Insurance policies often distinguish mental from physical disability, placing an arbitrary two year limitation on payments for mental disabilities.
The 4th District Court of Appeals finds this untenable.

Date: Sun, 18 Oct 1998 23:01:33 -0400
Subject: Here's the mental illness limitation overturned and why

Lewis v. Aetna Life Insurance and K-Mart
1997 WL (671815 (E.D. Va))

Mr. Lewis was disabled by depression from K-Mart.  His disability was
not disputed.  Aetna had a 2 year limit for mental illness.

K-Mart first tried to disqualify Lewis because under the ADA, you can't
sue unless you are a "qualified individual with a disability."  Since,
due to his depression, Lewis was no longer "qualified" to work, K-Mart
tried to have his suit thrown out.

The judge stated, however, that "at the time he was offered the
disability plan," he was still working so since he was not disabled at
THAT time, he was in fact a "qualified individual with a disability" and
he had standing to bring suit.  In other words the discrimination occurred
before he became disabled but he still had the disability, he just wasn't
disabled by it yet.  

Next K-Mart tried to say that since Lewis did not "physically enter the
premises of the insurance agency to purchase the disability plan
provided by his ...employer."

The wise judge said "Title III did not intend to withhold protections of
the ADA from millions of disabled persons who buy goods over the
telephone, by mail order or home delivery."

The Lewis court further found "distinctions between physical and mental
conditions to be illusory and unsupported."

So K-Mart and Aetna have to pay Mr. Lewis's benefits until age 65.

By the way, last week one of you wrote to me that in response to your
EEOC complaint, UNUM had written that so far, all courts had upheld the
2 year limitation.  As you can see, once again UNUM is lying.  This
decision was issued October 24, 1997.  UNUM should know about it.
(As far as I know it had not been overturned).

Unfortunately I guess this only applies to the 4th Circuit but you can
use this argument if you ever get before a judge.


Top of Page

Judydoc's Page

Insurance Page

Uncivilization and its Discontents

Home Page

Email Judy Morris
at: judydoc AT the-spa DOT com

Email me
at: bhammel AT graham DOT main DOT nc DOT us

The URL for this document is:
Created: October 20, 1998
Last Updated: May 28, 2000