Brooks v. JC PENNEY LIFE INSURANCE CO.

231 F. Supp. 2d 1136, 2002 U.S. Dist. LEXIS 22454, 2002 WL 31554101
CourtDistrict Court, N.D. Alabama
DecidedJuly 30, 2002
DocketCIV.A.00-JEO-3045-NE
StatusPublished

This text of 231 F. Supp. 2d 1136 (Brooks v. JC PENNEY LIFE INSURANCE CO.) is published on Counsel Stack Legal Research, covering District Court, N.D. Alabama primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Brooks v. JC PENNEY LIFE INSURANCE CO., 231 F. Supp. 2d 1136, 2002 U.S. Dist. LEXIS 22454, 2002 WL 31554101 (N.D. Ala. 2002).

Opinion

MEMORANDUM OPINION

OTT, United States Magistrate Judge.

This matter is before the court on the defendant’s motion for summary judgment filed on August 23, 2001. (Doc. 18). 1 Also before the court is the “Plaintiffs Motion *1138 to Allow a Reply Brief in Opposition to the Defendant’s Motion for Summary Judgment,” filed on June 28, 2002, (doc. 35), and the defendant’s motion to supplement the record (doc. 39). Upon consideration of the record, the submissions of the parties and the relevant law, the court finds that the defendant’s motion for summary judgment is due to be granted, the “Plaintiffs Motion to Allow a Reply Brief in Opposition to the Defendant’s Motion for Summary Judgment” is due to be denied, and the defendant’s motion to supplement the record is due to be denied.

1. PROCEDURAL BACKGROUND

Plaintiff Annette T. Brooks (“Mrs. Brooks” or “plaintiff’) claims that defendant J.C. Penney Life Insurance Company (“JCPL” or “defendant”) committed breach of contract, a variety of torts and bad faith failure to pay when, upon the death of the plaintiffs spouse, JCPL denied a claim the plaintiff made under an accidental death and dismemberment policy it had issued to her and her spouse. The plaintiff initially filed this action in the Circuit Court of Cullman County on September 27, 2000, and JCPL removed it to this court on October 27, 2000. (Doc. 1).

JCPL filed the instant motion for summary judgment on August 23, 2001, arguing that it is due summary judgment with respect to all of the plaintiffs’ claims. (Docs.18, 21). The plaintiff responded, arguing that the court should deny JCPL’s motion for summary judgment as to the breach of contract and bad faith claims, but conceding that summary judgment is due as to all the other claims. 2 (Doc. 25 at 1-2). The court will therefore address the motion only as it pertains to the breach of contract and bad faith claims asserted by the plaintiff.

II. FACTUAL BACKGROUND 3

Mrs. Brooks purchased and was issued Certificate of Insurance Number 74AY193130 (the “Certificate”) by JCPL under a group policy of accidental death and dismemberment insurance, Policy Number 25292, issued to J.C. Penney Company, Inc. (the “Policy”), which provided accident insurance coverage for Mrs. Brooks and her husband. (See Doc. 20 at Exs. 1-2). The benefits described under Parts I and II of the Certificate are inapplicable here, as they concern injuries associated with travel. (Doc. 20, Ex. 1 at 4). The benefits described under Part III are for “all other injuries resulting in a loss.” (Id.). Part III describes benefits due “[i]f a Covered Person is: 1. Injured in an accident not covered under Part I or Part II; and 2. not otherwise excluded in the policy.” (Id.). “Injury” is defined by the Policy as “bodily injury caused by an accident occurring while the insurance is in force resulting: 1. directly and independently of all other causes.” (Id. at 3). Certain losses and injuries are excluded from coverage. In pertinent part, the Certificate states that “[n]o benefit shall be paid for Loss or Injury that:... 7. is due to disease; bodily or mental infirmity; or medical or surgical treatment of these.” (Doc. 20, Ex. 1 at 5).

On March 12, 1999, Mr. Brooks went to Dr. Ben Bostick’s office, complaining of a *1139 history of increasing abdominal distention and swelling in his lower extremities. (Doc. 20 at Ex. 3). Dr. Bostick took an x-ray, which showed a “rather significant right pleural effusion.” (Id.). In his notes, Dr. Bostick stated as follows: “With his chronic smoking and the history of a questionable lung mass in the past by pri- or chart review, I think it’s prudent to go ahead and do a CT of the chest to make sure there’s no intrathoracic process going on.” (Id.). Dr. Bostick referred Mr. Brooks to the Woodland Medical Center, where a CT scan of Mr. Brooks’s chest was performed on March 15, 1999, revealing a “[l]arge right-side pleural effusion probably on the order of 1500-1800 cc’s.” (Id. at Ex. 5). After the CT scan procedure, Mr. Brooks developed a rash and his condition deteriorated. (Id.). He died in spite of the attempts of medical personnel to resuscitate him. (Id.). On his death certificate, the immediate cause of death is listed as “Anaphylactic Reaction to IV contrast,” 4 due to or as a consequence of right pleural effusion and possible lung cancer. (Id. at Ex. 11).

Mrs. Brooks alleged in her deposition that Mr. Brooks died because the medical personnel erroneously administered Lido-caine to him in the course of responding to his anaphylactic reaction. JCPL summarizes this allegation as follows:

Even though the available medical records do not provide additional information, Annette Brooks testified that Lido-caine was mistakenly administered to Mr. Brooks during treatment of this [anaphylactic] reaction. Specifically, she testified, “The Lidocaine is what killed him.” (Deposition of Annette Brooks, p. 58, excerpt attached as Exhibit “6” to Defendant’s Evidentiary Submission) [Doc. 20, Ex. 6 at 58]. Thus, Mrs. Brooks testified that Lidocaine was administered during the course of medical treatment for Mr. Brooks’ anaphylactic reaction, clearly an additional infirmity affecting Mr. Brooks.

(Doc. 21 at 3, n. 3). It is not entirely clear from her deposition testimony how Mrs. Brooks obtained this information. The court notes that it is not reflected in the medical records before the court, nor is it otherwise substantiated by the record evidence.

Mrs. Brooks made a claim for benefits under the Policy, characterizing Mr. Brooks’s death as being caused by “accidental anaphylactic reaction to IV contrast,” which claim was denied by JCPL after it had reviewed documents and records it had gathered pertaining to the claim. (Doc. 20 at Exs. 4, 7, 9). In a letter to Mrs. Brooks, JCPL explained its denial as follows:

This policy provides benefits for the death of a covered person due to accidental bodily injury resulting directly and independently of all other causes. We refer you to the Exclusions on page 5 of the policy. It states, “No benefit shall be paid for Loss of [sic] Injury that:... 7. is due to disease; bodily or mental infirmity; or medical or surgical treatment of these.”
According to the death certificate, your husband’s death was due to anaphylactic reaction to intravenous contrast due to right pleural effusion due to possible cancer of the lung. The medical records received from Dr. Bostick and Woodland Medical Center indicated your husband’s death followed a medical procedure that was performed for a disease. Based upon this information and the above exclusion, we are unable to provide bene *1140 fits. It appears your husband’s death does not come under the coverage terms of the policy.

(Doc. 20 at Ex. 9).

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Bluebook (online)
231 F. Supp. 2d 1136, 2002 U.S. Dist. LEXIS 22454, 2002 WL 31554101, Counsel Stack Legal Research, https://law.counselstack.com/opinion/brooks-v-jc-penney-life-insurance-co-alnd-2002.