Sixth Circuit Allows Lawsuit to Continue Despite ERISA Requirment

On October 2, 2015, in Waskiewicz v. UniCare Life & Health Ins. Co., the Sixth Circuit reversed a district court’s granting of summary judgment in favor of Ford’s ERISA Plan because the insured, who suffered from major depression and gender identity disorder, failed to provide notice of her disability to the Plan after she suffered a debilitating breakdown.  According to the terms of the Plan, an employee was required to provide notice within a five-day period if the employee is absent for more than five (5) consecutive workdays.  The insured failed to provide such notice and was terminated.  The Plan administrator then denied the claim for benefits and the insured sued under ERISA. The Sixth Circuit reversed with instructions that the insured should be allowed the opportunity to show the failure to comply with the notice requirements, resulted from the very disability for which the insured sought benefits, i.e., her debilitating breakdown.