After his heart attack, Thomas Wenner received benefit payments under his employer’s disability plan; but the insurer, Sun Life, later cut him off. The Sun Life notice letter cited Mr. Wenner’s failure to provide medical and personal activity information. But the insurer in fact ended benefit payments because it concluded that Mr. Wenner no longer suffered a disability.
The Sixth Circuit today reinstated Mr. Wenner’s benefits. It held that Sun Life violated ERISA section 503 by not giving Mr. Wenner a full and fair opportunity to contest the true basis of termination. The court believed that citing one reason for ending benefits (failure to furnish information) but basing termination on another reason (lack of disability) deprived Mr. Wenner of his right to challenge Sun Life’s decision. Wenner v. Sun Life Assur. Co. of Canada, Nos. 05-6534 & 05-6740 (6th Cir. Apr. 12, 2007).