UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA
WILLIAM DUN, et al.,
Plaintiffs, v. Civil Action No. 19-40 (JEB) TRANSAMERICA PREMIER LIFE INSURANCE COMPANY, et al.,
Defendants.
MEMORANDUM OPINION
In March 2013, Irmadell Dun, a 79-year-old resident of Bozeman, Montana, tripped on
the sidewalk, struck her head, and died within a week from ensuing complications. This case
asks whether Dun’s five adult children –– Plaintiffs William Dun, Irene Dun, Sheryl Dun, Pat
Ruggieri, and Dora Mengel –– can recover accidental-death benefits from Defendant
Transamerica Premier Life Insurance Company, which issued a group insurance policy here in
the District of Columbia. Transamerica denied their claim, explaining that Dun’s insurance only
covered deaths resulting from a motor-vehicle or common-carrier accident, as opposed to any
other sort of mishap. In their suit, Plaintiffs not only challenge Transamerica’s interpretation of
the policy, but they also allege that Defendants Financial Planning Services, Inc. (FPS) and
Aegon Direct Marketing Services, Inc. (ADMS), Trustee and Administrator respectively of a
trust established to maintain insurance policies including Dun’s, breached various trust laws and
fiduciary duties owed to Plaintiffs.
Following Plaintiffs’ twice amending their Complaint and the case’s transfer from the
District of Montana, both parties have filed Cross-Motions for Summary Judgment on all claims
1 asserted therein. While the parties’ submissions are mired in the weeds of standing doctrine and
the law of trusts, these discussions miss the forest for the trees. The case remains, at its core, a
straightforward dispute over contract interpretation. Because the Court finds that the deceased’s
insurance policy did not cover the accident in question, it will grant Defendants’ Motion and
deny Plaintiffs’.
I. Background
A. Factual Background
At the summary-judgment stage, given the Court’s ruling, it would typically set out the
facts in the light most favorable to Plaintiffs, but that is not necessary here, as the parties
generally agree on what happened. See Talavera v. Shah, 638 F.3d 303, 308 (D.C. Cir.
2011). In 2001, Peoples Benefit Life Insurance Company (a predecessor of Defendant
Transamerica) developed an accidental-death group insurance policy geared toward the elderly.
See ECF No. 97-2 (Def. Statement of Material Facts), ¶¶ 1, 6; see also ECF No. 28 (Second
Amended Complaint), ¶ 49 (same). The District of Columbia supplied the requisite regulatory
approval of that group policy. Peoples Benefit then issued the approved policy to Defendant FPS
in its capacity as Trustee of the Peoples Benefit Group Insurance Trust (now known as
Monumental Group Insurance Trust and hereinafter labeled simply “the Trust”). See ECF No.
97 (Def. MSJ), Exh. A (Declaration of Douglas Simino).
First established in 1982, the Trust reduced both administrative and regulatory burdens
on the insurer, Peoples Benefit. As to the former, it provided a mechanism by which insurance
plans could be administered on a group, rather than on an individual, basis. Id., ¶ 7. This
collective administration of insurance policies decreases operating costs by allowing insurers to
use group underwriting and impose consistent premium rates and terms of insurance certificates
2 sold across multiple states. Id.; see also Simino Decl., Exh. 3 (Agreement and Declaration of
Trust) at 1 (“[T]he Trustors desire to establish the said group insurance plans collectively, rather
than individually, so as to minimize the costs of operation.”). As to regulatory issues, while
neither side offers a complete description, it appears that the Trust provided a mechanism
whereby Peoples Benefit could issue a single “master policy,” hold that policy in trust in one
state, and then supply individual insurance certificates across all fifty states “without dealing
with fifty different regulators.” ECF No. 90 (Feb. 14, 2019, Hearing Transcript) at 12.
Defendant ADMS is the current Administrator of the Trust, which is declared under the laws of,
and has its principal place of business in, Washington, D.C. See Def. SMF, ¶ 48; Agreement and
Declaration of Trust at 1, 11.
After issuing the group policy to FPS, Transamerica’s predecessor began marketing
individual insurance certificates, primarily via “direct mail” solicitations. These materials were
sent to prospective customers in a variety of states, including Montana. See Def. SMF, ¶ 6.
Irmadell Dun, a resident of Bozeman, received one such solicitation –– referred to by both
parties as the “Flyer” ––– most likely in late 2003. Id., ¶¶ 6, 11. The Flyer consisted of a
double-sided piece of paper with a description of the coverage provided by the policy. Id., ¶ 7.
It began with the following pitch:
Motor vehicle deaths are on the rise . . . . And the older driver is 2 times more likely to be the one who gets hit. That’s why I want you to know about our “Ride and Drive” Accidental Death Insurance Coverage.
It covers you every time you get into your car with $100,000 of protection for just $4.33 monthly.
Def. MSJ, Exh. B (Declaration of Mary E. Pieschel), Exh. 3 (Flyer) at 1. At the bottom of this
first page lay a “tear-off” Enrollment Form that could be used by customers to purchase an
3 insurance certificate. Prospective customers such as Dun were instructed to “Sign Below” on the
Enrollment Form to “authorize your new coverage.” Id. The words “Yes, I want $100,000 of
this Accidental Death coverage” were displayed directly below the signature line on the
Enrollment Form. Id.
The Flyer continued on the other side of the page with further information about the
insurance. The first section, labeled “[e]veryday travel accident benefits you need now more
than ever,” declared:
As motor vehicle deaths continue to rise, this protection covers the very real risks you take every time you get into a car . . . . This ‘Ride and Drive’ accidental death coverage pays $100,00.00 benefits if you die from a covered injury as a result of: 1) driving a car . . .; 2) riding in a car or as a fare-paying passenger in a common carrier . . .; 3) being struck by any motor vehicle as a pedestrian.
Flyer at 2. This side of the Flyer also outlined “Exclusions” from the policy such as “death caused
by . . . intentionally self-inflicted injury[,] . . . the insured having a blood alcohol of .10% [or
higher,] . . . any sickness[,] . . . [and] participating in any race or speed contest involving motor
vehicles of any type.” Id.
Dun, then 70 and a bookkeeper by trade, signed the Enrollment Form on November 7,
2003. See Peischel Decl., Exh. 2 (Enrollment Form); Def. MSJ, Exh. H (Deposition of Sheryl
Dun) at 24. Once Peoples Benefit received a signed Enrollment Form, it issued applicants the
Insurance Certificate, which set forth the specific terms of coverage and provides the operative
insurance contract here. See Pieschel Decl., Exh. 1 (Certificate). The Certificate provided
insureds with 30 days to examine it, and if the insured was “not satisfied with his Certificate, he
[could] return it” and be refunded any paid premiums. Id. at 1. The Certificate was labeled
“Group Accidental Death Insurance Certificate,” and it explained that the policy “pays benefits
for death due to an accident.” Id. The Certificate continued:
4 PART III: ACCIDENTAL DEATH BENEFIT
We pay a benefit if an Insured dies as the result of an Injury that occurs from one of the Accident Hazards described below. The Accidental Death Benefit is shown on your Certificate Schedule. Death must occur within 90 days (180 days if this Certificate is issued in New Mexico) of the accident causing the Injury.
Motor Vehicle Hazard: This Hazard occurs if an Insured dies as a result of being Injured:
a. while riding in or driving a Private Passenger Automobile;
b. if struck, as a pedestrian, by a Private Passenger Automobile or any other Land Motor Vehicle; or
c. while driving for hire a Land Motor Vehicle.
Common Carrier Hazard: This Hazard occurs if an Insured dies as a result of being Injured while:
a. riding as a fare paying passenger on a Common Carrier; or
b. getting on or off a Common Carrier.
Id. at 3.
After enrolling in November 2003, Dun dutifully paid the $4.33 per month she owed
under the policy for nearly a decade, remitting almost $500 in total over the remainder of her
life. See Def. SMF, ¶ 19; SAC, ¶ 79. During that period, Monumental Life Insurance (formerly
Peoples Benefit) sent her a letter dated August 2011 confirming her enrollment in “Motor
Vehicle and Common Carrier Accidental Death Benefit Coverage.” Def. MSJ, Exh. 7
(Monumental Statement of Insurance Coverage) at 2. On March 8, 2013, Dun tripped and struck
her head, dying several days later. See SAC, ¶ 80.
Following her death, Plaintiffs –– Dun’s five children –– filed a claim for $100,000 with
Monumental Life (now Defendant Transamerica) under the Certificate. Defendant denied the
claim on the ground that Dun’s death was not the result of an accident involving a “motor
5 vehicle” or “common carrier” and therefore was “not covered” by the Certificate. See Def. MSJ,
Exh. F (Claim Letter from Monumental Life).
B. Procedural History
On December 11, 2015, Plaintiffs filed suit against Defendant Transamerica Premier in
Montana state court alleging that it had improperly denied their insurance claim. Transamerica
removed the case to federal court in Montana on diversity-jurisdiction grounds. See 28 U.S.C.
§ 1332. The parties proceeded to discovery, which revealed that the Insurance Certificate at
issue had been sold to more than 56,000 people nationwide, only 140 of whom had filed claims
for benefits at that time, with only 18 succeeding. See ECF No. 59 (Def. Motion to Transfer) at
5–6. On June 30, 2017, Plaintiffs filed an Amended Complaint, asserting substantially the same
claims but attempting to bring a class action against Transamerica on behalf of other certificate
holders. See ECF No. 21 (Amended Complaint).
Two months later, Plaintiffs filed a Second Amended Complaint (the operative
Complaint here). This pleading continues to allege that Transamerica misconstrued the
insurance policy, while also asserting claims against Defendants FPS and ADMS. Plaintiffs
explain that they added FPS and ADMS as Defendants because they “learned in discovery” that
the insurance purchased by Dun “arose from a trust” and was marketed through the Trust. See
SAC, ¶ 1. Plaintiffs’ Second Amended Complaint is not easy to decipher. It appears to assert
counts for breach of contract, breach of fiduciary duty, breach of trustee duties, and breach of
administrator duties, while also requesting an administrative accounting and offering allegations
under abstract headings such as “Joint Enterprise and Similar Theories” and “Benefits Owed.”
Id., ¶¶ 116–23. The Second Amended Complaint also mentions vague “class claims[,]” but at
this point, these are the only Plaintiffs. Id., ¶¶ 126–33.
6 With the case newly focused on FPS and ADMS, Plaintiffs filed a motion to transfer the
matter to those Defendants’ principal place of business, the District of Columbia. See Def.
Motion to Transfer at 9. The Montana court granted that motion, offering this Court its first
opportunity to handle a case from Big Sky Country. Following a few more months of discovery
overseen by this Court, both sides now move for summary judgment.
II. Legal Standard
Summary judgment may be granted if “the movant shows that there is no genuine dispute
as to any material fact and the movant is entitled to judgment as a matter of law.” Fed. R. Civ. P.
56(a); see also Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 247–48 (1986); Holcomb v.
Powell, 433 F.3d 889, 895 (D.C. Cir. 2006). A fact is “material” if it is capable of affecting the
substantive outcome of the litigation. See Liberty Lobby, 477 U.S. at 248; Holcomb, 433 F.3d at
895. A dispute is “genuine” if the evidence is such that a reasonable jury could return a verdict
for the nonmoving party. See Scott v. Harris, 550 U.S. 372, 380 (2007); Liberty Lobby, 477
U.S. at 248; Holcomb, 433 F.3d at 895. “A party asserting that a fact cannot be or is genuinely
disputed must support the assertion” by “citing to particular parts of materials in the record” or
“showing that the materials cited do not establish the absence or presence of a genuine dispute,
or that an adverse party cannot produce admissible evidence to support the fact.” Fed. R. Civ. P.
56(c)(1).
When a motion for summary judgment is under consideration, “[t]he evidence of the non-
movant is to be believed, and all justifiable inferences are to be drawn in [its] favor.” Liberty
Lobby, 477 U.S. at 255; see also Mastro v. PEPCO, 447 F.3d 843, 850 (D.C. Cir. 2006); Aka v.
Wash. Hosp. Ctr., 156 F.3d 1284, 1288 (D.C. Cir. 1998) (en banc). The nonmoving party’s
opposition, however, must consist of more than mere unsupported allegations or denials and
7 must be supported by affidavits, declarations, or other competent evidence, setting forth specific
facts showing that there is a genuine issue for trial. See Fed. R. Civ. P. 56(e); Celotex Corp. v.
Catrett, 477 U.S. 317, 324 (1986).
III. Analysis
In moving for summary judgment, Defendants initially argue that Plaintiffs do not have
standing to sue either FPS in its capacity as Trustee or ADMS in its capacity as Administrator.
Additionally, on the merits, they assert that there is no genuine issue of material fact as to the
validity of the denial of the Duns’ insurance claim, which would foreclose Plaintiffs from
prevailing on any of the counts alleged in their Second Amended Complaint. The Court will first
assure itself of its jurisdiction and, having done so, will turn to the proper construction of the
scope of Dun’s insurance coverage.
A. Standing
The Court begins, as it must, by considering its own jurisdiction to hear this case.
See Steel Co. v. Citizens for a Better Env’t, 523 U.S. 83, 94–95 (1998). The doctrine of standing
ensures “that federal courts do not exceed their authority” because it “limits the category of
litigants empowered to maintain a lawsuit in federal court.” Spokeo, Inc. v. Robins, 136 S. Ct.
1540, 1547 (2016). The “‘irreducible constitutional minimum’ of standing consists of three
elements. The plaintiff must have “(1) suffered an injury in fact, (2) that is fairly traceable to the
challenged conduct of the defendant, and (3) that is likely to be redressed by a favorable judicial
decision.” Id. (citation omitted) (quoting Lujan v. Defs. of Wildlife, 504 U.S. 555, 560 (1992)).
In certain of its permutations, the doctrine can prove muddled. As commentators and jurists
alike have observed, the “law of standing is so cluttered and confused that almost every
8 proposition has some exception.” Linda R.S. v. Richard D., 410 U.S. 614, 617 n.4 (1973)
(quoting Kenneth Davis, Administrative Law 428–29 (3d ed. 1972)).
In support of dismissal for lack of standing, Defendants argue that Plaintiffs have not
identified a “concrete injury fairly traceable” to ADMS or FPS. This is so, they posit, because
Dun did not enter into a relationship with these two Defendants, contractual or otherwise. Those
companies, Defendants assert, did not market or sell Dun’s insurance certificate. In fact, they
maintain that the Trust itself is entirely unconnected to insured persons such as Dun and instead
simply exists to make it easier for insurance companies to administer such plans. Plaintiffs
argue, by contrast, that FPS and ADMS controlled the Trust, which was responsible for paying
out the benefits owed them. They also claim insureds (and their descendants) are beneficiaries of
the Trust, and that ADMS and FPS therefore stand in fiduciary relationships with Plaintiffs.
Defendants’ arguments erroneously conflate the standing and the merits analyses.
“Although the two concepts unfortunately are blurred at times, standing and entitlement to relief
are not the same thing. Standing is a prerequisite to filing suit, while the underlying merits of a
claim . . . determine whether the plaintiff is entitled to relief.” Arreola v. Godinez, 546 F.3d 788,
794–95 (7th Cir. 2008). As the D.C. Circuit has consistently reminded us, “[I]n reviewing the
standing question, the court must be careful not to decide the questions on the merits for or
against the plaintiff, and must therefore assume that on the merits the plaintiffs would be
successful in their claims.” Parker v. Dist. of Columbia, 478 F.3d 370, 377 (D.C. Cir.
2007), aff’d sub nom. Dist. of Columbia v. Heller, 554 U.S. 570 (2008) (quoting Waukesha v.
EPA, 320 F.3d 228, 235 (D.C. Cir. 2003)); see also Warth v. Seldin, 422 U.S. 490, 501–02
(1975) (assuming validity of legal theory and factual allegations in complaint for purposes of
standing analysis); Simon v. E. Ky. Welfare Rights Org., 426 U.S. 26, 65 (1976) (Brennan, J.,
9 concurring) (“The books are full of opinions that dismiss a plaintiff for lack of ‘standing’ when
dismissal, if proper at all, actually rested . . . upon the plaintiff’s failure to prove on the merits the
existence of the legally protected interest that he claimed.”).
Defendants’ assertions that Plaintiffs’ “erroneous legal arguments” pertaining to the Trust
and the fiduciary duties assumed by ADMS and FPS “do not establish standing,” ECF No. 10
(Def. Reply) at 4 (emphasis added), are thus inapposite. To be sure, at the summary-judgment
stage, the Court no longer need accept the factual allegations in a plaintiff’s complaint as true,
and a plaintiff must “identify in [the] record evidence sufficient to support its standing to seek
review.” Sierra Club v. EPA, 292 F.3d 895, 899 (D.C. Cir. 2002); see also Clapper v. Amnesty
Int’l USA, 568 U.S. 398, 411–12 (2013) (at summary-judgment stage, party invoking federal
jurisdiction must set forth specific facts to establish standing). Yet simply because a plaintiff
may not (or even will not) ultimately succeed in persuading a court as to the validity of his legal
theories or his factual allegations does not mean he lacks standing. Were it otherwise, “every
losing claim would be dismissed for want of standing.” Initiative & Referendum Inst. v.
Walker, 450 F.3d 1082, 1092 (10th Cir. 2006) (en banc).
The sufficiency of Plaintiffs’ demonstration of a “concrete injury fairly traceable to”
ADMS and FPS is thus clear at this stage. Assuming “arguendo” the merits of Plaintiffs’ “legal
claim,” they were wrongfully denied benefits due to them under their late mother’s Insurance
Certificate. See Parker, 478 F.3d at 377. Contrary to Defendants’ assertion, Plaintiffs need not
establish a contractual relationship with all three Defendants in order to establishing standing to
sue them. Even if neither FPS or ADMS marketed or sold the insurance coverage, Plaintiffs
have pointed to evidence in the record indicating that the funds owed to them were controlled by
the Trust, over which both ADMS and PDS shared authority as Trustee and Administrator
10 respectively. For example, the Declaration of Trust dictates that “[t]he Trustee shall make
payments from the Trust Funds . . . upon written direction of the Administrator,” Declaration of
Trust, § 4.3, and that “[t]he Administrator shall have the authority to determine the requirements,
which shall be set forth in the policy, with which an individual must comply in order to be
eligible for benefits . . . [t]he time for payment of premiums, the premium due date, the amount
of contribution required from each insured . . . and other matters relating to benefits.” Id. § 5.2.
Taking the facts in the light most favorable to Plaintiffs, ADMS and PDS are responsible
for distributing benefits to insured people, and they wrongfully withheld benefits from Plaintiffs
in violation of their various trust responsibilities and fiduciary duties. It may ultimately transpire
that Defendants did not owe Plaintiffs any duties, fiduciary or otherwise, but such disputes over
the legal contours of their relationship are not properly resolved on standing grounds.
B. Insurance Coverage
While Plaintiffs have established standing to sue, their victory will be short lived because
their case fails on the merits. At bottom, Plaintiffs’ claims, whether characterized as breach of
contract or breach of fiduciary duty, rest on a single premise: that Dun’s insurance policy is
properly construed as covering not just accidental death via motor vehicle or common carrier,
but instead death resulting from any accident. If her insurance also covered her slip and fall,
then Defendants may have breached the terms of the contract or violated their fiduciary duties to
Plaintiffs (assuming the disputed premise that they maintained any such duties to begin with).
As a threshold matter, this case is ripe for resolution on summary judgment. Indeed, both
parties have so moved, and there are no remaining disputes outside of the proper interpretation of
language contained within the contracts. The parties further agree that District of Columbia law
should apply, presumably because the Trust Agreement states that it will be governed by D.C.
11 law, and, in any event, there is no conflict between D.C. and Montana law as to the contract
interpretation principles at stake. See Def. MSJ at 12 n.8; see also ECF No. 104 (Pl. MSJ)
(citing to D.C. law); Norris v. Norris, 419 A.2d 982, 984 (D.C. 1980) (District honors choice-of-
law provisions “as long as there is some reasonable relationship with the state specified”).
In the District, “an insurance policy is a contract between the insured and the insurer.”
Rockhill Ins. Co. v. Hoffman-Madison Waterfront, LLC, 2019 WL 4860874, at *6 (D.D.C. Sept.
30, 2019) (alterations omitted) (quoting Travelers Indem. Co. v. United Food & Commercial
Workers Int’l Union, 770 A.2d 978, 986 (D.C. 2001)). In the context of insurance disputes, as in
all cases involving contract interpretation, “whether a genuine issue of material fact is in dispute
will depend generally upon whether the contract is ambiguous.” Nat’l Trade Prods. v. Info. Dev.
Corp., 728 A.2d 106, 109 (D.C. 1999). Resolution of the question of a contract’s ambiguity “is a
question of law,” making summary judgment appropriate “when the agreement is unambiguous
and where there is no question as to the parties’ intent.” Id. (quoting Gryce v. Lavine, 675 A.2d
67, 69 (D.C. 1996)); see also Hedgeye Risk Mgmt., LLC v. Heldman, 196 F. Supp. 3d 40, 47
(D.D.C. 2016) (“Whether a contract is ambiguous is a legal question for the court, not a
factfinder, to decide.”) (internal quotation marks omitted).
“A contract is not rendered ambiguous merely because the parties disagree over its proper
interpretation.” Parker v. United States Tr. Co., 30 A.3d 147, 150 (D.C. 2011) (quotation marks
omitted). Instead, a contract is ambiguous when “the provisions in controversy are[] reasonably
or fairly susceptible of different constructions or interpretations, or of two or more different
meanings.” Id. (quotation marks omitted). “Conversely, a contract is unambiguous when a court
can ascertain the contract’s meaning by merely looking at the contract.” Potomac Elec. Power
Co. v. Mirant Corp., 251 F. Supp. 2d 144, 149 (D.D.C. 2003). In other words, if the Court can
12 determine that the scope of Dun’s insurance coverage is unambiguous based on the terms of the
policy alone, and if Plaintiffs have not offered any material evidence that would call that
interpretation into question, it can resolve the dispute without conducting a trial. Indeed,
Plaintiffs have not explained what a factfinder would do here, given that contract interpretation is
a matter of law and that there are no disputes of material fact.
To ascertain the scope of this contract, the Court looks to “the written language
embodying the terms of an agreement.” Hedgeye Risk Mgmt., 196 F. Supp. 3d at 47 (quoting
Aziken v. Dist. of Columbia, 70 A.3d 213, 218–19 (D.C. 2013)). In doing so, it conducts a
“reasonableness inquiry to determine what a reasonable person in the position of the parties
would have thought the disputed language means.” Potomac Elec. Power Co., 251 F. Supp. 2d at
149. In recognition of the nature of insurance contracts, which are generally drafted by an
insurer with subject-area expertise and tendered to those “often without technical training,”
ambiguities in an insurance policy are “construed against the insurer.” Chase v. State Farm Fire
& Cas. Co, 780 A.2d 1123, 1127 (D.C. 2001). At the same time, the Court may not “indulge in
forced constructions to create an obligation against the insurer.” Id. (quotation marks omitted).
“If an insurance contract states in plain terms what is covered, then ‘the man or woman in the
street’ should be able to understand what is said.” Whiting v. AARP, 637 F.3d 355, 362 (D.C.
Cir. 2011).
Plaintiffs contend that the Flyer, Enrollment Form, and Insurance Certificate, when
considered in conjunction, supply convoluted and contradictory language that could be
interpreted to provide coverage for any accidental death. As to the Certificate, Plaintiffs concede
that Part III “could be read . . . to include a restriction limiting coverage to motor vehicle[s].” Pl.
MSJ at 35. This section, however, is “buried on page 3,” while the first page is “filled with
13 language informing the consumer that she is purchasing an ordinary accidental death policy.” Id.
at 31, 35. For example, the Certificate was labeled “Group Accidental Death Insurance
Certificate,” and at the bottom of the first page, it declared that “this coverage is limited to
accidents and does not pay for death due to sickness. Coverage stops at age 80.” Id. at 30–32;
see also Certificate at 1 (same). They also note that the Enrollment Form, which served as an
application for coverage, stated above the signature line, “Yes, I want $100,000 of this
Accidental Death Coverage,” id. at 29, as opposed to, say, “Accidental Motor-Vehicle Death
Coverage.” Pointing to these sentences, Plaintiffs suggest that an average person could
reasonably conclude that the policy covers deaths resulting from any accident. They also argue
that Dun may not even have received the Certificate because no party has recovered a copy of it,
and she was known to be a meticulous record keeper. See Sheyl Dun Dep. at 23:15–16 (“She
was meticulous on how she filed.”).
Although Plaintiffs’ position is certainly not frivolous, the Court believes that their
interpretation is too strained to carry the day. Looking to the plain terms of the contract, a
reasonable person would have to conclude that the coverage is limited to motor-vehicle and
common-carrier deaths. The Certificate clearly establishes that the policy pays “a benefit if an
Insured dies as a result of an Injury that occurs from one of the Accident Hazards described
below.” Certificate at 3. It then defines the covered accidents as either a “Motor Vehicle
Hazard” or a “Common Carrier Hazard.” Id. While Plaintiffs point to more general provisions
in other sections of the Certificate, the Court must “strive to give reasonable effect to all [the
contract’s] parts and eschew an interpretation that would render part of it meaningless.” Dist. of
Columbia v. Young, 39 A.3d 36, 40 (D.C. 2012) (internal quotation mark omitted); see also Hunt
Constr. Grp., Inc. v. Nat’l Wrecking Corp., 587 F.3d 1119, 1121–22 (D.C. Cir. 2009) (“In
14 reading contract provisions we take the contract’s entirety into account, seeking to give all its
provisions effect.”) (quoting Steele Founds., Inc. v. Clark Constr. Grp. Inc., 937 A.2d 148, 154
(D.C. 2007)). In addition, it is “a familiar principle of contract interpretation, that ‘specific terms
and exact terms are given greater weight than general language.’” Wash. Auto Co. v. 1828 L St.
Assocs., 906 A.2d 869, 880 (D.C. 2006) (quoting Restatement (Second) of Contracts
§ 203(c) (1981)). Giving “effect” to the specific language in Section III, which defines the sorts
of accidents covered by the insurance, clearly limits the policy’s coverage to those hazards
specified therein –– viz., motor-vehicle and common-carrier accidents.
While Plaintiffs argue that the word “only” should have been added before these
descriptions –– e.g., “the policy will pay a benefit only if an Insured dies as a result of an Injury
that occurs from one of the Accident Hazards described below” –– a contract is not ambiguous
merely because its terms “could have been clearer.” Dist. No. 1––Pac. Coast Dist. v. Travelers
Cas. & Sur. Co., 782 A.2d 269, 274 (D.C. 2001) (quotation marks omitted). Put differently, that
one of the parties could imagine a hypothetical contract describing the coverage with perfect
clarity does not render the actual contract ambiguous.
Even if the Certificate were ambiguous, or if Plaintiffs were able to support their
unsubstantiated theory that Dun never received it, the “breach of contract claim still fails because
the promotional materials clear up any ambiguity.” Whiting, 637 F.3d at 363 (looking to
promotional materials at motion-to-dismiss stage to resolve any potential ambiguity regarding
insurance policy). The Enrollment Form encouraged the applicant to sign up for “this Accidental
Death Coverage,” a clear reference to the coverage described by the attached Flyer. See
Enrollment Form (emphasis added). The Flyer proclaimed that “Motor vehicle deaths are on the
rise.” Flyer at 1 (emphasis added). It further advertised the “‘Ride and Drive’ Accidental Death
15 Insurance coverage,” which “covers you every time you get into your car.” Id. (emphases
added). This description of the coverage, limiting it to vehicular accidents, was repeated on the
back of the Flyer, along with this further explanation: The “‘Ride and Drive’ accidental death
coverage pays $100,000 benefits if you die from a from a covered injury as a result of: 1) driving
a car . . . 2) riding in a car [or] . . . 3) being struck by any motor vehicle as a pedestrian.” Id. at 2.
Far from being “deceptive,” or introducing ambiguity, as Plaintiffs would suggest, the marketing
materials served to further clarify the terms of the policy.
Finally, Plaintiffs have not offered any admissible evidence that might call into question
the Court’s construction of the insurance policy. They cite only to the inadmissible hearsay
statement made by Sheryl Dun that Irmadell at one point expressed an impression that the
insurance covered all accidental deaths. See Dun Dep. at 43–45; see also United States ex rel.
Barko v. Halliburton Co., 241 F. Supp. 3d 37, 53 (D.D.C. 2017), aff’d, 709 F. App’x (D.C. Cir.
2017) (explaining that no genuine dispute of material fact was created where none of proffered
evidence was admissible). Dun’s state of mind, in any event, is entirely irrelevant to the Court’s
inquiry because under D.C. law we analyze a contract “based on the meaning which common
speech imports, and not based on any analysis of how [the insured] herself would read the
contract.” Whiting, 637 F.3d at 361.
Given that the contract and accompanying promotional material unambiguously limit
themselves to the construction supplied by Defendants, summary judgment must be granted to
them not only on Plaintiffs’ breach-of-contract claim but also on their tort counts. This is so
because Plaintiffs do not point to any improper conduct, beyond the language of the insurance
materials, or any redressable injury, beyond the denial of their insurance claim, that could sustain
those additional causes of action. See Choharis v. State Farm Fire & Cas. Co., 961 A.2d 1080,
16 1089 (D.C. 2008) (tort claim independent of contract claim is viable only where plaintiff can
establish “an independent injury over and above the mere disappointment of plaintiff’s hope to
receive his contracted-for benefit”); Whiting, 637 F.3d at 363 (in case resulting from denial of
insurance coverage, claim based on plaintiff’s status as third-party beneficiary of agreement
between insurer and marketer redundant of breach-of-contract claim); Klayman v. Judicial
Watch, Inc., 255 F. Supp. 3d 161, 173 (D.D.C. 2017) (“[I]t cannot be that the conduct is tortious
because of some duty imposed by the contract itself.”). Because Plaintiffs’ common-law claims
rise and fall together, the Court will grant Defendants’ Motion for Summary Judgment as to them
all.
C. Statutory Claims
Finally, Plaintiffs’ Opposition asserts never-before-mentioned claims under the D.C.
Insurance Code, D.C. Code § 31-2231.04, and D.C. Consumer Protection Procedures Act, D.C.
Code § 28-3904. See Pl. MSJ at 37–38. The Court can make quick work of these statutory
claims because it is “well-established in this district that a plaintiff cannot amend his Complaint
in an opposition to . . . summary judgment.” Jo v. Dist. of Columbia, 582 F. Supp. 2d 51, 64
(D.D.C. 2008). As these claims are not properly pleaded (or pleaded at all), they do not stand in
the way of summary judgment.
IV. Conclusion
For these reasons, the Court will grant Defendants’ Motion for Summary Judgment and
will deny Plaintiffs’. A separate Order so stating will issue this day.
/s/ James E. Boasberg JAMES E. BOASBERG United States District Judge Date: March 5, 2020