Elam v. First Unum Life Insurance Co.

James Elam (plaintiff) was insured under a disability-insurance policy issued by First Unum Life Insurance Co. (Unum) (defendant). The policy (1) provided for the payment of benefits until age 65 if the insured became disabled, (2) limited payments for disability due to mental illness to a period of 24 months, and (3) defined mental illness as mental, nervous, or emotional diseases or disorders of any type. Unum began paying benefits to Elam at age 43 due to Elam’s bipolar disorder. After 24 months, Unum terminated the payments based on the policy’s mental-illness limitation. Elam filed suit in state trial court against Unum, asserting that bipolar disorder was biological in origin and therefore did not fall within the policy’s mental-illness limitation. Elam and Unum filed motions for summary judgment. Medical doctors Bradley Diner and Joe Backus each offered testimony and stated their belief that bipolar disorder had a biological origin. However, Diner acknowledged that bipolar disorder was a mental disease typically treated by psychiatrists, and Backus acknowledged that the definition of mental illness might be broad enough to include behavioral problems that were neurological or chemical in origin. The trial court granted Unum’s motion, finding that the term “mental illness” as used in the policy was unambiguous and included bipolar disorder. Elam appealed.