The Ninth Circuit U.S. Court of Appeals, in a case arising in Nevada, has reversed summary judgment in favor of a disability insurer and remanded for jury trial on the question of whether an attorney who suffered a serious facial injury and resulting depression sustained a “disability” as defined in the policy. The facts of the case present a sad story that will cause many an attorney to shudder a bit :
Milton Eichacker is a lawyer who started his own law practice in Las Vegas, Nevada. . . .On September 14, 1996, Eichacker was an innocent bystander in a barroom brawl. When he attempted to stop the fighting, someone hurled a billiard ball at him. It hit him directly between the eyes, causing serious fractures and lacerations that required substantial reconstructive surgery. . . .
[Eichacker returned to work 60 days after his injury, but . . .] [o]n September 26, 1997, Dr. Peprah diagnosed Eichacker with major depression. He found that Eichacker had been depressed for the preceding nine months and had been “completely paralyzed into inaction.” His symptoms included sleep disturbance, impaired concentration and thinking ability, feelings of hopelessness, uncontrollable crying episodes, fear of leaving the house, and low energy. By September 1997, his emotional state had become so debilitating that he closed his law office. Over the next several months, his inability to function resulted in problems with the state bar, bankruptcy, and the eventual loss of his home.
Eichacker’s disability insurance policy included two requirements: that he be “unable to perform the important duties” of his occupation and that he be “receiving a physician’s care.” The insurer argued successfully in the trial court that it had no coverage for Eichacker’s condition because his practice had failed as a result of his depression, not as a result of his original injury, and that Eichacker was no longer under a physician’s care for that original injury at the time.
The Ninth Circuit disagrees. From the facts available, the court reasons, a jury could conclude that Eichacker was substantially unable to function as an attorney even though he returned to work within sixty days after his original injury. Moreover, a jury could also conclude that the care he received for his depressive condition was a direct outflow from the original, physical injury. The District Court should, therefore, have allowed the case to proceed to trial rather than granting judgment in favor of the insurer.
The decision in Eichacker v. The Paul Revere Life Ins. Co. (January 20, 2004), Case No. 02-17136 can be found at this link in PDF format.
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