Marianne Wible was a registered nurse working for Boeing. She had been fighting a ten year battle with lupus. The drugs needed to combat the disease are themselves toxic, and her physician had been trying to maintain a balance between the impact of the disease and the impact of the drugs.
Finally, Ms. Wible's condition deteriorated to the point where she went on disability. She had been paying premiums for disability insurance for years with Aetna, so now she filed a claim which was strongly supported by her doctor (not some hack, btw, Dr. Wallace is the Chief of Rheumatology at Cedar Sinai).
Aetna initially paid benefits, but kept looking around for reasons to cut her off. It sent Ms. Wible to be examined by an independent physician, but that doctor agreed she was disabled. Then Aetna paid for eight days of surveillance on Ms. Wible, but she pretty much just sat in her home, acting just like one would expect a sick person to act.
Finally Aetna got an allergist - who didn't know anything about Lupus - to opine - without actually seeing Ms. Wible or speaking to any of her physicians - that her condition was mild and she could go back to work. At that point Aetna denied further benefits.
Within six months of the denial Ms. Wible died of lupus, the condition that Aetna said was so mild that she should be working. Remarkably, Aetna continued to insist that it had properly denied Ms. Wible's claim, and that its tame doctor who opined that Ms. Wible's condition was mild was right. It even refused to have her medical records re-examined by a physician.
This was all well and good for Aetna, until we took them to Court. As you can see from his decision, Judge Tevrezian did not approve of the manner in which Aetna handled Ms. Wible's claim.