Benson sought long-term disability benefits under a policy issued by Life Insurance Company of North America ("LINA") and governed by ERISA. The policy included the following contractual limitations provision: "No action at law or in equity may be brought to recover benefits under the policy ... more than three years after the time satisfactory proof of loss is required to be furnished." The policy required that proof of loss be given "within 90 days after the date of the loss for which a claim is made."
Benson's alleged disability date was June 10, 2010. Under the terms of the policy, Benson had 90 days − until September 8, 2010 − to submit her proof of loss. Benson exhausted her administrative remedies on February 18, 2011, the date that LINA denied her final appeal. Benson did not file suit until February 7, 2014, nearly three years later.
LINA argued that the contractual limitations period required Benson to bring suit by September 8, 2013, which was three years from the deadline to submit proof of loss. The district court agreed with LINA and dismissed the claim for LTD benefits. Citing Heimeshoff v. Hartford Life & Accident Ins. Co., 134 S.Ct. 604 (2013), the court found that the contractual limitations provision afforded Benson a reasonable amount of time to file the suit following the exhaustion of all administrative remedies. Because Benson failed to file suit within the three years provided by the policy, her LTD claim was precluded by the limitation provision.
Click here to view the full January 2015 Edition of the ERISA and Life Insurance News.