Edwards v. Monumental Life Insurance

812 F. Supp. 2d 1263, 2011 U.S. Dist. LEXIS 94103, 2011 WL 3704254
CourtDistrict Court, D. Kansas
DecidedAugust 23, 2011
DocketCase No. 10-2299-WEB
StatusPublished
Cited by2 cases

This text of 812 F. Supp. 2d 1263 (Edwards v. Monumental Life Insurance) is published on Counsel Stack Legal Research, covering District Court, D. Kansas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Edwards v. Monumental Life Insurance, 812 F. Supp. 2d 1263, 2011 U.S. Dist. LEXIS 94103, 2011 WL 3704254 (D. Kan. 2011).

Opinion

MEMORANDUM AND ORDER

WESLEY E. BROWN, Senior District Judge.

Plaintiffs filed the above entitled case against Monumental Life Insurance Company, alleging breach of an insurance contract in failing to pay insurance benefits. Plaintiffs request judgment for the amount of the life insurance contract, interest, and attorney fees. The parties have filed cross motions for summary judgment.

[1266]*1266I. Facts

1. Monumental issued a policy of accidental death insurance, Policy No. 14A9150558 (hereinafter the “Policy”) to Patricia M. Smith. (Pretrial Order Stipulation, Doc. 27).

2. The Policy was in effect beginning November 8, 2006 and was in effect on June 2-June 4, 2008. (Pretrial Order Stipulation, Doc. 27).

3. The beneficiaries under the Policy are Malachi Edwards and Malcolm Edwards. (Pretrial Order Stipulation, Doc. 27).

4. Patricia Smith was last seen alive on June 2, 2008. (Police Report, Doc. 29-2).

5. Patricia M. Smith died sometime between June 2, 2008 and June 4, 2008. (Pretrial Order Stipulation, Doc. 27).

6. Prior to her death, Smith was treated and prescribed Oxycodone for severe chronic back pain, severe chronic neck pain, as well as hip pain and knee pain from arthritis. (Accidental Death Benefit Claim, Doc. 29-6).

7. The cause of death was listed as “oxycodone toxicity.” (Report of Death, Doc. 29-2; Certificate of Death, Doc. 29-3).

8. The Certificate of Death also specified that the manner of death was an “accident.” (Certificate of Death, Doc. 29-3).

9. Dr. Donald Pojman, Medical Coronor, stated in the autopsy report, “Toxicology revealed toxic levels of oxycodone within the blood, urine, liver and brain. These levels were most consistent with an accidental overdose.” (Autopsy Report, Doc. 29-4).

10. Dr. Pojman testified that at least 17 oxycodone pills were unaccounted for at the time of her death. (Doe. 29-5, Pojman Depo., p. 3).

11. Dr. Wimbish testified that the concentration of oxycodone found in Smith’s blood was 2.5 times the expected blood concentration, a value much higher than expected from the dosage she was taking. (Depo. Of Dr. Wimbish, Doc. 33-2).

12. Dr. Wimbish opined that Smith did not take the medication as prescribed. (Depo. Of Dr. Wimbish, Doc. 33-2).

II. Jurisdiction

Jurisdiction is not in dispute and is properly before the court pursuant to 28 U.S.C. § 1332.

III. Standard of Review

Summary judgment is appropriate when “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; Thomas v. Metropolitan Life Ins. Co., 631 F.3d 1153, 1160 (10th Cir.2011). A fact is “material” if under the substantive law it is essential to the proper disposition of the claim. Wright ex rel. Trust Co. of Kansas v. Abbott Laboratories, Inc., 259 F.3d 1226, 1231-1232 (10th Cir.2001), quoting Adler v. Wal-Mart Stores, 144 F.3d 664, 670 (10th Cir.1998). “An issue is genuine if there is sufficient evidence on each side so that a rational trier of fact could resolve the issue either way.” Adler, 144 F.3d at 670. The court must “view the evidence and draw all reasonable inferences therefrom in the light most favorable to the party opposing summary judgment.” Atl. Richfield Co. v. Farm Credit Bank of Wichita, 226 F.3d 1138, 1148 (10th Cir.2000). The burden of showing that no genuine issue of material fact exists is borne by the moving party. E.E.O.C. v. Horizon/CMS Healthcare Corp., 220 F.3d 1184, 1190 (10th Cir.2000). Once the moving party meets the burden, the nonmoving party must demonstrate a genuine issue for trial on a material mat[1267]*1267ter. Concrete Works of Colorado, Inc. v. City & County of Denver, 36 F.3d 1513, 1517 (10th Cir.1994).

IV. Discussion

Defendant Monumental Life Insurance Company (Monumental) requests summary judgment, arguing that plaintiffs cannot establish, as a matter of law, that the death of Patricia Smith was the result of a loss for which the Policy provides coverage. Monumental argues that the Policy excludes coverage when death results from medical treatment, including the taking of medication. Monumental also argues that since 17 pills were missing, and plaintiff cannot establish whether the overdose was accidental or intentional, plaintiffs cannot show the death of Smith comes under the Policy’s accidental death language.

Plaintiffs allege that there is no evidence that Smith intentionally overdosed, she was taking the medication under the care of a doctor, and the cause of death was an accidental overdose. Plaintiffs allege that Smith suffered a loss of life as a result of injury, and they are entitled to death benefits of $150,000.00, including interest and attorney fees.

a. Insurance Contract

The language of an insurance policy should be construed to give effect to the intention of the parties. Catholic Diocese of Dodge City v. Raymer, 251 Kan. 689, 693, 840 P.2d 456 (1992). A policy of insurance should be considered as a whole. Farm Bureau Mut. Ins. Co. v. Horinek, 233 Kan. 175, 180, 660 P.2d 1374 (1983). Insurance policy language should be clear and unambiguous, otherwise the policy will be liberally construed in favor of the insured. Catholic Diocese, 251 Kan. at 693, 840 P.2d 456. To be ambiguous, “a contract must contain provisions or language of doubtful or conflicting meaning, as gleaned from a natural and reasonable interpretation of its language. Ambiguity in a written contract does not appear until the application of pertinent rules of interpretation to the face of the instrument leaves it genuinely uncertain which one of two or more meanings is the proper meaning.” Id. The test in determining whether an insurance contract is ambiguous is not what the insurer intends the language to mean, but what a reasonably prudent insured would understand the language to mean. First Financial Ins. Co. v. Bugg, 265 Kan. 690, 694, 962 P.2d 515 (1998).

The Policy at issue in the case was effective on November 8, 2006, and remained in effect at the time of Smith’s death. The Policy contained the following provisions:

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Bluebook (online)
812 F. Supp. 2d 1263, 2011 U.S. Dist. LEXIS 94103, 2011 WL 3704254, Counsel Stack Legal Research, https://law.counselstack.com/opinion/edwards-v-monumental-life-insurance-ksd-2011.