Cherri Walker v. Life Insurance Company of North America

59 F.4th 1176
CourtCourt of Appeals for the Eleventh Circuit
DecidedFebruary 8, 2023
Docket21-12493
StatusPublished
Cited by18 cases

This text of 59 F.4th 1176 (Cherri Walker v. Life Insurance Company of North America) is published on Counsel Stack Legal Research, covering Court of Appeals for the Eleventh Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Cherri Walker v. Life Insurance Company of North America, 59 F.4th 1176 (11th Cir. 2023).

Opinion

USCA11 Case: 21-12493 Document: 53-1 Date Filed: 02/08/2023 Page: 1 of 38

[PUBLISH] In the United States Court of Appeals For the Eleventh Circuit

____________________

No. 21-12493 ____________________

CHERRI WALKER, Plaintiff-Appellant, versus LIFE INSURANCE COMPANY OF NORTH AMERICA,

Defendant-Appellee.

Appeal from the United States District Court for the Northern District of Alabama D.C. Docket No. 5:16-cv-00506-HNJ ____________________ USCA11 Case: 21-12493 Document: 53-1 Date Filed: 02/08/2023 Page: 2 of 38

2 Opinion of the Court 21-11736

Before LAGOA and BRASHER, Circuit Judges, and BOULEE,* District Judge. LAGOA, Circuit Judge: This case arises from an insurance dispute between Cherri Walker and Life Insurance Company of North America (“LINA”). Between 2013 and 2015, LINA made multiple determinations that Walker did not qualify for disability benefits under her long-term disability insurance policy and her life insurance policy. In re- sponse, Walker sued LINA for breach of contract and bad-faith fail- ure to provide insurance benefits. The district court granted summary judgment for LINA on Walker’s bad-faith claim based on the multiple medical opinions that supported LINA’s determinations. At a pre-trial hearing, the district court held that, under Alabama law, Walker could not re- cover mental anguish damages for her breach of contract claim and excluded evidence of such damages. Finally, following a jury ver- dict in Walker’s favor on the breach of contract claim related to the long-term disability insurance policy, the district court determined that Walker was entitled to simple pre-judgment interest at a rate of 1.5 percent under the policy and simple post-judgment interest at a rate of 0.08 percent pursuant to 28 U.S.C. § 1961. In determin- ing that the long-term disability insurance policy provided for sim- ple rather than compound interest, the district court struck a

* Honorable J.P. Boulee, United States District Judge for the Northern District of Georgia, sitting by designation. USCA11 Case: 21-12493 Document: 53-1 Date Filed: 02/08/2023 Page: 3 of 38

21-12493 Opinion of the Court 3

document produced by Walker because it was not properly au- thenticated. Walker now argues that the district court erred at each of these steps. After careful review, and with the benefit of oral argu- ment, we affirm all of the district court’s rulings on appeal. I. FACTUAL AND PROCEDURAL HISTORY Walker is a citizen of Alabama. The Healthcare Authority of Athens Limestone Hospital (the “Authority”) is a state entity that operates the Athens Limestone Hospital in Athens, Alabama. The Authority employed Walker as a respiratory therapist and as a director. The Authority held for the benefit of its employees two group insurance policies: (1) a long-term disability insurance policy and (2) a life insurance policy.1 LINA, a citizen of Pennsylvania, issued both policies.

1 The life insurance policy provides certain disability benefits (e.g., waiver of premium, extension of coverage) separate from the disability policy. The jury did not find in Walker’s favor on the life insurance policy, however, and the issues raised in this appeal relate solely to the disability policy. Thus, while we sometimes refer to the life policy during our discussion of the factual and pro- cedural history of this case, we do not discuss in any detail the terms of that policy as they are not relevant to our consideration of the issues before us on this appeal. USCA11 Case: 21-12493 Document: 53-1 Date Filed: 02/08/2023 Page: 4 of 38

4 Opinion of the Court 21-12493

The disability policy provides for monthly disability pay- ments if an employee becomes “disabled.” The policy defines “dis- abled” as follows: The Employee is considered Disabled if, solely be- cause of Injury or Sickness, he or she is: 1. unable to perform the material duties of his or her Regular Occupation; and 2. unable to earn 80% or more of his or her In- dexed Earnings from working in his or her Regular Occupation. After Disability Benefits have been payable for 24 months, the Employee is considered Disabled if, solely due to Injury or Sickness, he or she is: 1. unable to perform the material duties of any occupation for which he or she is, or may rea- sonably become, qualified based on education, training or experience; and 2. unable to earn 60% or more of his or her In- dexed Earnings. Thus, the disability policy defines “disabled” differently, using one definition for initial claims and a more stringent definition after benefits have been payable for twenty-four months. USCA11 Case: 21-12493 Document: 53-1 Date Filed: 02/08/2023 Page: 5 of 38

21-12493 Opinion of the Court 5

Separately, for initial coverage purposes, the policy gener- ally requires an elimination period of ninety days. 2 And as relevant to interest paid on claims, the disability policy provides: Time of Payment Disability Benefits will be paid within 45 days, upon receipt of due written proof of loss, at regular inter- vals of not more than one month. Disability Benefits not paid within 45 days of receipt of due written proof of loss shall be considered overdue. The Insurance Company will pay the insured one and one-half per- cent per month on the amount of any claim which is considered overdue until it is finally settled and adju- dicated. Any balance unpaid at the end of any period for which the Insurance Company is liable will be paid at that time. On October 12, 2012, Walker ceased working at the Author- ity due to fibromyalgia, rheumatoid arthritis, and chronic pain. Walker subsequently submitted disability claims under both the disability policy and the life policy. On February 26, 2013, the Au- thority’s Director of Human Resources, Sabrina Weaver, emailed LINA. At that point, LINA had not yet approved either of Walker’s

2 In the insurance industry, the term “elimination period” refers to the length of time between the occurrence of a qualifying event/condition and the re- ceipt of benefits. Thus, under the disability policy, a disabled employee will begin receiving monthly benefits ninety days after the date of his or her disa- bility. USCA11 Case: 21-12493 Document: 53-1 Date Filed: 02/08/2023 Page: 6 of 38

6 Opinion of the Court 21-12493

disability claims. In her email, Weaver stated: “The delay in finding resolution to Ms. Walker’s request for [short-term disability] and LTD has caused her severe stress which has triggered an adrenal crash. She has an appointment with a lawyer today following her doctor’s appointment.” LINA approved Walker’s claim under the disability policy the next day. By doing so, LINA found that Walker was incapable of per- forming the material duties of her regular occupation and of earn- ing at least 80 percent of her regular earnings and therefore deter- mined that she was entitled to twenty-four months of disability benefits. For some reason, LINA designated August 12, 2012, as Walker’s date of disability, making November 11, 2012, the effec- tive start date for the disability benefits pursuant to the disability policy’s ninety-day elimination period. LINA’s long-term disability claims manager, Deborah Bacak, later acknowledged that it was a mistake to select August 12, 2012, as Walker’s date of disability given that Walker continued to work through October 12, 2012. In light of its decision to approve Walker’s claims for disability bene- fits under the disability policy, LINA also automatically provision- ally approved Walker’s claim for waiver of premium under the life policy. On July 9, 2013, LINA sent Walker a letter indicating that it was reviewing her claim for waiver of premium under the life pol- icy.

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59 F.4th 1176, Counsel Stack Legal Research, https://law.counselstack.com/opinion/cherri-walker-v-life-insurance-company-of-north-america-ca11-2023.