Eventually, Carl's diabetes forced him to retire, and one day
at age 66 he stepped on a screw while working in the yard. He
developed an infection in his right foot and soon thereafter his
foot had to be amputated.
insurer, Provident Life & Accident Insurance Co., refused to pay
Carl his accidental dismemberment benefits, contending Carl lost
his foot as a result of his diabetes, a "disease" excluded under
the terms of the policy, and not as a result of his "acci- dental"
stepping on a screw. While a difficult and expensive case to litigate,
falling under a body of federal law known as "ERISA", and while
a relatively small policy benefit of $25,000 was at stake, we
took the case anyway because it offended our notions of justice
that a company as large as Provident would deny Carl $25,000 in
dismemberment benefits after he had paid premiums on his policy
for 28 years. After more than a year of litigation, and after
survi- ving and defeating Provident's Motion for Summary Judgment,
Provident chose not to risk trial on the case and paid Carl 90%
of the insurance benefits due to him.