Denise Child v. Unum Life Insurance Co. of America

── Denise Child v. Unum Life Insurance Co. of America ── Court: Court of Appeals for the Eighth Circuit Date: May 11, 2026 Category: General United States Court of Appeals For the Eighth Circuit ___________________________ No. 24-2347 ___________________________ Denise J. Child Plaintiff - Appellant v. Unum Life Insurance Company of America Defendant - Appellee ____________ Appeal from United States District Court for the Northern District of Iowa - Eastern ____________ Submitted: November 18, 2025 Filed: May 11, 2026 ____________ Before BENTON, GRASZ, and STRAS, Circuit Judges. ____________ STRAS, Circuit Judge. Does a long-term-care insurance policy in Iowa cover losses that occurred before it went into effect? Although Denise Child thinks so, the district court1 disagreed. So do we. 1 The Honorable Leonard T. Strand, United States District Judge for the Northern District of Iowa.  I. Over 40 years ago, Child lost the use of her arms and legs after a car accident. She has needed substantial help with basic activities like bathing, dressing, and eating ever since. Despite her limitations, she worked as a speech therapist at an Iowa education agency for over three decades. Midway through her time there, the agency began offering group long-term- care insurance. The policy, issued by Unum Life Insurance Company of America, covered nursing-home, assisted-living, and home-care expenses. See Collins v. Metro. Life Ins. Co., 117 F.4th 1010, 1015–16 (8th Cir. 2024) (describing long-term- care insurance). It was “guaranteed issue,” meaning that preexisting conditions were no barrier to coverage. See, e.g., Crowne Invs., Inc. v. Bryant, 638 So. 2d 873, 875 (Ala. 1994) (explaining that a “guaranteed[-]issue” policy is one offered “regardless of health history”). Before enrolling, Child had questions about how the policy worked. She consulted specialists within her own agency, who told her that Unum would issue the insurance if she chose monthly benefits at or below the $6,000 mark. If she opted for more, however, she would need to answer questions about her medical history. She went with the guaranteed-issue option. But one provision, what the parties call the “existing-loss provision,” still worried her. It carved out “loss[es] of [an ability to perform a daily living activity]” that already existed on the “effective date of coverage.” Among the activities listed were “bathing,” “dressing,” “toileting,” “transferring,” “continence,” and “eating,” none of which she could do without help. Although Unum denies she ever called about the carveout, it is undisputed that, if she did, the full extent of her condition never came up. Based on the limited information she shared, the representative reportedly told her that the provision would not affect her right to future benefits. With her questions answered, she enrolled by completing a benefit-election form. -2-  When she saw the existing-loss provision in her Certificate of Insurance, she again became concerned. She contacted one of the specialists from before, who assured her that preexisting conditions would not stand in the way of benefits. She also allegedly called Unum, which gave her the same advice. But like the first time, her inability to perform the listed daily activities did not come up. Based on these conversations, she decided to keep paying the premiums. She did so for nearly 20 years, until continuing to work became too difficult. At that point, she gave notice that she was resign