Opinion ID: 2994484
Heading Depth: 1
Heading Rank: 2

Heading: Ill Comp. Stat. 305/1 et seq. After his injury,

Text: Wyatt applied for benefits under both policies. He began receiving benefits from Federal in the amount of $670 per week. Later, UNUM approved his application for benefits under its policy, subject to an offset of $670 per week that he was getting from Federal. On March 19, 1996, Wyatt reached a settlement with third parties for his injuries in the amount of $4 million. The Federal policy provided that any recovery from a third party would offset the amount of benefits Federal would pay. Specifically, the Federal plan provided that [i]f the persons entitled to the benefits of this insurance make a recovery from others, they must reimburse us for the benefits we paid them. Therefore, the parties agree that Federal did not owe Wyatt anything under his policy until the $4 million is exhausted. Pursuant to this condition, Wyatt reimbursed Federal for the amount of the benefits Federal had paid to him between 1992 and 1996. Furthermore, Federal notified Wyatt that future payments were suspended until exhaustion of Mr. Wyatt’s [$4 million] settlement. Wyatt requested UNUM discontinue the $670 offset against his benefits because he was no longer eligible for benefits under the Federal policy. UNUM responded that the offset remained appropriate because Wyatt was still eligible for the Federal benefits. The parties then disagreed as to whether Federal’s benefits were properly considered workers compensation benefits as defined by the UNUM policy. Wyatt contended that the Federal benefits were not paid under Workers’ or Workmen’s Compensation Laws, since those laws did not encompass Wyatt as a partner in the firm. UNUM countered that, even so, the Federal plan qualified as any group insurance plan, for which Wyatt was still eligible. Wyatt filed a one-count complaint for declaratory relief in the Circuit Court of Cook County, Illinois, and UNUM removed the case to federal district court. After cross-motions for summary judgment, the district court held that Wyatt was not eligible for benefits under the Federal policy and ordered UNUM to pay Wyatt $116,133.20 in retroactive benefits, prejudgment interest and attorneys’ fees.