Bombaugh v. Unum Life Insurance Company of America

• Court: Massachusetts Appeals Court
• Decided: March 4, 2026
• Docket: AC 24-P-946
• Status: Published

Opinion

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24-P-946 Appeals Court

MARYANNE BOMBAUGH vs. UNUM LIFE INSURANCE COMPANY OF AMERICA & another.1

No. 24-P-946.

Worcester. December 10, 2025. – March 4, 2026.

Present: Blake, C.J., Hand, & Toone, JJ.

Insurance, Disability insurance, Construction of policy. Contract, Insurance, Construction of contract, Performance and breach. Practice, Civil, Summary judgment.

Civil action commenced in the Superior Court Department on December 30, 2021.

The case was heard by Valerie A. Yarashus, J., on motions for summary judgment, and entry of final judgment was ordered by her.

Joseph M. Hamilton for the defendants. Mala M. Rafik for the plaintiff.

BLAKE, C.J. Defendant Unum Life Insurance Company of

America (Unum Life) issued a disability income policy to the

plaintiff, Maryanne Bombaugh, in 1992 and has paid benefits to

1 Unum Group. 2

her under the terms of that policy since 2008. Following a

dispute over whether Unum Life had to increase the amount of

Bombaugh's benefits annually after she turned sixty-five years

old, Bombaugh brought suit against Unum Life and its parent

company, Unum Group. On cross motions for summary judgment, a

Superior Court judge concluded that the policy language was

ambiguous and construed it in Bombaugh's favor. Judgment

entered for Bombaugh for breach of contract.2 Unum Life and Unum

Group appeal. We reverse.

Background. The following facts are undisputed. As noted,

Unum Life issued a disability income policy to Bombaugh in 1992.

The policy was intended to provide replacement income to

Bombaugh in the event that she became unable to perform the

duties of her occupation due to a disability.

The policy included a base policy plus some riders that

expanded the coverage provided for in the base policy. The base

policy provided that Unum Life would pay a total disability

benefit as follows:

"We will pay the Maximum Disability Benefit in any month after you have satisfied the Elimination Period that:

"1. you are totally disabled; and

2 Bombaugh also brought claims for violations of G. L. c. 93A, and breach of the implied covenant of good faith and fair dealing. Those claims were resolved in favor of Unum Life and Unum Group. Bombaugh did not cross-appeal, and thus, there are no issues as to them in this appeal. 3

"2. your total disability is a result of the injury or sickness which caused you to satisfy the Elimination Period.

"The Total Disability Benefit will not be paid beyond the Maximum Benefit Period."3

Under the base policy, the monthly maximum disability benefit

was $9,371, and the maximum benefit period was the later of (1)

the policy anniversary after Bombaugh turned sixty-five years

old or (2) twenty-four months after disability payments began.

As pertinent here, additional language in two riders

expanded this coverage. First, a lifetime sickness benefit

rider affected the duration of the maximum benefit period. It

provided that Unum Life would continue to pay the maximum

disability benefit "[b]eginning on the later of the policy

anniversary when your age is 65 or the end of the Maximum

Benefit Period," provided that, among other things, the total

disability "is the result of sickness which began before the

policy anniversary when your age was 60 and while this rider was

in effect."

3 "Elimination Period" was defined as "the number of days stated on [the policy schedule] preceding the date benefits become payable . . . , during which you are totally or residually disabled. The Elimination Period begins on the first day that you are totally or residually disabled." 4

Second, a cost-of-living adjustment rider affected the

amount of the maximum disability benefit and provided as

follows:

"On each anniversary of the first day of a period of disability which began while this rider was in effect, we will increase the Maximum Disability Benefit by multiplying the Maximum Disability Benefit in effect on the first day of the disability by the [Consumer Price Index for All Urban Consumers] Factor to determine the new Maximum Disability benefit if:

"1. you are disabled;

"2. the disability is caused by an injury that occurs, or by a sickness that begins, after this rider became effective; and

"3. the policy anniversary when your age is 65 has not occurred."

The cost-of-living adjustment rider further provided, "If you

are disabled on the policy anniversary when your age is 65,

future payments for that disability will be based on the Maximum

Disability Benefit in effect on that policy anniversary."4

In 2008, Bombaugh became unable to perform the duties of

her occupation as an obstetrician and gynecologist, and Unum

Life began paying the maximum disability benefit to her.

4 The cost-of-living adjustment rider also included a termination provision, which specified that the rider would terminate on the earliest of (1) "the policy anniversary when your age is 65 except with respect to a disability which exists on that policy anniversary," (2) "the date we receive your request to terminate this rider," or (3) "the date the policy terminates." It is undisputed that the triggers for termination have not occurred and that the cost-of-living adjustment rider remains in effect. 5

Pursuant to the cost-of-living adjustment rider, Unum Life

increased the amount of the maximum disability benefit annually

but stopped doing so on the policy anniversary after Bombaugh

turned sixty-five years old. At that time, Bombaugh's monthly

maximum disability benefit was $14,421.03, which equaled the

original maximum disability benefit of $9,371 plus $5,050.03 in

increases. Since then, Unum Life has continued to pay Bombaugh

a monthly maximum disability benefit of $14,421.03, which

includes the $5,050.03 in increases that had accrued prior to

her sixty-fifth birthday.

Discussion. Unum Life argues that, under the terms of the

policy including all the riders, Bombaugh's maximum disability

benefit effectively froze on the policy anniversary after she

turned sixty-five years old. Unum Life does not dispute that

Bombaugh's maximum disability benefit continues to include the

cost-of-living adjustment increases that accrued prior to her

sixty-fifth birthday, only that Bombaugh's maximum disability

benefit is not subject to any additional increases. Bombaugh,

however, argues that Unum Life must continue to increase the

amount of her maximum disability benefit annually.

The question presented turns on the interpretation of the

policy, which is a question of law that we review de novo. See

Green Mountain Ins. Co. v. Wakelin, 484 Mass. 222, 226 (2020).

"[T]he rules governing the interpretation of insurance contracts 6

are the same as those governing the interpretation of any other

contract" (citation omitted). Sullivan v. Southland Life Ins.

Co., 67 Mass. App. Ct. 439, 442 (2006). Our "objective is to

construe the [insurance policy] as a whole, in a reasonable and

practical way, consistent with its language, background, and

purpose" (citation omitted). Id. If the language of an

insurance policy is unambiguous, then we construe the words

according to their plain meaning. See id. The language of an

insurance policy "is ambiguous only if it is susceptible of more

than one meaning and reasonably intelligent persons would differ

as to which meaning is the proper one" (citation omitted). Id.

at 443. Controversy between the parties does not alone create

an ambiguity, nor does difficulty in comprehension. See id.

Here, the focus of the parties' dispute is on the language

providing that, "[o]n each anniversary," Unum Life will increase

the maximum disability benefit if, among other things, "the

policy anniversary when your age is 65 has not occurred." This

provision sets forth a requirement that Bombaugh had to meet on

each anniversary for Unum Life to increase her maximum

disability benefit that year. On the policy anniversary after

Bombaugh turned sixty-five years old, she no longer met the

requirement. Accordingly, Unum Life stopped increasing

Bombaugh's maximum disability benefit in accordance with the

terms of the policy. 7

We are not persuaded by Bombaugh's argument that this

interpretation does not give full effect to the lifetime

sickness benefit rider. The lifetime sickness benefit rider

addresses the duration of the maximum benefit period, not the

amount of the maximum disability benefit. Consistent with the

lifetime sickness benefit rider, Unum Life continues to pay

Bombaugh the maximum disability benefit, as that benefit had

been adjusted under the cost-of-living adjustment rider.

Likewise, we are not persuaded by Bombaugh's argument that

the language requiring Unum Life to increase the maximum

disability benefit on each anniversary if certain criteria are

satisfied is ambiguous. Bombaugh argues that the provision

could be interpreted to set forth criteria that she had to

satisfy only at one point in time -- when she became unable to

perform the duties of her occupation. However, that is not what

the provision says.

First, we look to the grammatical structure of the

provision. See DeWolfe v. Hingham Ctr., Ltd., 464 Mass. 795,

803 (2013). The provision includes (1) an action (on each

anniversary, Unum Life will increase the amount of the maximum

disability benefit) and (2) a conditional clause that must be

satisfied for the action to occur. In ordinary usage, where a

sentence contemplates that an action may recur, the conditional

clause must be satisfied at each recurrence. Take, for example, 8

the following sentence: on the 15th of every month, you must

pay a $100 late fee if your balance has not been paid in full.

That sentence sets forth a test that must be satisfied on the

15th of every month, not a one-time test that must be satisfied

at an unspecified point in time. Likewise, here, the

conditional clause sets forth a test that must be satisfied on

each anniversary for the action to occur that year.

Second, Bombaugh's interpretation does not read the policy

as written. See Continental Cas. Co. v. Gilbane Bldg. Co., 391

Mass. 143, 147 (1984). To create a one-time test that Bombaugh

had to satisfy only when she became unable to perform the duties

of her occupation, Unum Life would have needed to include

additional language tying the conditional clause to that moment

in time. For example, the provision could have said that Unum

Life will increase the maximum disability benefit on each

anniversary if, at the time the disability begins, the policy

anniversary when the insured's age is sixty-five has not

occurred. Where no such language was included, the ordinary

interpretation, as discussed above, would be that Bombaugh had

to satisfy the conditional clause at each recurrence.

Third, Bombaugh's interpretation would render some of the

language of the provision superfluous. See Sherman v.

Employers' Liab. Assur. Corp., 343 Mass. 354, 357 (1961) ("An

interpretation which gives a reasonable meaning to all of the 9

provisions of a contract is to be preferred to one which leaves

a part useless or inexplicable"). The provision sets forth

three criteria that must be satisfied for Unum Life to increase

the maximum disability benefit: (1) "you are disabled," (2)

"the disability is caused by an injury that occurs, or by a

sickness that begins, after this rider became effective," and

(3) "the policy anniversary when your age is 65 has not

occurred." If Bombaugh's interpretation were correct, the first

requirement would redundantly read that Unum Life will adjust

the amount of the maximum disability benefit on each anniversary

if, at the time the disability begins, the insured is disabled.

Separately, Bombaugh's interpretation does not give effect

to all the language in the cost-of-living adjustment rider. See

Verveine Corp. v. Strathmore Ins. Co., 489 Mass. 534, 538-539

(2022). As indicated, the cost-of-living adjustment rider

includes the following additional language: "If you are

disabled on the policy anniversary when your age is 65, future

payments for that disability will be based on the Maximum

Disability Benefit in effect on that policy anniversary." This

language again frames the policy anniversary after an insured

has turned sixty-five years old as a point at which the maximum

disability benefit is calculated differently. When read in

conjunction with the language providing that Unum Life will

increase the amount of the maximum disability benefit if "the 10

policy anniversary when your age is 65 has not occurred," the

two provisions establish that the cost-of-living adjustment

increases stop on the policy anniversary after an insured has

turned sixty-five years old. Unum Life's interpretation -- that

the cost-of-living increases stop but that an insured continues

to receive the increases that previously accrued -- gives full

effect to both provisions. Bombaugh's interpretation -- that

she should continue to receive cost-of-living increases after

her sixty-fifth birthday -- does not.

We acknowledge that there are ways Unum Life could have

made it even clearer that it would stop increasing the amount of

the maximum disability benefit after Bombaugh turned sixty-five

years old. Bombaugh suggests, for example, that the cost-of-

living adjustment rider could have provided that increases to

the maximum disability benefit will freeze on the policy

anniversary after an insured has turned sixty-five years old.

However, the fact that different language could have been even

clearer does not render the language used ambiguous. Reading an

insurance policy is often a formidable task, and "difficulty in

comprehension does not equate with ambiguity."5 Massachusetts

5 Given our conclusion, we need not address additional arguments raised by the parties, including Unum Group's argument that it is not a proper party to this lawsuit. 11

Prop. Ins. Underwriting Ass'n v. Wynn, 60 Mass. App. Ct. 824,

827 (2004).

Conclusion. The judgment entered in favor of Bombaugh on

her breach of contract claim is reversed, and a new judgment

shall enter dismissing the complaint.

So ordered.