Gregory Cannon v. Aetna Life Insurance Company: Case Overview
This case summary addresses the legal action, Gregory Cannon v. Aetna Life Insurance Company, et al, filed in the District of Massachusetts under the Employee Retirement Income Security Act (ERISA). The case, identified as CA 12-10512-DJC, involved a dispute over the denial of short-term disability benefits.
Procedural Posture
The case progressed to a hearing on cross-motions for summary judgment. The hearing took place on July 19, 2013, at the J. Joseph Moakley Courthouse in Boston, MA, with Judge Denise J. Casper presiding.
Case Summary
Gregory Cannon, the Plaintiff, initiated the lawsuit against the Defendants: the PharMerica Temporary Disability Income Plan and its claims fiduciary, Aetna Life Insurance Company. The Plaintiff’s central claim was that the Defendants had wrongfully denied him short-term disability benefits.
In August 2010, Cannon sought medical attention for various symptoms. The examining doctor attributed the symptoms to Lyme disease and stated that the Plaintiff was not in acute distress. At the time, Cannon was an employee of PharMerica and a participant in its Temporary Disability Income Plan, an ERISA-governed plan administered by Aetna.
Cannon filed a claim with the Defendants to receive short-term disability benefits. Aetna initially approved the claim but later terminated the benefits following a peer review conducted by a different physician. After spending three nights in an emergency room in December 2010, Cannon appealed the benefits termination.
Aetna then tasked another independent physician, specializing in internal medicine, to review the file. However, the file did not include records from Cannon’s primary care physician, which the physician noted could adversely affect their findings. Aetna awarded the Plaintiff short-term disability benefits for the three nights spent in the emergency room but upheld its original decision to terminate the benefits.
Cannon brought the lawsuit on March 21, 2012, in the District of Massachusetts, contending that he was entitled to both short-term and long-term benefits. The Plaintiff and the Defendants each filed motions for summary judgment.
The court denied the Defendants’ motion. The court granted the Plaintiff’s motion, in part. The Court subsequently remanded the case to Aetna with instructions for independent reviewing physicians to update their reports with additional medical records from Cannon’s primary care physician.
Case Highlights
The key events in the case include:
- Complaint filed: March 21, 2012 (Doc #1)
- Answer filed: May 14, 2012 (Doc #7)
- Defendant filed Motion for Summary Judgment: February 26, 2013 (Doc #36)
- Plaintiff filed Motion for Summary Judgment: February 26, 2013 (Doc #39)
- Hearing held on cross motions: July 19, 2013 (Doc #51)
- Order entered granting in part Plaintiff’s motion: September 17, 2013 (Doc #52)
Case-related documents are available through the Public Access to Court Electronic Records (PACER) service. For more information, see Pacer.gov.
