Judges rule on pre-existing condition case

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Highlighting the highly controversial health care debate that’s played out during the past year, the 7th Circuit Court of Appeals today ruled on a pretty straightforward case about a pre-existing condition clause that denied a man’s claim for long-term disability benefits.

Judge Terry Evans wrote for the unanimous panel, affirming a decision from Judge Larry McKinney in the Southern District of Indiana that had rejected the man’s Employment Retirement Income Security Act suit and granted summary judgment in favor of the employer. The case is The Estate of Norman Blanco, by its personal representative Steven C. Blanco v. Prudential Insurance Company Of America, Pruvalue Insurance Benefits Trust, and Porsche Engineering Services Inc., No. 08-2074.

“The phrase ‘preexisting condition’ was frequently in the news as efforts to enact national health care reform were debated over the last year,” Judge Evans began in the ruling. “And although our case today involves a preexisting condition exclusion, there is a twist.”

Now deceased, Norman Blanco had started at the age of 45 as an engineer at Porsche Engineering Services in Michigan in April 2005. His company’s welfare benefit plan covered by ERISA kicked in a month later and was underwritten and administered by Prudential Insurance, providing long- and short-term disability benefits to those who couldn’t work. Blanco suffered a heart attack in July and was unable to work for several days while hospitalized, and he later submitted a disability benefit claim. The short-term benefits were approved, but the long-term benefits weren’t because Prudential determined he had a preexisting condition based on a history of worsening heart disease and prior heart attacks and treatment that he didn’t always adhere to.

At the District Court level, Judge McKinney granted a summary judgment motion by Prudential Insurance, which had upheld the claim denial during an internal review process. The trial judge had limited some of the evidence in that case, and the appellate panel affirmed his decision. Blanco died following that decision, and his estate carried on the appeal.

Analyzing Judge McKinney’s ruling, the 7th Circuit decided that Blanco did fall under the pre-existing exclusion sections of ERISA and couldn’t receive those long-term benefits.

“The purpose of the policy is to exclude from coverage a person who is aware of something – be it a sign or symptom – for which a reasonably prudent person should seek treatment,” Judge Evans wrote.


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  1. I think the cops are doing a great job locking up criminals. The Murder rates in the inner cities are skyrocketing and you think that too any people are being incarcerated. Maybe we need to lock up more of them. We have the ACLU, BLM, NAACP, Civil right Division of the DOJ, the innocent Project etc. We have court system with an appeal process that can go on for years, with attorneys supplied by the government. I'm confused as to how that translates into the idea that the defendants are not being represented properly. Maybe the attorneys need to do more Pro-Bono work

  2. We do not have 10% of our population (which would mean about 32 million) incarcerated. It's closer to 2%.

  3. If a class action suit or other manner of retribution is possible, count me in. I have email and voicemail from the man. He colluded with opposing counsel, I am certain. My case was damaged so severely it nearly lost me everything and I am still paying dearly.

  4. There's probably a lot of blame that can be cast around for Indiana Tech's abysmal bar passage rate this last February. The folks who decided that Indiana, a state with roughly 16,000 to 18,000 attorneys, needs a fifth law school need to question the motives that drove their support of this project. Others, who have been "strong supporters" of the law school, should likewise ask themselves why they believe this institution should be supported. Is it because it fills some real need in the state? Or is it, instead, nothing more than a resume builder for those who teach there part-time? And others who make excuses for the students' poor performance, especially those who offer nothing more than conspiracy theories to back up their claims--who are they helping? What evidence do they have to support their posturing? Ultimately, though, like most everything in life, whether one succeeds or fails is entirely within one's own hands. At least one student from Indiana Tech proved this when he/she took and passed the February bar. A second Indiana Tech student proved this when they took the bar in another state and passed. As for the remaining 9 who took the bar and didn't pass (apparently, one of the students successfully appealed his/her original score), it's now up to them (and nobody else) to ensure that they pass on their second attempt. These folks should feel no shame; many currently successful practicing attorneys failed the bar exam on their first try. These same attorneys picked themselves up, dusted themselves off, and got back to the rigorous study needed to ensure they would pass on their second go 'round. This is what the Indiana Tech students who didn't pass the first time need to do. Of course, none of this answers such questions as whether Indiana Tech should be accredited by the ABA, whether the school should keep its doors open, or, most importantly, whether it should have even opened its doors in the first place. Those who promoted the idea of a fifth law school in Indiana need to do a lot of soul-searching regarding their decisions. These same people should never be allowed, again, to have a say about the future of legal education in this state or anywhere else. Indiana already has four law schools. That's probably one more than it really needs. But it's more than enough.

  5. This man Steve Hubbard goes on any online post or forum he can find and tries to push his company. He said court reporters would be obsolete a few years ago, yet here we are. How does he have time to search out every single post about court reporters and even spy in private court reporting forums if his company is so successful???? Dude, get a life. And back to what this post was about, I agree that some national firms cause a huge problem.