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Nature of Suit Code: 110
Nature of Suit: Insurance
Cause of Action: 

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FOR PUBLICATION

UNITED STATES COURT OF APPEALS

FOR THE NINTH CIRCUIT

ROBERT B. FIER, 

No. 09-17520 Plaintiff-Appellant,

D.C. No.

v.  2:06-cv-01162-

UNUM LIFE INSURANCE CO. OF RLH-LRL

AMERICA,

OPINION Defendant-Appellee. 

Appeal from the United States District Court

for the District of Nevada

Roger L. Hunt, Chief District Judge, Presiding

Submitted December 8, 2010*

San Francisco, California

Filed January 4, 2011

Before: David R. Thompson, Robert E. Cowen, and

Barry G. Silverman, Circuit Judges.**

Per Curiam Opinion

*The panel unanimously concludes this case is suitable for decision

without oral argument. See Fed. R. App. P. 34(a)(2). 

**The Honorable Robert E. Cowen, Senior United States Circuit Judge

for the Third Circuit, sitting by designation. 

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COUNSEL

Steven J. Parsons, Las Vegas, Nevada, and Douglas K.

deBries, Sacramento, California, for the plaintiff-appellant.

Von S. Heinz, Las Vegas, Nevada, for the defendant-appellee.

FIER v. UNUM LIFE INSURANCE CO. 341

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OPINION

PER CURIAM:

Robert B. Fier appeals the district court’s denial of benefits

under two insurance policies that he purchased from Unum

Life Insurance Company of America (Unum) while working

at the Boyd Group. Fier v. Unum Life Ins. Co. of Am., No.

2:06-cv-01162-RLH-LRL, 2009 WL 3644187 (D. Nev. Nov.

3, 2009). Both policies are maintained pursuant to the

Employee Retirement Income Security Act of 1974 (ERISA),

29 U.S.C. § 1001 et seq. We have jurisdiction under 28

U.S.C. § 1291. Reviewing the district court’s legal conclusions de novo and its factual findings for clear error, Metro.

Life Ins. Co. v. Parker, 436 F.3d 1109, 1113 (9th Cir. 2006),

we affirm.

I.

Fier began repairing casino slot machines for the Boyd

Group in 1987, later earning a promotion to a managerial

position. After his promotion, Fier enrolled in the Boyd

Group’s benefits program for managers, including the two

Unum policies at issue in this appeal: a Group Long Term

Disability Policy (the LTD policy) and a Group Life and

Accidental Death and Dismemberment Insurance Policy (the

AD&D policy). 

In 1992, a drunk person shot Fier in the throat at a hunting

lodge in Utah. The shot severed Fier’s spinal cord at the C6

level, leaving him permanently quadriplegic. Fier was able to

return to work at the Boyd Group in early 1993. He worked

in a new position tailored to accommodate his many physical

limitations, but earned the same salary he received before the

accident. In 1997, the Boyd Group assigned Fier to a new

position and reduced his salary by $20,000. 

Fier submitted a claim for benefits under the LTD policy in

March 1997. Between late 1997 and late 2004, Unum paid

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Fier a total of $152,069.02. In late 2004, Unum informed Fier

that his claim had not been payable since 1998, when Fier left

the Boyd Group and began earning a salary comparable to

what he received before the accident. Unum determined Fier

was ineligible for benefits under a paragraph in the LTD policy titled “Termination of Disability Benefits,” which provides:

Disability benefits will cease on the earliest of:

1. the date the insured is no longer disabled;

2. the date the insured dies;

3. the end of the maximum benefit period;

4. the date the insured’s current earnings exceed

80% of his pre-disability earnings. 

Fier, 2009 WL 3644187, at *5. The district court found, and

Fier does not dispute, that he earned greater than eighty percent of his pre-disability earnings between 1993 and 1997,

and from 1998 onward. See id. at **7-8.

Fier filed suit in the District of Nevada for backpay of benefits from 1993 to 1997 and for a declaratory judgment that

he is entitled to continuing payment of benefits. The district

court found that Fier was ineligible for benefits from 1993 to

1997, and from 1998 onward, when his income exceeded

eighty percent of his pre-injury earnings.1 The court also

found that Fier was not currently insured under the LTD policy because he no longer worked at the Boyd Group. Finally,

the district court rejected Fier’s claim for benefits under the

1Unum counterclaimed for reimbursement of approximately $140,000

in alleged overpayment under the LTD policy for the years 1998 to 2004.

The district court found Unum did not establish entitlement to reimbursement, and Unum does not appeal this ruling. 

FIER v. UNUM LIFE INSURANCE CO. 343

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AD&D policy, concluding he was ineligible because his

hands and feet were not physically severed from his body.

II.

1. The Group Long Term Disability Policy

The district court correctly determined that Fier was ineligible for benefits under the LTD policy from 1993 to 1997, and

from 1998 onward. 

We “interpret terms in ERISA insurance policies in an ordinary and popular sense as would a [person] of average intelligence and experience.” Evans v. Safeco Life Ins. Co., 916

F.2d 1437, 1441 (9th Cir. 1990) (internal quotations omitted).

We will “not artificially create ambiguity where none exists.”

Id. (internal quotations omitted). 

[1] The LTD policy’s paragraph titled “Termination of

Disability Benefits” states that “[d]isability benefits will cease

on the earliest of: . . . the date the insured’s current earnings

exceed 80% of his pre-disability earnings.” Fier, 2009 WL

3644187, at *5. This provision unambiguously serves to terminate “disability benefits” at the time an insured person

earns greater than eighty percent of his pre-disability earnings.2

2Fier argues that the LTD policy is ambiguous and that the district court

failed to apply the rule of contra proferentem, “under which ambiguities

in a contract are construed against the contract’s drafter.” See Scharff v.

Raytheon Co. Short Term Disability Plan, 581 F.3d 899, 905 (9th Cir.

2009), cert. denied, 130 S. Ct. 3508 (2010). However, to the extent the

LTD policy’s “Termination of Disability Benefits” paragraph creates any

ambiguity, it is as to whether the paragraph terminates only “disability”

benefits, or both “disability” and “partial disability” benefits. In Fier’s

case, both interpretations of the paragraph lead to the same result. If Fier

is “disabled,” as he contends, he is ineligible under the plain language of

the termination paragraph. If the paragraph does not apply to “partial disability” benefits, Fier is nevertheless ineligible because he does not meet

the definition of “partial disability,” which requires that an insured earn at

least twenty percent less than his pre-disability earnings. In either case,

Fier could not recover benefits between 1993 and 1997, and from 1998

onward. 

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Fier was an insured person and received “disability benefits”

under the LTD policy from 1997 until 2004. He does not challenge the district court’s finding that he earned greater than

eighty percent of his pre-disability earnings from 1993 to

1997, and from 1998 onward. Under the plain terms of the

LTD policy, Fier is ineligible for continuing benefits, and he

is ineligible for backpay of benefits during the specified years.

[2] The district court was also correct in finding that Fier’s

coverage under the LTD policy terminated when he left the

Boyd Group in 1998. The LTD policy provides that “[a]n

employee will cease to be insured on the earliest of the following dates: . . . . 5. the date employment terminates.” Id. at

*9. Fier concedes that he left the Boyd Group, “causing the

LTD policy to possibly terminate.” Appellant’s Opening Br.

at 43. He maintains he is nevertheless eligible for benefits

under a separate provision of the policy stating that

“[t]ermination of this policy under any conditions will not

prejudice any payable claim which occurs while the policy is

in force.” Id. Fier’s argument is essentially an extension of his

contention that Unum’s obligation to pay benefits did not

cease under the “Termination of Disability Benefits” paragraph. See supra. But because Fier became ineligible for disability benefits in 1998, he does not have “any payable claim”

under which to demand additional benefits. 

2. The Group Life and Accidental Death and 

Dismemberment Insurance Policy

Fier also challenges the district court’s conclusion that his

AD&D policy requires an insured to have his hands or feet at

least partially “cut off.” See Fier, 2009 WL 3644187, at *10.

The relevant portion of the policy provides for a lump sum

payment in the event an insured loses both hands or both feet.

The policy defines “loss” as follows:

For hands or feet, “loss” means dismemberment by

severance at or above the wrist or ankle joint.

FIER v. UNUM LIFE INSURANCE CO. 345

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Id. at *9. 

[3] Fier argues that although his hands and feet remain

physically attached to his body, he has lost them from a functional standpoint due to the “severance” of his spinal cord.

This circuit has not yet construed the terms “dismemberment

by severance” in an ERISA plan. We now interpret those

terms to require physical removal of the limbs. 

[4] In Cunninghame v. Equitable Life Assurance Society of

the United States, 652 F.2d 306, 307 (2d Cir. 1981) (per

curiam), the plaintiff’s AD&D policy defined “loss” of hands

or feet as “dismemberment by severance at or above wrist or

ankle joints respectively.” As in Fier’s case, the plaintiff in

Cunninghame had suffered a severed spinal cord resulting in

paralysis. Id. The plaintiff urged the court to award benefits

because he had lost the use of his legs from a functional

standpoint. Id. The Second Circuit concluded the policy’s definition of “loss” was unambiguous and construed the terms

“dismemberment by severance” as follows:

The word “dismemberment” itself implies actual

separation; the noun derives from the transitive verb

“dismember,” defined as meaning “to cut or tear off

or disjoin the limbs, members, or part of” or “to tear

into pieces: take apart roughly or divide (a whole)

into sections or separate units” or, obsoletely, to

“lop” or “sever.” “Dismemberment” as a noun,

therefore, refers to “the act of dismembering or the

state of being dismembered: division into separate

parts or units.” Furthermore, “severance” is defined

as “the act or process of severing,” and derives from

“sever,” meaning “to put asunder,” “to join or disunite from one another,” “to keep separate or apart,”

“to divide or break up into parts,” “to cut in two:

sunder, cleave[.]” Thus, “dismemberment by severance” has to mean in our view some actual, physical

separation; the use of two words essentially express346 FIER v. UNUM LIFE INSURANCE CO.

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ing the same idea strikes us as unambiguous draftsmanship by an abundantly cautious lawyer. And

when added to this phrase is the clause “at or above

wrist or ankle joints,” it would seem plain that the

policy had the limited scope which we ascribe to it.

Id. at 309 (internal citations to dictionary omitted). We agree

with and adopt this reasoning. Reading the AD&D policy’s

language in its “ordinary and popular sense,” Evans, 916 F.2d

at 1441, the terms “dismemberment by severance” are unambiguous and require “actual, physical separation.” See Cunninghame, 652 F.2d at 309. Because Fier did not suffer the

physical detachment of his limbs, Unum does not owe him

benefits under the AD&D policy.

AFFIRMED.

FIER v. UNUM LIFE INSURANCE CO. 347

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