United States District Court, C.D. California
For Avery Armani, Plaintiff: Charles J Fleishman, Paul A Fleishman, LEAD ATTORNEYS, The Fleishman Law Firm, Woodland Hills, CA.
For Northwestern Mutual Life Insurance Company, a corporation, Defendant: Charles Kelechi Chineduh, Linda Marie Lawson, Meserve Mumper and Hughes LLP, Los Angeles, CA.
RULING AND ORDER RE COURT TRIAL
HONORABLE RONALD S.W. LEW, Senior United States District Judge.
On November 17, 2014, the above matter commenced in a bench trial before this Court. Having received, reviewed, and considered the evidence presented, as well as the Parties' arguments at trial, the Court makes the following ruling:
I. FINDINGS OF FACT
Plaintiff Avery Armani (" Plaintiff") began working for Renaissance Insurance Agency as a full-time controller on November 3, 2008 and continued working in that position until May 18, 2011. Admin. R. 591, 683, 685. As an employee of Renaissance, Plaintiff was insured under a group LTD policy sponsored by Renaissance and issued by Northwestern Mutual under group policy number L651293. Id. at 817. The relevant portions of the LTD Plan provide the following definitions of disability
DEFINITION OF DISABILITY FOR ALL OTHER MEMBERS
The definition of Disability changes after LTD Benefits have been paid for 24 months.
1. Until LTD Benefits have been paid for 24 months, you are only required to be Disabled from your own occupation.
You are Disabled from your own occupation if, as a result of Sickness, Accidental Bodily Injury or Pregnancy, you are EITHER:
a. Unable to perform with reasonable continuity the material duties of your own occupation; OR
b. Unable to earn more than 80% of your Indexed Predisability Earnings while working in your own occupation.
Until LTD Benefits have been paid for 24 months, you will be considered Disabled while working in another occupation if you are Disabled from your own occupation. There is no limit on the amount you can earn from work in another occupation while you are Disabled from your own occupation. However, one-half the amount of your earnings will be Income From Other Sources used to reduce the amount of your LTD Benefit.
2. After LTD Benefits have been paid for 24 months, you must be Disabled from all occupations.
You are Disabled from all occupations if, as a result of Sickness, Accidental Bodily Injury or Pregnancy, you are EITHER:
a. Unable to perform with reasonable continuity the material duties of any gainful occupation for which you are reasonably fitted by education, training, and experience; OR
b. Unable to earn more than 80% of your Indexed Predisability Earnings while working in your own or any other occupation. (AR 836-837).
Mental Disorder: Payment of LTD Benefits is limited to 24 months for each period of Disability caused or contributed to by a Mental Disorder. However, if you are a resident patient in a Hospital at the end of the 24 months, this ...