Opinion ID: 661096
Heading Depth: 2
Heading Rank: 1

Heading: Allen Shelton

Text: 4 Shelton was a chemical operator at NFS, where he worked in the manufacturing process. He has suffered back problems since 1977, when he had surgery for a ruptured disc. He returned to work without restrictions and worked until January 1987, when he suffered another back injury due to an automobile accident. Shelton returned to work in February 1987, after he was released with no restrictions. In September 1988, Shelton suffered another back injury while lifting a 60 to 70 pound tube at NFS. Since being treated for his most recent injury, Shelton has not worked. 5 On August 2, 1989, Shelton filed a claim for benefits under the Policy, which provides: PERMANENT TOTAL DISABILITY (Employee Only) 6 If injury occurring after the effective date of coverage and commencing within 365 days after an accident causes continuous total disability for 12 continuous months and you are judged to be permanently and totally disabled (unable to engage in each and every occupation or employment for compensation or profit for which you are reasonably qualified by reason of your education, training or experience), you will be paid the Principal Sum [$250,000] less any amount paid or payable under the policy as the result of the same accident. 7 The Policy excludes from coverage that loss which results from illness or disease, and insures the employee against loss resulting directly and independently of all other causes from bodily injuries caused by accident. On December 29, 1989, and February 9, 1990, Commercial Life denied the claim by letter for the reasons previously stated.