DISCLAIMER: Any unofficial case summaries below are prepared by the clerk's office
as a courtesy to the reader. They are not part of the opinion of the court.
994139P.pdf 06/19/2001 Michael E. Walke v. Group Long Term
U.S. Court of Appeals Case No: 99-4139
and No: 00-1403
District of Minnesota
Civil case - ERISA. When an insurer issues a policy containing
ambiguous claims submission language commonly used in
non-ERISA contexts, the presumption should be that there was
no intent to confer discretion, and the decision to deny benefits
is subject to de novo review; evidence established plaintiff
could not perform his duties without adverse and objectively
demonstrated physical consequences and was entitled to benefits;
however, because plaintiff's disabling stress-induced tachycardia
was the result of a mental or nervous disorder, it was subject to
the plan's 24 month benefits limit; attorneys' fees award
affirmed; dissent by Judge John R. Gibson on the mental or
nervous disorder limitation.