Ferragamo v. Chubb Life Insurance Co. of America

894 F. Supp. 33, 1995 U.S. Dist. LEXIS 11190, 1995 WL 464803
CourtDistrict Court, D. Massachusetts
DecidedJune 27, 1995
DocketNo. 94 Civ. 10164 (MEL)
StatusPublished
Cited by2 cases

This text of 894 F. Supp. 33 (Ferragamo v. Chubb Life Insurance Co. of America) is published on Counsel Stack Legal Research, covering District Court, D. Massachusetts primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Ferragamo v. Chubb Life Insurance Co. of America, 894 F. Supp. 33, 1995 U.S. Dist. LEXIS 11190, 1995 WL 464803 (D. Mass. 1995).

Opinion

LASKER, District Judge.

Paul Ferragamo sues Chubb Life Insurance Company of America, alleging that Chubb wrongfully stopped paying him disability benefits under a Chubb disability insurance policy. Ferragamo alleges that Chubb breached, and was negligent in its handling of, the policy, committed violations of M.G.L. c. 93A and both negligently and intentionally inflicted emotional distress on him. On the theory that Chubb has repudiated its obligations, Ferragamo seeks as damages both the amount of benefits that have been withheld since July 1993 and the present value of all future benefits payable under the policy. Chubb moves for partial summary judgment on the grounds that Ferragamo is entitled to, at most, withheld benefits only, is not eligible for the protection of M.G.L. c. 93A and cannot prove the physical harm element of a cause of action for negligent infliction of emotional distress.

The motion is granted to the extent of declaring that Chubb has not repudiated the policy. The motion is denied as to Ferragamo’s M.G.L. c. 93A claim and denied as to Ferragamo’s cause of action for negligent infliction of emotional distress.

I.

Chubb’s predecessor, United Life and Accident Insurance Company, issued a disability insurance policy to Ferragamo in December 1981. Ferragamo owns, operates and— until March 19, 1982, participated in the manual labor attendant to — a scrap metal business. On that date, an accident at work caused severe injuries to Ferragamo’s left leg and ankle. As a result of these injuries, Ferragamo alleges that he is incapable of performing virtually all physical tasks associated with his business and, for the most part, he must remain sedentary.

Shortly after his injury, Ferragamo filed a claim with Chubb for monthly benefits based upon his alleged total disability. The Chubb policy provides:

“Total Disability” means that the Insured, due to injury or sickness, can’t do all of the main tasks of his or her regular job, and is not working at some other job for pay or profit.

The policy also provides for benefits based on partial disability. As defined in the policy:

“Partial Disability” means that the Insured, due to injury or sickness, can’t do all of the tasks of his or her regular job full time, but: (a) can do and is doing some of those tasks; or (b) is working at some other job. At the same time the Insured must be earning at least 20% less than his or her Monthly Earned Income Base [(which measures the beneficiary’s aver[35]*35age monthly income prior to the injury or sickness) ].

Aside from these eligibility rules, the policy is silent as to the conditions under which Chubb must start, and may cease, paying benefits.

Despite the fact that Chubb personnel periodically initiated examinations of Ferragamo’s claim in response to suspicions that Ferragamo had found alternative employment and thus was not totally disabled, Chubb paid benefits under the policy from April 1982 until June 1998 in response to monthly reports from Ferragamo indicating that his disability continued to be total.

During the summer of 1993, Chubb became convinced Ferragamo was employed despite being unable to perform the manual tasks that he undertook at his scrap metal yard before his injury. Chubb knew — and Ferragamo did not deny — that he continued to oversee the scrap metal business. In addition, Chubb hired a private investigator who, after observing Ferragamo, concluded that he was operating a real estate construction and development business. In July 1993, Chubb suspended Ferragamo’s benefits.

Through counsel, Ferragamo made a formal demand on Chubb to reinstate the payments, a prerequisite to suit under M.G.L. c. 93A. Chubb responded by letter dated October 6,1993, stating that Chubb was “currently investigating whether Mr. Ferragamo is totally or partially disabled and if partially disabled, what his level of income is.” The letter specified that “before any subsequent payments are made to Mr. Ferragamo, we must determine whether Mr. Ferragamo is receiving the correct amount of benefits under either the total or partial disability provisions in his policy.” The letter requested certain documents, including tax returns and social security records.

Ferragamo filed suit on December 17,1993 in Massachusetts state court, seeking damages for breach of contract, negligence, violations of M.G.L. c. 93A, negligent infliction of emotional distress and intentional infliction of emotional distress. Chubb removed the action to this Court.

II.

Ferragamo alleges that Chubb has repudiated its contract with him by refusing to continue making benefit payments and that, therefore, Chubb is liable for the present value of all future payments under the policy, as well as all amounts that have been withheld. Without disputing that a repudiation of the policy would result in a total breach, which in turn would entitle Ferragamo to the present value of all future payments, Chubb responds that it has not repudiated the policy. At most, Chubb maintains, it has failed to live up to the policy’s terms during the period in which it has suspended benefits. If that is in fact the case — and Chubb disputes that it is — the most Ferragamo would be entitled to is the amount that Chubb has failed to pay since July 1993.

Neither party has cited Massachusetts decisions. However, the decision of the United States Supreme Court in New York Life Insurance Company v. Viglas, 297 U.S. 672, 56 S.Ct. 615, 80 L.Ed. 971 (1936) is a clear guide. There, in a case which is a forerunner of this one, the Court held that an insurance company cannot be held to repudiate an insurance policy when it discontinues benefit payments in the belief that the disability which predicated the benefits had itself ceased. Id. at 676, 56 S.Ct. at 616. The Court cited Mobley v. New York Life Insurance Company, 295 U.S. 632, 55 S.Ct. 876, 79 L.Ed. 1621 (1935), in which, in addressing a claim that an insurance company had repudiated a disability policy, the Court noted that:

[repudiation by one party, to be sufficient in any ease to entitle the other to treat the contract as absolutely and finally broken and to recover damages as upon total breach, must at least amount to an unqualified refusal, or declaration of inability, substantially to perform according to the terms of his obligation____ Mere refusal, upon mistake or misunderstanding as to matters of fact or upon an erroneous construction of the disability clause, to pay a monthly benefit when due is sufficient to constitute a breach of that provision, but it does not amount to a renunciation or repudiation of the policy.

[36]*36295 U.S. at 688, 55 S.Ct. at 878 (citations omitted). The Vigías Court held that the damages available in the case of a “mistake or misunderstanding” “do not exceed the benefits in default at the commencement of the suit.” 297 U.S. at 678, 56 S.Ct. at 617. In such a case, “[t]he insured, if he proves that the benefits are due, mil have a judgment effective to reinstate his policy.” Id.

Although neither Vigías nor Mobley cited or discussed Massachusetts law, they are persuasive and this case is on all fours with them.

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Cite This Page — Counsel Stack

Bluebook (online)
894 F. Supp. 33, 1995 U.S. Dist. LEXIS 11190, 1995 WL 464803, Counsel Stack Legal Research, https://law.counselstack.com/opinion/ferragamo-v-chubb-life-insurance-co-of-america-mad-1995.