Blue v. Hartford Life & Accident Insurance

698 F.3d 587, 83 Fed. R. Serv. 3d 1227, 2012 WL 4944317, 2012 U.S. App. LEXIS 21718
CourtCourt of Appeals for the Seventh Circuit
DecidedOctober 18, 2012
Docket11-3554
StatusPublished
Cited by238 cases

This text of 698 F.3d 587 (Blue v. Hartford Life & Accident Insurance) is published on Counsel Stack Legal Research, covering Court of Appeals for the Seventh Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Blue v. Hartford Life & Accident Insurance, 698 F.3d 587, 83 Fed. R. Serv. 3d 1227, 2012 WL 4944317, 2012 U.S. App. LEXIS 21718 (7th Cir. 2012).

Opinion

FLAUM, Circuit Judge.

William Blue’s insurance company, Hartford Life & Accident (“Hartford”), withdrew his long-term disability benefits after doctors indicated that his condition had improved such that he was no longer incapable of occupying “any occupation” as his policy required. After an unsuccessful appeal, Blue filed the instant lawsuit alleging breach of contract and bad faith denial of benefits. In the course of the suit, Blue discovered that Hartford had applied the incorrect standard to his policy determination. Instead of applying the “any occupa *590 tion” standard, Hartford should have applied the more lenient “own occupation” standard. After an investigation, Hartford agreed that it applied the incorrect standard, and reinstated Blue’s benefits with backpay. Hartford then filed a motion for summary judgment, arguing that Blue’s contract claim was moot and that it was entitled to summary judgment on the bad faith claim. On the day his response was due, Blue’s counsel requested an extension of time because of medical difficulties. The court granted that motion. Two days later, when Blue’s response was again due, he requested a second extension of time, this time arguing that he was missing necessary discovery. The district court denied this request, and ruled on Hartford’s summary judgment motion without Blue’s response, concluding that Blue’s contract claim was moot and that Hartford was entitled to summary judgment on the bad faith claim.

For the reasons set forth below, we affirm.

I. Background

William Blue, a bus driver for the City of Madison, Wisconsin, was insured under a group long-term and short-term disability plan issued by Hartford. On September 10, 1998, Blue stopped working because of chronic headaches, and on September 18, Hartford approved his request for short-term disability (“STD”) benefits. After being diagnosed with sphenopalatine ganglion neuralgia, a condition that subjects the victim to chronic “ice cream headaches,” Blue applied for long-term disability (“LTD”) benefits, which Hartford approved. When Blue applied for STD and LTD benefits respectively, the qualifying criterion for the two policies differed. To qualify for STD benefits, Blue needed to show that he was unable to perform the duties of his own occupation. To qualify for LTD benefits, in contrast, he needed to show that he was prevented from doing “any occupation or work for which he was or could become qualified by training, education or experience.” It is more difficult for a claimant to satisfy the “any occupation” standard.

On February 5, 2002, Hartford amended its LTD-insurance policy with the City, retroactive to February 1, 1993. The amendment changed the LTD policy’s definition of disability from the original “any occupation” standard, to the more lenient “own occupation” standard.

When Blue applied for LTD benefits on March 29, 2001, the applicable LTD policy required a claimant to satisfy the “any occupation” standard. Blue was able to meet that standard, and he received LTD benefits for seven years. Each year, Hartford received a physician’s statement reporting on Blue’s condition, and by 2008, medical records suggested that his condition had improved significantly enough to allow him to return to work. Specifically, Blue’s cardiologist reported that Blue had “improved cranial nerves” and acknowledged that his condition had improved. In May 2007, Maureen Van Dinter, a nurse practitioner and Blue’s primary medical provider, reported that Blue was “beginning to notice significant improvement in his headaches” due to new medication and that she anticipated he would be able to return to work in six to eight months. In response to a letter from Hartford in July 2008, Van Dinter indicated that Blue was capable of performing full-time light or sedentary work. Hartford’s inquiry had focused on whether Blue could return to work at all, rather than whether he was capable of returning to work as a bus driver.

Hartford sent Blue a letter on September 24, 2008 notifying him that he was no *591 longer eligible for LTD benefits. The letter quoted the “any occupation” language from Blue’s original policy. The application of this standard, however, was a mistake. Hartford should have applied the more lenient “own occupation” standard that had become part of the policy pursuant to the 2002 retroactive amendment. Based on various reports from and conversations with Blue’s doctors, Hartford denied Blue’s claim for LTD benefits. Blue filed an appeal with Hartford challenging the decision, but his appeal was denied. Blue did not challenge the application of the “any occupation” standard at that time.

Hartford explains the application of the wrong standard as an innocent mistake caused by cross-office inefficiencies. The 2008 letter terminating Blue’s LTD benefits was issued by Madeline Farrell, who was located in Hartford’s Georgia office where Blue’s claim was first evaluated. When Farrell requested a copy of the applicable policy for Blue’s claim in 2008, Hartford’s Minneapolis office provided her with the “any occupation” policy that was in effect at the time of Hartford’s initial approval of Blue’s LTD benefits in 2001. The claim file does not reflect that the Minneapolis office sent Farrell the 2002 retroactive amendment. Accordingly, Farrell analyzed the file under the wrong disability definition.

Following his unsuccessful appeal, Blue retained counsel and filed suit in Wisconsin state court alleging (1) breach of contract and (2) bad faith denial of benefits. Hartford timely removed the lawsuit to the district court. The parties eventually filed cross-motions for summary judgment, Hartford on Blue’s bad faith claim, and Blue on the breach of contract claim. Blue’s filing of his motion for summary judgment began a series of missed deadlines by Blue’s counsel. Blue’s initial motion was due on January 31, 2011, but Blue’s counsel missed the deadline and asked for an extension on February 7, 2011. Blue’s counsel cited a long list of personal hardships that prevented him from filing on time: the death of a friend, the death of an aunt, the death of his uncle, and a series of illnesses (cold, bronchitis, torn retina, recurrence of torn retina, obstructed vision, food poisoning, fever, and a partially collapsed lung). He also indicated that his only associate had left his law firm. The court granted the motion and gave him until February 8, 2011 to file his motion for summary judgment. Blue’s counsel missed the new February 8 deadline, claiming technical problems with his office computer. Blue eventually filed his motion for summary judgment on February 10, 2011 and asserted for the first time that Hartford applied the incorrect standard to his claim.

Hartford investigated the allegation that it applied the wrong standard, and discovered that Blue was correct. On March 17, 2011, Hartford filed a motion with the district court acknowledging the mistake. The motion included an affidavit from Bruce Luddy, Hartford’s Director of Litigation and Appeals, explaining the cross-office inefficiencies that led to the application of the “any occupation” standard rather than the “own occupation” standard. Hartford admitted liability, reinstated Blue’s LTD benefits, and issued Blue a check for retroactive benefits dating from September 24, 2008, the date on which Hartford terminated his benefits.

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Bluebook (online)
698 F.3d 587, 83 Fed. R. Serv. 3d 1227, 2012 WL 4944317, 2012 U.S. App. LEXIS 21718, Counsel Stack Legal Research, https://law.counselstack.com/opinion/blue-v-hartford-life-accident-insurance-ca7-2012.