Contact: Patrick McLaughlin; Spencer Fane Britt & Browne LLP (Missouri, USA)
The Eighth Circuit recently handed down a decision determining whether a chiropractor whose license to practice was suspended prior to a purported diagnosis of disability qualified for disability payments under two disability insurance policies he maintained. Cich v National Life Ins. Co. et al., No. 12-3223, April 8, 2014.
Curtis Cich sued National Life Insurance Company and Penn Mutual Life Insurance Company after both companies denied his claims for disability benefits under policies they issued to him. Cich obtained his license as a doctor of chiropractic in Minnesota in 1987 and established a private practice. Cich purchased the disability income policies from National Life and Penn Mutual during his practice. The policies provide monthly payments in the event Cich suffers a “total disability.”
Both policies contained fairly standard definitions of total disability, paraphrased as follows – the insured is totally disabled if he is unable to perform the material and substantial duties of his occupation due to accidental injury or sickness.
Between 1998 and 2006, the Minnesota Board of Chiropractic Examiners received numerous complaints that Cich misled patients about treatment costs and insurance coverage. On March 27, 2008, the Board suspended Cich’s chiropractic license for two years and assessed a fine. In April and May 2009, Cich submitted claims to National Life and Penn Mutual for disability benefits, claiming he was totally disabled as of February 5, 2009 because of an “adjustment disorder with mixed emotional features” with symptoms including “extreme anxiety and stress” that prevent him from operating his practice. Cich claimed he last worked on March 27, 2008 and did not expect to return to his practice. Cich’s evidence showed that he first received treatment for his disability on February 5, 2009 from a licensed social worker, who provided Cich therapy and other treatment. She opined that Cich could work, but not at his chiropractic practice due to his anxiety issues.
After removing the case to federal court, National Life and Penn Mutual moved for summary judgment, arguing that Fitch was not totally disabled under the policies because his inability to work was caused by his license suspension rather than a sickness or injury. The federal district court agreed, granting summary judgment in favor of the insurers. Cich appealed.
On appeal, Cich argued that even if his chiropractic license had not been suspended, his adjustment disorder prevented him from performing his occupation since the onset of the illness, which Cich claimed actually predated his licensure suspension – he just didn’t seek treatment until later. The Eighth Circuit did not find this argument persuasive, noting that as of March 2008, Cich was unable to practice because his license was suspended, which is not a “sickness” or “injury” that qualifies as a total disability under the policies. The Court explained that even if the sickness manifested itself prior to his suspension, Cich did not seek treatment until almost a year later – which is the key date for determining a disability under the insurance policies. The Eighth Circuit concluded that once Cich lost his chiropractic license in March of 2008, the practice of chiropractic was no longer an occupation from which he could become disabled by virtue of sickness he first sought treatment for in February 2009.
