A California physician is challenging the way Guardian Life Insurance Company of America defines "total disability" in an individual disability insurance policy.
The plaintiff, Dr. Henry Kamali, and Guardian are clashing over whether a California disability insurer can prohibit working as part of the requirements for an insured who seeks to be classified as totally disabled, according to a complaint filed in the U.S. District Court in San Jose, California, and available on Law.com Radar.
Kamali is asking the court to let him represent a class consisting of all Guardian disability insureds in California who have trouble collecting benefits due to a "no work" policy provision.
What It Means
If Kamali is successful, clients who file individual disability insurance claims in California might have an easier time collecting benefits.
Case Details
Kamali was working as a board-certified anesthesiologist in 2016 when he learned that he had prostate cancer, which subsequently spread to his lymph nodes.
Surgery and chemotherapy left him with effects such as fatigue, insomnia, joint pain and anemia.
Kamali is now the medical director of a hospital and the CEO of a large anesthesiology practice, but he says he can no longer work as a clinical anesthesiologist.
In most of the United States, Guardian and other issuers of individual disability insurance often use a relatively broad definition of a term such as "total disability" during the first few years after an insured qualifies for benefits, and then shift to a tighter definition later.
