08-2074 Estate of Blanco v. Prudential Ins. Co. of America

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Insurance
ERISA; preexisting conditions

Where an employee had a long history of heart disease and hypertension before beginning employment, his long term disability benefits were properly denied after he had a heart attack.

“Blanco admits that he was taking prescription medication for hypertension during the look-back period. That triggers the preexisting condition exclusion under subsection (a) of the policy. Blanco’s disabilities—CHF, dilated cardiomyopathy—were almost certainly due, at least in part, to Blanco’s extreme hypertension. Therefore, even assuming he was taking prescription drugs just for hypertension, he would not be eligible for disability under the policy. Using the same logic, Blanco is not eligible for LTD because he also received consultation for his hypertension during his visit to the doctor during the look-back period.”

Affirmed.

08-2074 Estate of Blanco v. Prudential Ins. Co. of America

Appeal from the United States District Court for the Southern District of Indiana, McKinney, J., Evans, J.

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