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3d Cir. – Own Occupation Does Not Mean in the National Economy

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  • 3d Cir. – Own Occupation Does Not Mean in the National Economy

    Here’s a new case out of the Third Circuit, unpublished, entitled Christopher Patterson v. Aetna Life Insurance Company. The sole issue before the court is whether Aetna was required to interpret “own occupation” as referring to Patterson’s actual job duties or as performed in the national economy. The court concludes that Aetna was wrong and that it should be interpreted as actual job duties.

    Here, Aetna has discretionary authority to interpret Patterson’s policy. But our precedent—particularly Lasser—indicates that “own occupation” is unambiguous and that Aetna’s “national economy” interpretation of the term cannot stand.

    In Lasser, we interpreted a long-term disability policy that considered a person to be “disabled… if as a result of injury, illness or disease he is capable only ‘of performing the material duties of his/her regular occupation on a part-time basis or some of the material duties on a full-time basis.’” 344 F.3d at 385. We held that the term “regular occupation” is unambiguous and refers to “the usual work that the insured is actually performing immediately before the onset of disability[,]” at least where no other definition appears in a policy or has been otherwise anticipated by the parties. Id. at 385-86. We therefore rejected the insurer’s interpretation of “regular occupation” as referring to a job “in the general economy.” Id. at 385-87.

    Aetna argues that Lasser is not controlling because the policy in Lasser used the term “regular occupation” whereas the policy here uses the term “own occupation.” But we have equated “own occupation” with Lasser’s definition of “regular occupation.” See McCann v. Unum Provident, 907 F.3d 130, 148 (3d Cir. 2018) (“We held [in Lasser] that [b]oth the purpose of disability insurance and the modifier his/her before regular occupation made clear the analysis had to be conducted based on the insured’s own occupation.” (emphasis added) (citation and internal quotation marks omitted)). Other courts, moreover, have recognized that the distinction between “own occupation” and “regular occupation” is one without a legal difference. See Osborne v. Hartford Life & Accident Ins. Co., 465 F.3d 296, 300 (6th Cir. 2006) (“The only possibly significant distinction between that case and the present one is that there the policy term was ‘regular occupation’ and here it is ‘own occupation.’ That relatively minor difference in language does not warrant a different result.”); see also Hankins v. Std. Ins. Co., 677 F.3d 830, 835-36 (8th Cir. 2012) (discussing case law relevant to the interpretation of “Own Occupation[,]” when that term is undefined, and referencing both “regular occupation” and “own occupation” cases). Additionally, even if a difference between “own occupation” and “regular occupation” could be teased out, the words “own occupation” would seem even more directly to capture the idea of one’s actual job duties than the words “regular occupation.” See Osborne, 465 F.3d at 302-03 (Cole, J., dissenting) (“Whatever the meaning of ‘regular’ is, it is not synonymous with ‘own.’ …Construing the policy language according to its ‘plain meaning in an ordinary and popular sense’ then, ‘own occupation’ refers to [the insured’s] actual job duties.” (citations omitted)); see also House v. Am. United Life Ins. Co., 499 F.3d 443, 453-54 (5th Cir. 2007) (quoting the Osborne dissent’s statement that, “[w]hatever the meaning of ‘regular’ is, it is not synonymous with ‘own[,]’” to support the proposition that an attorney’s “regular occupation” was “not restricted to his own specific job” (citation omitted)). In short, there is no reason to treat “own occupation” and “regular occupation” differently here.
    The opinion is attached below.
    Attached Files