Canada Life Assurance Co. v. Salwan

817 N.E.2d 1021, 353 Ill. App. 3d 74, 288 Ill. Dec. 371, 2004 Ill. App. LEXIS 1153
CourtAppellate Court of Illinois
DecidedSeptember 28, 2004
Docket1-03-0549
StatusPublished
Cited by14 cases

This text of 817 N.E.2d 1021 (Canada Life Assurance Co. v. Salwan) is published on Counsel Stack Legal Research, covering Appellate Court of Illinois primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Canada Life Assurance Co. v. Salwan, 817 N.E.2d 1021, 353 Ill. App. 3d 74, 288 Ill. Dec. 371, 2004 Ill. App. LEXIS 1153 (Ill. Ct. App. 2004).

Opinion

JUSTICE HALL

delivered the opinion of the court:

The plaintiff, Canada Life Assurance Company, filed a declaratory judgment action against the defendant, Ayodhia Salwan, seeking determination that it was entitled to a refund of money paid to the defendant, based upon a reimbursement agreement between the parties. The defendant filed a counterclaim for benefits he alleged were wrongfully withheld from him by the plaintiff. The circuit court of Cook County entered judgment in favor of the plaintiff on its complaint and entered summary judgment in favor of the plaintiff on the defendant’s counterclaim. The defendant appeals only the dismissal of his counterclaim.

The sole issue on appeal is whether the trial court erred in granting summary judgment to the plaintiff on the defendant’s counterclaim. The following facts are taken from the pleadings, affidavits and depositions contained in the record on appeal.

The defendant had been employed by Abrasive-Form as a grinder since 1979. Abrasive-Form provided its employees with disability benefits under a policy with the plaintiff. In 1990, the defendant was injured in an automobile accident, unrelated to his employment, and informed his employer that he could no longer perform his job. Effective, May 5, 1990, the plaintiff began paying disability benefits to the defendant in the amount of $1,144 gross per month.

The disability policy provided in pertinent part as follows:

“Proof of continued disability and regular attendance of a physician must be given to us within thirty days of the date we request the proof. The proof must cover:

1. The date the disability began.

2. The cause of the disability.

3. How serious the disability is.”

The disability policy further provided that the payments under the policy would be reduced by income received from other sources and contained the following provision:

“If, at the time of calculating the amount of any payments to be made under this policy, the benefit which a person is entitled to apply for and receive under any other source described in this provision has not been awarded nor denied, we will estimate the amount of such benefit. The estimate will be used to reduce the amount of the payments under this policy until such time as the benefit under such source has been awarded or denied. However, such estimate will not be used if, within six months of becoming disabled, the person meets both the following conditions.

1. The person has applied for the benefit under the other sources; and

2. The person completes and signs our Reimbursement Agreement. This agreement states that the person promises to repay to us any overpayment caused by an award of the benefit under the other source.”

On February 5, 1993, the defendant signed the reimbursement agreement, acknowledging that he had made a claim with the Social Security Administration. In consideration for the plaintiff s payment of the full monthly disability benefit to him, upon payment of his claim, the defendant agreed to “refund immediately to [the plaintiff] the amount awarded to the extent of the full amount they paid us under this Agreement.” On March 24, 1994, the defendant was awarded $800 in monthly social security benefits, retroactive to February 3, 1990.

The defendant had submitted proof of continuance of disability claim and attending physician’s statement of disability forms in 1991 and 1992. In a June 10, 1993, letter to the defendant, the plaintiff advised the defendant that if he did not provide it with updated medical information within 30 days, his claim may be terminated. The plaintiff sent the required information on June 24, 1993.

In an April 15, 1994, letter to the defendant, the plaintiff referenced a February 2, 1994, visit by its representatives to the defendant and requested that the defendant furnish the name and address of the physician he had seen and the address of the hospital where he had undergone testing. The letter also requested the name and address of the attorney representing the defendant in the litigation over medical bills.

On June 14, 1994, the plaintiff notified the defendant that it had received the information regarding the $800 social security payments the defendant was now receiving and that his new net monthly benefit would be $344. The plaintiff calculated its overpayment to the defendant to be $36,800 and requested that the defendant reimburse that sum to the plaintiff within 15 days. The letter also advised the defendant that it would not issue any further benefits until the overpayment was recovered in full.

On July 19, 1994, the defendant wrote to the plaintiff acknowledging that the plaintiff had ceased paying him his monthly benefit and that the plaintiff wanted the $36,800. The defendant also acknowledged the plaintiffs April 15, 1994, letter and advised that his attorney had died and nothing was happening in the case. Finally, the defendant pleaded financial hardship and requested that the plaintiff send his benefit check as soon as possible. The defendant did not supply the medical information requested in the April 15, 1994, letter.

On February 20, 1995, an attorney for the plaintiff wrote to the defendant advising him as follows:

“This letter is in regards to your indebtedness to Canada Life. Originally, the amount was $36,800. I understand this amount has decreased due to withheld benefits, dating back to your failure to repay.

By agreement dated February 5, 1993, we agreed to continue your benefits unreduced until the outcome of your Social Security claim, in exchange for your agreement to immediately refund any overpayment resulting from a favorable outcome. You have breached the agreement.

Please contact me at your first convenience to discuss your prompt repayment of the indebtedness. Should you continue in breach of the agreement we shall have no choice but to continue to withhold your benefits, and to consider other appropriate legal action.”

On April 28, 1998, the plaintiff filed its verified complaint seeking a declaration that it was entitled to payment from the defendant under the terms of the reimbursement agreement and an order for payment in the amount not reimbursed by the defendant. The defendant answered the complaint on or about August 6, 1998. 1 On September 26, 2001, the defendant filed a motion to amend his pleadings to add a counterclaim. On December 17, 2001, the circuit court granted the defendant’s motion to amend.

On January 22, 2002, the plaintiff filed an amended motion for summary judgment on both its complaint and the defendant’s counterclaim.

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Cite This Page — Counsel Stack

Bluebook (online)
817 N.E.2d 1021, 353 Ill. App. 3d 74, 288 Ill. Dec. 371, 2004 Ill. App. LEXIS 1153, Counsel Stack Legal Research, https://law.counselstack.com/opinion/canada-life-assurance-co-v-salwan-illappct-2004.