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McINTYRE v. AETNA LIFE INSURANCE COMPANY, CV15-02103-JGB (DTBx). (2017)

Court: District Court, C.D. California Number: infdco20170524831 Visitors: 7
Filed: May 19, 2017
Latest Update: May 19, 2017
Summary: JUDGMENT JESUS G. BERNAL , District Judge . TO THE COURT, ALL PARTIES, AND THEIR ATTORNEYS OF RECORD: Pursuant to the Findings of Fact and Conclusions of Law (In Chambers), dated May 12, 2017 (Docket No. 30), judgment shall be entered in favor of Michael McIntyre ("Plaintiff") and against Defendant Aetna Life Insurance Company ("Aetna") as follows: 1. Plaintiff was employed by Home Depot. 2. Plaintiff was insured by Aetna under a long-term disability ("LTD") plan insured and administered
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JUDGMENT

TO THE COURT, ALL PARTIES, AND THEIR ATTORNEYS OF RECORD:

Pursuant to the Findings of Fact and Conclusions of Law (In Chambers), dated May 12, 2017 (Docket No. 30), judgment shall be entered in favor of Michael McIntyre ("Plaintiff") and against Defendant Aetna Life Insurance Company ("Aetna") as follows:

1. Plaintiff was employed by Home Depot.

2. Plaintiff was insured by Aetna under a long-term disability ("LTD") plan insured and administered by Aetna under which Plaintiff was a participant.

3. Plaintiff's last day of work was February 20, 2014.

4. Plaintiff became entitled to receive LTD benefits after the 180 elimination period ended on August 21, 2014.

5. Aetna denied the claim in a letter dated April 6, 2015. Aetna did not pay any benefits to Plaintiff.

6. Plaintiff appealed Aetna's denial, which Aetna also denied. This action followed, and the parties briefed the issue to the Court.

7. The Court conducted a bench trial on November 14, 2016.

8. The Court ruled on May 12, 2017, that Plaintiff met his burden of proving he was permanently disabled as of August 22, 2014.

9. Plaintiff has met his burden of proving he was permanently disabled as of August 22, 2014. The medical records also demonstrate that Plaintiff's total and permanent disability remains as Plaintiff has adequately established diagnoses that would support a functional impairment that prevents him from performing any reasonable occupation.

10. Plaintiff's gross LTD monthly benefit is $1,632.80. From August 22, 2017, through May 21, 2017, these benefits total $53,882.40 ($1,632.80 * 33).

11. Plaintiff received State Disability Insurance benefits during the LTD period in the total amount of $10,067.24. These benefits are an offset against the Aetna LTD benefits.

12. The net benefits owed to Plaintiff by Aetna through May 21, 2017, are $43,815.16 ($53,882.40 — $10,067.24).

13. Future benefits subsequent to May 21, 2017, are to be paid by Aetna in accordance with the LTD plan and the Court's Findings of Fact and Conclusions of Law (Docket. No. 30).

14. Plaintiff has applied for Social Security Disability Benefits which have been denied. The denial has been appealed and a final determination is pending. Should Plaintiff be awarded Social Security Disability, Aetna shall be entitled to reimbursement for any overpayment in accordance with the terms of the LTD plan and the Reimbursement Agreement signed by Plaintiff on February 5, 2015.

15. Therefore, the Court orders judgment in favor of Plaintiff and against Aetna in the amount of $43,815.16.

16. Plaintiff shall have leave to file motions for attorney fees and costs.

IT IS SO ORDERED.

Source:  Leagle

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