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Whitley v. Standard Insurance Co.

United States Court of Appeals, Eighth Circuit

March 4, 2016

Gwendolyn Whitley, Plaintiff - Appellee
v.
Standard Insurance Company, Defendant - Appellant

Submitted October 21, 2015

Appeal from United States District Court for the District of Minnesota - Minneapolis.

For Gwendolyn Whitley, Plaintiff - Appellee: Sean Thomas Foss, KENNELLY & O'KEEFFE, Fargo, ND.

For Standard Insurance Company, Defendant - Appellant: Molly R. Hamilton Cawley, Terrance J. Wagener, MESSERLI & KRAMER, Minneapolis, MN.

Before LOKEN, MURPHY, and COLLOTON, Circuit Judges.

OPINION

Page 1135

LOKEN, Circuit Judge.

In February 2011, Dr. Gwendolyn Whitley was involved in a roll-over car accident, suffering a serious head injury. Board certified in family medicine, Dr. Whitley had worked as an emergency room physician at Lake Region Hospital (" Lake Region" ) in Fergus Falls, Minnesota, in the twenty-four months preceding the accident. She returned to work full-time from

Page 1136

March 16 through March 24, but fatigue and short-term memory issues forced her to stop. On June 28, she filed a claim for long-term disability (" LTD" ) benefits under Lake Region's Group Long Term Disability Insurance Policy issued by Standard Insurance Company (" Standard" ). Standard, serving as administrator of the Policy, approved Whitley's claim and paid LTD benefits beginning May 22, 2011.

In August 2012, Standard determined that Whitley was no longer disabled, discontinued benefits effective July 31, 2012, and rejected Whitley's internal appeal of that decision. She then commenced this action in state court, asserting various claims against Standard and Lake Region. After Standard removed the case to federal court, Whitley filed an amended complaint asserting, as relevant here, a claim under ERISA that Standard's denial of continuing disability benefits was contrary to the terms of its Policy. See 29 U.S.C. § 1132(a)(1)(B). The district court granted summary judgment for Whitley, concluding that Standard abused its discretion in discontinuing LTD benefits. Standard appeals. Reviewing the grant of summary judgment de novo and Standard's decision for abuse of discretion, we reverse. See Manning v. Am. Republic Ins. Co., 604 F.3d 1030, 1038 (8th Cir.), cert. denied, 562 U.S. 1062, 131 S.Ct. 648, 178 L.Ed.2d 480 (2010) (standard of review).

I. Background.

For physician members of the insured group, such as the 57-year-old Whitley, the Policy provided " Own Occupation" disability benefits up to retirement age, if the disability persisted:

[Y]ou are required to be Disabled only from your Own Occupation.
You are Disabled from your Own Occupation if, as a result of Physical Disease, Injury, ...

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