Mosely v. Unum Life Ins. Co. of Am.

In this 2023 ERISA case, the Defendant ceased providing disability benefits to the Plaintiff pursuant to a mental illness limitation of her long-term disability policy. The Plaintiff challenged this decision, arguing that the Defendant abused its discretion by finding that the basis for her disability is psychological rather than physical. The Defendant moved for summary judgment. The Court examined the record and immediately notes that the Defendant failed to provide the Plaintiff with an independent medical examination (IME) when she requested it, and that constituted a procedural error and rendered the Defendant’s benefits determination inherently arbitrary and capricious. For this reason, the Court denied the Defendant’s motion for summary judgment and remanded the case for an IME to be conducted.

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