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Weiss v. First Unum Life Insurance Co.

482 F.3d 254 (2007)

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Weiss v. First Unum Life Insurance Co.

United States Court of Appeals for the Third Circuit
482 F.3d 254 (2007)

  • Written by Noah Lewis, JD

Facts

Richard Weiss (plaintiff), an investment banker, had an employer-based group disability insurance policy. A severe heart attack rendered Weiss unable to work. Weiss applied for short-term disability benefits through First Unum Life Insurance Co. (First Unum) (defendant), which approved them for six months. First Unum subsequently paid long-term disability benefits of more than $11,000 per month for three months. First Unum employees allegedly met for the purpose of terminating Weiss’s benefits for nonmedical reasons. First Unum failed to examine his hospital records or order appropriate medical tests before terminating the benefits. Believing the termination to be part of a pattern of targeting large disability payouts, Weiss filed suit under the Racketeer Influenced and Corrupt Organizations Act (RICO), 18 U.S.C. §§ 1961–1968. The district court dismissed the case, finding RICO would interfere with New Jersey’s statutory regulation of insurers in violation of the McCarran-Ferguson Act, 15 U.S.C. §§ 1011–1015, which prohibits federal laws from impinging on state insurance regulation unless the federal law specifically regulates insurance. Weiss appealed.

Rule of Law

Issue

Holding and Reasoning (Rendell, J.)

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