Colonial Penn Life Ins. Co. v. Parker

362 F. Supp. 3d 380
CourtDistrict Court, S.D. Texas
DecidedJanuary 24, 2019
DocketCivil Action No. 4:17-CV-01233
StatusPublished
Cited by7 cases

This text of 362 F. Supp. 3d 380 (Colonial Penn Life Ins. Co. v. Parker) is published on Counsel Stack Legal Research, covering District Court, S.D. Texas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Colonial Penn Life Ins. Co. v. Parker, 362 F. Supp. 3d 380 (S.D. Tex. 2019).

Opinion

V.

Plaintiffs second contention-that Parker's insurance application contains critical misstatements-also has merit. Below, *384the application is reproduced in pertinent part:

Question 3b and its answer are at issue:

In the past 3 years have you had or been treated for:

* * *
b. Cancer... mental or nervous disorder, drug or alcohol abuse ...

As can be seen, Parker answered, "no" by marking the corresponding box. The application continues on to stress that the accuracy of the information provided is important. Directly above Parker's signature it states:

I have read the questions and my answers are true and correct to the best of my knowledge and belief ... The application will be made part of any policy issued and, within the first two years, a material misrepresentation or answer can be used to contest coverage as of its effective date or to deny a claim.

The application was signed by Parker and dated October 30, 2014. Thus, his answers as to the preceding three-year period should cover treatment back to October 30, 2011. Colonial claims that there is overwhelming evidence of both alcohol and drug abuse during this time period. They have also presented uncontroverted evidence that in this kind of application and policy that had Parker, or any other applicant for that matter, answered accurately with a "yes" instead of the "no" with which he responded, the application would have been automatically rejected and no policy would have been written.

A. The Evidence of Drug and Alcohol Abuse4

Parker, as a veteran, was receiving most, if not all of his medical treatment *385and counseling at the main Houston Veterans Administration ("VA") Hospital Facility (more formally known as the Michael E. DeBakey Veterans Administration Medical Center). Those records are included in Plaintiff's summary judgment evidence.5 The Court below will summarize the records provided in chronological order providing the date and quoting the records.6 The following excerpts are pertinent to Plaintiff's claims:

November 16, 2011 PROBLEM: Substance Abuse: Mr. Parker first said that he last used cocaine "a month ago", then he said that he used "over Labor Day in September". Writer expressed concern about his use and encouraged Veteran to get back involved with SDTP. Veteran shared that he drinks alcohol every Sunday during football games. "I have two or three". Veteran provided the following input for this monthly meeting: Veteran shared that he use [sic] to be on medications for *386depression however he never took them consistently. He denied any current symptoms besides "feeling tired all the time". Writer talked with Veteran about rescheduling an appt with his psychiatrist he recently missed- see chart. December 19, 2011 PROBLEM: Substance Abuse Veteran denies any cocaine use since his last report of use which was a few months ago, Veteran states that he continues to drink on the weekend. Per Veteran his drinking has increased, "I am drinking more than I plan to drink". Per Veteran he wants to stop altogether-"maybe I'll ask my doctor for those pills again to help me stop". "My personality changes, I'm more argumentative when I drink". Veteran identified needing to change his "thinking" related to drinking. Writer reflected on Veteran's reasons for wanting to stop drinking and how his alcohol use is negatively affecting his life. PROBLEM: Mental Health Care Veteran has an upcoming appt with his psychiatrist the end of this month. He plans to speak with his Dr. about his alcohol use/treatment. December 30, 2011 S: 57 yo AAM with hx of cocaine and MJ dependence in reported full early remission and alcohol abuse who was last seen in 9/2011 presents for scheduled f/u. P: was irritable upon approach, stated "why did you call me in for, I'm very busy today". Pt proceeded to talk about how he is moving today and how he does not like to move in the mid of the holidays. Pt admits that he has been drinking more than b/f, 6-pack beer daily. States he realize [sic] he needs to stop and wants to get back on Acamprosate again, since it helped him in the past.7 Pt has several bottles left over from a yr ago. States he has been feeling more "stress" b/c of his move but as well as trying to look for job [sic] and the holiday season. States he started drinking more b/c alcohol is more relaxing to him and helps him to sleep. States Hydroxyzine was only moderately helpful with sleep. States his mood has been a little down 2/2 recent stressors. States no SI/HI/AVH. Alcohol: 6-pack per day Drugs: states none: however, when asked to give UDS, pt adamantly refused, stating, he just went and unable to do *387so, pt also refused to wait, stating he needs to go in order to continue his move. * * * A/P: AXIS I: Alcohol Abuse; Cocaine and MJ Dependence - in reported full, early remission (but refused UDS today) AXIS II: Def AXIS III: see prob list AXIS IV: employment, move AXIS V: 60 1. SUBSTANCE ABUSE/DEPENDENCE: Pt. encouraged to seek sobriety. Discussed with pt about setting up as a schedule to cut down on drinking instead of "cold turkey". Pt declined re-enrolling in the program stating he will not have time. 2. MEDICATIONS: - Restart Acamprosate 666mg TID as pt reported it was helpful for his alcohol use in the past and requested to be placed back on it - Inc Hydroxyzine to 25mg Qday PRN anxiety and 50mg QHS PRN sleep - Discussed risks/benefits/side effects and alternatives of medications. 3. CONSULTS/REFERRALS: none 4. LABS: Pt refused UDS today, stating he just went and will not be able to wait long enough to go again. Informed pt that UDS will be documented as a positive. January 24, 2012 PROBLEM: Substance Abuse Veteran reports that he continues to drink however he has cut back significantly. Only drinking on the weekend and `an occasional beer'. Veteran states that he is very motivated with his new job opportunity therefore plans to quit entirely. February 27, 2012 ACTIVE PROBLEMS: SUBSTANCE INDUCED MOOD ,resolved Hypertrophy (Benign) of Prostate without Urinary o [sic] Rehabilitation, Vocational (ICD-9-CM V57.22) *388Rehabilitation, Vocational (ICD-9-CM V57.22) Elevated Prostate Specific Antigen (PSA) (ICD-9-CM [sic] Assault by other Specified Means (ICD-9-CM E968.8) Tobacco Use Disorder (ICD-9-CM 305.1) Other and unspecified alcohol dependence, in remis [sic] Cocaine dependence, in remission (ICD-9-CM 304.23) Cannabis dependence, episodic use (ICD-9-CM 304.32 [sic] Other (or unknown) Substance Dependence (DSM-IV 30 Cocaine Abuse, Episod [sic] Neck Pain (ICD-9-CM 723.1) Hypertrophy (Benign) of Prostate with Urinary obst [sic] Arthritis (ICD 9 CM 716.90) Retinopathy (ICD-9-CM 362.10) Alcohol Abuse Cocaine Abuse Legal problems/circumstances Probation until 2004 Benign essential hypertension Sinusitis (ICD-9-CM 473.9) HPI: Pt is a 57 y/o BLACK OR AFRICAN AMERICAN veteran with htn, substance dependence (alcohol, cannabis, cocaine), tobacco use 1 ppd since age 29. * * * He reports drinking 40 oz of beer a day.

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362 F. Supp. 3d 380, Counsel Stack Legal Research, https://law.counselstack.com/opinion/colonial-penn-life-ins-co-v-parker-txsd-2019.