Allen v. First UNUM Life Insurance Company

CourtDistrict Court, M.D. Florida
DecidedOctober 22, 2020
Docket2:18-cv-00069
StatusUnknown

This text of Allen v. First UNUM Life Insurance Company (Allen v. First UNUM Life Insurance Company) is published on Counsel Stack Legal Research, covering District Court, M.D. Florida primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Allen v. First UNUM Life Insurance Company, (M.D. Fla. 2020).

Opinion

UNITED STATES DISTRICT COURT MIDDLE DISTRICT OF FLORIDA FORT MYERS DIVISION MARCUS ALLEN, M.D., Plaintiff, v. CASE NO. 2:18-cv-69-FtM-99NPM FIRST UNUM LIFE INSURANCE COMPANY, PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY and UNUM GROUP, Defendants. OPINION AND ORDER This matter comes before the Court on Defendants’ Motion for Judgment on the Pleadings for Count III Breach of Fiduciary Duty of the Second Amended Complaint (Doc. #114) filed on December 26, 2019. Plaintiff filed an Opposition to Defendants’ Motion (Doc. #121) on January 8, 2020. For the reasons set forth below, the motion is granted. I. This case is before the Court on Plaintiff’s seven-count Second Amended Complaint alleging claims for breach of contract (Counts I, II), breach of fiduciary duty (Count III), and RICO violations (Counts IV-VI). (Doc. #87.) The Court previously

granted Defendants’ Motion to Dismiss Counts IV, V, VI (RICO claims) of Plaintiff’s Second Amended Complaint. (Docs. ##92, 103). Defendants now seek judgment on the pleadings on the breach of fiduciary duty claim in Count III. Defendants argue that regardless of whether New York or Florida law applies, the pleadings establish there was no fiduciary duty owed by any Defendant to the insured in connection with the insured’s first- party claim. (Doc. #114, p. 1.) Plaintiff, on the other hand,

contends that both Florida and New York law impose a fiduciary duty upon all Defendants in a first-party claim where there is a “special relationship of trust and confidence” with the insured. Plaintiff asserts that such a relationship is sufficiently alleged in the Second Amended Complaint and supporting exhibits, and therefore the motion must be denied. (Doc. #121, p. 2.) II. The Federal Rules of Civil Procedure provide that "[a]fter the pleadings are closed but within such time as not to delay the trial, any party may move for judgment on the pleadings." FED. R. CIV. P. 12(c). “Judgment on the pleadings is proper when there are

no material facts in dispute, and the moving party is entitled to judgment as a matter of law” based on the substance of the pleadings and any judicially noticed facts. Palmer & Cay, Inc. v. Marsh & McLennan Cas., Inc., 404 F.3d 1297, 1303 (11th Cir. 2005). See also Interline Brands, Inc. v. Chartis Spec. Ins. Co., 749 F.3d 962, 965 (11th Cir. 2014). The Court may consider the complaint and any exhibits attached thereto, as well as the answer and any attached exhibits that are undisputedly authentic and central to the claim. Horsley v. Feldt, 304 F.3d 1125, 1134-35 (11th Cir. 2002); Eisenberg v. City of Miami Beach, 54 F. Supp. 3d 1312, 1319 (S.D. Fla. 2014). All facts alleged in the complaint are viewed in the light most favorable to the nonmoving party. Cunningham v. Dist. Attorney’s Office for Escambia Cnty., 592 F.3d

1237, 1255 (11th Cir. 2010). “Legal conclusions without adequate factual support are entitled to no assumption of truth.” Mamani v. Berzain, 654 F.3d 1148, 1153 (11th Cir. 2011).1 III. Plaintiff Marcus Allen (Plaintiff or Dr. Allen) is a former Diagnostic Radiologist and partner in Prospect Hill Radiology Group, P.C. located in Syracuse, New York. From 1986 through 1989, Plaintiff purchased four individual disability insurance policies (the Individual Policies) from Provident Life & Casualty Insurance Company (Provident). (Doc. #87, ¶¶ 21-28; Docs. ##87-1, 87-2, 87-

1 The Court strikes Plaintiff’s Declarations (Docs. ##43-1; 74-1), which were not attached to the Second Amended Complaint or any other pleading, and declines to convert the motion into a summary judgment motion. Plaintiff’s arguments based upon the summary judgment legal standard are therefore misplaced. Frattallone v. Black Diamond Coating, Inc., No. 8:14-cv-2818-T-33TBM, 2015 U.S. Dist. LEXIS 13904, at *4, 6 (M.D. Fla. Feb. 5, 2015) (declining to convert defendants’ motion for judgment on the pleadings into a motion for summary judgment, noting "[t]he court has a broad discretion when deciding whether to treat a motion [for judgment on the pleadings] as a motion for summary judgment . . ." ). As stated above, however, the facts alleged in the Second Amended Complaint are viewed in the light most favorable to Dr. Allen as the non-moving party. 3, 87-4.) In 2005, Plaintiff became part of a work-related group disability insurance policy (the Group Policy) issued by First Unum Life Insurance Company (First Unum). (Id., ¶¶ 36-37; Doc. #87-5.) All five policies (collectively “the Policies”) provided “own occupation” disability income insurance coverage during the relevant time periods.2 Claims made under the Policies were

administered by Unum Group (Doc. #87, ¶ 14), and Plaintiff alleges in summary fashion that the three defendants are alter egos of each other. (Id., ¶ 10). In May 2010, Dr. Allen began suffering changes in his vision which prevented him from performing the acute visual analysis required of a diagnostic radiologist. (Doc. #87, ¶¶ 47-49.) Dr. Allen was examined by three separate physicians and was ultimately diagnosed with ocular degeneration, posterior vitreous detachment with retinal tear, and bleeding in his left eye, as well as significant floaters and visual disturbances in both eyes detrimentally impacting his visual field. (Id., ¶ 50.) Dr. Allen

resigned from his radiology practice on June 23, 2010, and filed a claim for disability benefits with Defendants asserting that he became totally disabled as of May 1, 2010. (Id., ¶¶ 51-55.)

2 The Group Policy was ultimately changed from an “own occupation” policy to an “any occupation” policy. (Id., ¶ 68.) Defendants agreed Plaintiff was totally disabled, and paid Dr. Allen monthly benefits pursuant to the Policies for the next five years. On August 31, 2015, however, Defendants determined that Dr. Allen failed to support the continued existence of his permanent disability with objective medical findings. (Id., ¶¶ 56- 57, 59, 113.) While continuing to pay disability benefits,

Defendants requested Dr. Allen’s medical records as part of periodic medical reviews, and Dr. Allen was required to apply for Social Security disability benefits. (Id., ¶¶ 70, 72, 76, 105.) The Social Security Administration (SSA) determined that Dr. Allen was incapable of performing the occupation of diagnostic radiologist since June 2010, but that he could perform other work. (Doc. #87, ¶¶ 77, 101-102.) Defendants thereafter required plaintiff to undergo independent medical examinations (IMEs) with its chosen physicians. Defendants used the IMEs to find that Dr. Allen was no longer disabled. (Id., ¶¶ 105 106, 110, 113-114.) Although Dr.

Allen’s field of vision never improved, Defendants determined that he could return to his own occupation as a Diagnostic Radiologist, and therefore terminated his benefits under the Policies. (Id., ¶¶ 114, 129, 134.) In Count I, Dr. Allen sues Provident and the Unum Group for breach of the Individual Policies contracts. (Doc. #87, ¶¶ 198- 218.) In Count II, Dr. Allen sues First Unum and the Unum Group for breach of the Group Policy contract. (Id., ¶¶ 219-240.) Neither of these claims are currently before the Court. In Count III, Dr. Allen alleges that the termination of his benefits under the Policies constituted a breach of Defendants’ fiduciary duty to him. (Doc. #87, ¶¶ 246-248.) Specifically, Plaintiff asserts that he had a fiduciary relationship with all

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Allen v. First UNUM Life Insurance Company, Counsel Stack Legal Research, https://law.counselstack.com/opinion/allen-v-first-unum-life-insurance-company-flmd-2020.