Rick V. Caldwell, et ux. v. Unum Life Insurance Company of America
Arbitration ERISA Jurisdiction JusticiabilityDoctri
Does construing ambiguous insurance policy terms against ERISA beneficiaries undermine the purpose of ERISA?
QUESTIONS PRESENTED FOR REVIEW I. UNUM (and other insurers) asserts ERISA insurers do not have a legal duty to draft unambiguous plans and policies. UNUM then argues that is has discretion to construe any ambiguities in its own favor and courts must affirm these decisions in the name of Firestone deference. The 10th Circuit (among others) agreed, at least for insurers whose policy includes a discretionary provision. Does construing ambiguous insurance policy terms against ERISA beneficiaries undermine the purpose of ERISA? II. If ERISA insurers have a duty to draft unambiguous policies, should courts enforce this duty through the longstanding doctrine of contra proferentem regardless of whether or not the insurer has granted itself deference to interpret policy terms? III. Did Congress intend to create two different classes of ERISA beneficiaries based on whether a plan or policy contained a grant of deference — one with the same substantive rights enjoyed before the creation of ERISA and one with less substantive rights and protections? IV. Should the 10th Circuit’s decision be reversed and judgment entered in favor of the Caldwells?