Compliance June 14, 2004

AIDS Infected Actuary Entitled to LTD Benefits

June 14, 2004 (PLANSPONSOR.com) - An AIDS patient who participated in a long-term disability (LTD) plan is entitled to benefits due to the illness and the drug regimen that is required.
Reported by

>Granting the plaintiff’s request for summary judgment, the U.S. District Court for the Southern District of New York found the plaintiff met the definition of “totally disabled” per the company’s LTD plan.   In order to meet the this definition the plaintiff had to show that they were unable to perform, with reasonably continuity, all the material and substantial duties of his or her own or any other occupation for which he is or becomes reasonably fitted by training or experience.  

>The court found plaintiff Pat Rasile, an actuarial consultant for KPMG Peat Marwick, meet this definition and was entitled to full benefits despite evidence submitted by KPMG that showed Rasile was still involved in a number of activities, including:

  • leaving the apartment to run short errands;
  • being away from home for a week’
  • playing and composing music.

>However, the court denied the plaintiff’s request for attorney’s fees and costs.   The court based this decision on a determination that KPMG, even though incorrect in its initial determination, did not “act in bad faith, or even unreasonably.”  

The case is Rasile v. Liberty Life Assurance Co. of Boston, S.D.N.Y., No. 03 Civ. 4316 (NRB).

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