Heller v. Equitable Life Assurance Society of the United States

Dr. Stanley Heller (plaintiff), an invasive cardiologist, had an Equitable (defendant) disability policy paying $7,000 monthly for total disability, defined as inability to perform his regular occupation while under the regular care of a physician. He developed carpal tunnel syndrome and could no longer practice invasive cardiology, but declined recommended surgery. Equitable sought to deny benefits based on his refusal to have surgery.

Whether a disability policy's requirement that the insured be under a physician's care also obligates the insured to undergo surgery for the disabling condition in order to receive benefits.