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pay a monthly benefit provided it received proof that the insured
employee was disabled. As relevant in this case, under the UNUM
policy, the terms “disability” and “disabled” meant that, because
of injury or sickness: (1) The insured could not perform any of the
material duties of his regular occupation; or (2) while able to
perform at least one but not all of the material duties of his
regular occupation on a part-time or full-time basis, the insured
was earning not more than 80 percent of his indexed predisability
earnings.
Under the UNUM policy, if an insured employee provided proof
of continued disability and regular attendance of a physician, UNUM
agreed to pay the monthly benefit for the period of disability
following a 90-day elimination period. The monthly benefit could
neither exceed the insured employee’s amount of insurance nor be
paid for a period longer than the maximum benefit period. The
amount of insurance was 66-2/3 percent of the insured employee’s
basic monthly earnings, not to exceed the maximum monthly benefit,
less other income benefits. The maximum monthly benefit was
$10,000; the minimum monthly benefit was the greater of $100 or 10
percent of the monthly benefit before deductions for other income
benefits. If an insured employee earned more than 20 percent of
his pre-disability monthly earnings in his regular occupation or
another occupation, then the monthly benefit was to be reduced (but
not below the minimum benefit) by the excess of the monthly benefit
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Last modified: May 25, 2011