Hai Dang v. Northwestern Mutual Life Insurance

960 F. Supp. 215, 1997 U.S. Dist. LEXIS 11426, 1997 WL 160377
CourtDistrict Court, D. Nebraska
DecidedFebruary 6, 1997
DocketNo. 8:CV95-00352
StatusPublished
Cited by3 cases

This text of 960 F. Supp. 215 (Hai Dang v. Northwestern Mutual Life Insurance) is published on Counsel Stack Legal Research, covering District Court, D. Nebraska primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Hai Dang v. Northwestern Mutual Life Insurance, 960 F. Supp. 215, 1997 U.S. Dist. LEXIS 11426, 1997 WL 160377 (D. Neb. 1997).

Opinion

STROM, Senior District Judge.

MEMORANDUM OPINION

This matter is before the Court on Northwestern Mutual Life Insurance Company’s motion for summary judgment (Filing No. 26). Northwestern Mutual contends that summary judgment is proper because the plaintiff, Dr. Hai Dang, does not have a covered disability as defined in his occupational disability insurance policy. For the reasons set forth herein, the motion will be granted.

FACTS

The plaintiff stipulates to the detailed statement of facts set forth in the defendant’s brief. Plaintiffs Brief at 1 and 2. Briefly, in March of 1993, when he was a first-year surgery resident at Creighton University and St. Joseph Hospital, Dang purchased occupational disability insurance from Northwestern Mutual Life listing his primary occupation as “general surgeon.” The policy provides benefits if Dang becomes partially or totally disabled. Dang is totally disabled within the meaning of the policy if [216]*216he is unable to perform the principal duties of his occupation as a result of accident or sickness. Dang is partially disabled within the meaning of the policy if, as a result of accident or sickness, he is unable to perform one or more of the principal duties of his occupation or to spend as much time at his occupation as he did before the disability started, and he has at least a twenty percent loss of earned income.

In May of 1993, during a routine screening, Dang tested positive for the hepatitis B “b” surface antigen. Hepatitis B is an infectious virus transmitted primarily through direct contact with blood or sexual contact. Dang is physically unaffected by the virus, but he is considered a chronic carrier of the hepatitis B virus.

After learning of the test result, Creighton and St. Joseph Hospital formed a committee to develop recommendations to govern the remainder of Dang’s residency. The committee recommended among other things that Dang get informed consent from his patients before he performed any “exposure-prone” procedure. An “exposure-prone” procedure was defined as follows:

Digital palpation of a needle tip in a body cavity or the simultaneous presence of the [health care worker’s] fingers and a needle or other sharp instrument or object in a poorly visualized or highly confined anatomic site.

Defendant’s Brief at 5.

For the next year, Dang continued his surgery residency. He cared for preoperative and postoperative patients and performed educational and training activities, but he refrained from all exposure-prone procedures and never sought informed consent from any patient to perform such a procedure. In July of 1994, Dang transferred to Creighton’s radiology residency program.

Dang filed a claim seeking disability benefits under the policy. Northwestern Mutual denied the claim. On June 15, 1995, Dang filed suit in Nebraska state court alleging that Northwestern Mutual had improperly denied the claim. Northwestern Mutual removed the case to this Court and now seeks summary judgment.

SUMMARY JUDGMENT STANDARD

Rule 56(c) of the Federal Rules of Civil Procedure provides that summary judgment “shall be rendered forthwith if the pleadings, depositions, answers to interrogatories and admissions on file, together with the affidavits, if any, show that there is no genuine issue as to any material fact and that the moving party is entitled to judgment as a matter of law.” Summary judgment will not lie if the evidence is such that a reasonable jury could return a verdict for the nonmoving party. Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248, 106 S.Ct. 2505, 2510, 91 L.Ed.2d 202 (1986). In order for the moving party to prevail, it must demonstrate to the court that “there is no genuine issue as to any material fact and that the moving party is entitled to a judgment as a matter of law.” Celotex Corp. v. Catrett, 477 U.S. 317, 323, 106 S.Ct. 2548, 2552, 91 L.Ed.2d 265 (1986). A fact is material only when its resolution affects the outcome of the case. Anderson, 477 U.S. at 248, 106 S.Ct. at 2510. A material issue is genuine if it has any real basis in the record. Matsushita Elec. Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 586-87, 106 S.Ct. 1348, 1355-56, 89 L.Ed.2d 538 (1986). On a motion for summary judgment, the Court must view all evidence and inferences in the light most favorable to the non-moving party. Anderson, 477 U.S. at 250, 106 S.Ct. at 2511. However, the nonmoving party may not rest on the mere denials or allegations in the pleadings, but must set forth specific facts sufficient to raise a genuine issue for trial. Celotex, 477 U.S. at 324, 106 S.Ct. at 2553. And if the plaintiff cannot support each essential element of his claim, summary judgment must be granted because a complete failure of proof regarding an essential element necessarily renders other facts immaterial. Id. at 322-23, 106 S.Ct. at 2552-58.

DISCUSSION

The issue in this case is whether Dang is disabled, either partially or totally, as a result of accident or sickness within the mean[217]*217ing of Ms occupational disability policy. The Court concludes as a matter of law that Dang is not disabled witMn the meaning of the policy.

Under Nebraska law, insurance policies are to be construed as any other contract to give effect to the parties intentions when they entered into the contract. Katskee v. Blue Cross/Blue Shield, 245 Neb. 808, 813, 515 N.W.2d 645, 649 (1994).

Where the terms the contract are clear, a court may not resort to rules of construction, and the terms are to be accorded their plain and ordinary meaning as the ordinary or reasonable person would understand them. In such a case, a court shall seek to ascertain the intention of the parties from the plain language of the policy.

Id. “[W]hile for the purpose of judicial decision dictionary definitions often are not controlling, they are at least persuasive that meanings which they do not embrace are not common.” Decker v. Combined Ins. Co. of Am., 244 Neb. 281, 284, 505 N.W.2d 719, 722, (1993). An insurance contract should be reasonably construed so as to effectuate the purpose for which it was made. Id.

In this ease, the Court must determine if Dang is disabled within the meaning of the contract. The plain and ordinary meaning of disabled is “crippled; injured; incapacitated.” Random House Dictionary of the English Language 560 (2d. ed.1987). Disability is defined as “lack of adequate power, strength, or physical or mental ability; incapacity. A physical or mental handicap, esp. one that prevents a person from living a full, normal life or from holding a gainful job.” Id. In sum, the term disabled or disability contemplates the loss of physical or mental ability.

The Court finds the case of Gates v. Prudential Ins. Co., 240 A.D.

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Bluebook (online)
960 F. Supp. 215, 1997 U.S. Dist. LEXIS 11426, 1997 WL 160377, Counsel Stack Legal Research, https://law.counselstack.com/opinion/hai-dang-v-northwestern-mutual-life-insurance-ned-1997.