Case Studies - Disability Insurance Case 1

Verdict in favor of Court Reporter

Our client could no longer continue her work as a court reporter due to cubital tunnel syndrome and related wrist injuries. Her insurance company, pointing out that Total Disability was defined in its policy as the inability to perform “the” important duties of her occupation, not “any one” of the important duties. The insurer cut her off saying that she could still perform most of her professional duties. These included “scoping,” (proofreading), the certification of transcripts for appellate courts and the use of specialized equipment that she was trained to use.

The insurer also argued that its definition of disability in the policy required that to be totally disabled, the insured could not be “gainfully employed” in any occupation. Since she was earning income by summarizing depositions (a task she could perform because in doing so she could work at her own pace and take breaks whenever she needed to) that she did not meet the ‘no gainful employment’ requirement.

The trial court, and a unanimous court of appeals, ruled that (1) because the claimant could no longer work as a court reporter, she was disabled under the law whether or not she could still perform some of the duties of her profession; and (2) that the ‘no gainful employment’ provision in her policy was not enforceable and was in violation of the very concept of total disability insurance. This case reaffirmed the concept that an insured does not have to be unable to do anything in order to qualify for benefits under an own-occupation disability policy. He/she only needs to be unable to perform the substantial and material duties of their occupation, in the usual and customary manner and with reasonable continuity.

A seven-figure jury verdict was upheld by the trial court and the court of appeals.