witnesses to be heard. Over the strong objections of Sun Life, Judge Covello has determined a trial is required to decide whether Sun Life’s termination of our client’s claim was an abuse of discretion.
Here, the Federal Judge in West Virginia has determined that the trier of fact must determine whether Aetna relied on substantial conflicting medical evidence in denying coverage. The Court determined that a genuine issue of fact existed as to whether there was sufficient conflicting medical evidence to discount (as typically occurs) the treating doctor’s opinion regarding impairment.
In addition, the Court determined that there was a disputed issue of material fact concerning whether Aetna properly evaluated the objective medical evidence including MRIs and the weight to be applied to this evidence.
Dupell v. Aetna