Court Opinion

ID: 9516015
Source: CourtListenerOpinion
Date Created: 2023-08-06 23:19:32.157899+00
Date Added: 2024-06-11T09:08:14.073848
License: Public Domain

dissenting:
After careful consideration of the record, the briefs, and the oral argument, I remain unpersuaded that the terms of the Deere Plan unambiguously exclude coverage for the contested services provided to Ms. Wall from January 1995 to April 1995. Quite simply, on this record, neither the description of the services provided, nor Prudential’s explanation of its basis for denying benefits, sufficiently establishes that the services fall under the Plan’s custodial care exclusion.
In the circumstances, I believe the district court’s decision should be vacated and this case remanded for further development of the record on the pertinent issues, particularly the applicability of the Plan’s hospice care coverage. With all respect to my colleagues, I dissent.