Halprin v. Equitable Life Assurance Society of the United States

267 F. Supp. 2d 1030, 30 Employee Benefits Cas. (BNA) 2999, 2003 U.S. Dist. LEXIS 10299
CourtDistrict Court, D. Colorado
DecidedJune 17, 2003
DocketCIV. Ol-B-1321 (CBS)
StatusPublished
Cited by6 cases

This text of 267 F. Supp. 2d 1030 (Halprin v. Equitable Life Assurance Society of the United States) is published on Counsel Stack Legal Research, covering District Court, D. Colorado primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Halprin v. Equitable Life Assurance Society of the United States, 267 F. Supp. 2d 1030, 30 Employee Benefits Cas. (BNA) 2999, 2003 U.S. Dist. LEXIS 10299 (D. Colo. 2003).

Opinion

MEMORANDUM OPINION AND ORDER

BABCOCK, Chief Judge.

Plaintiff Arthur Halprin brings claims for: 1) breach of contract; 2) willful and wanton breach of contract; 3) bad faith breach of insurance contract; 4) violation of the Colorado Consumer Protection Act (“CCPA”); and 5) negligence against Defendant The Equitable Life Assurance Society of the United States (“Equitable”). Equitable moves for judgment on the pleadings with respect to plaintiffs second and fifth claims, for summary judgment with respect to all of plaintiffs claims pursuant to Fed.R.Civ.P. 56(b), and for partial summary judgment dismissing plaintiffs bad faith and CCPA claims. Dr. Halprin moves for partial summary judgment regarding entitlement to contract benefits. The motions are adequately briefed and argued. For the reasons set forth below, I GRANT Equitable’s motion for judgment on the pleadings, GRANT Equitable’s motion for summary judgment pursuant to Fed.R.Civ.P. 56(b), DENY AS MOOT Equitable’s motion for partial summary judgment dismissing plaintiffs bad faith and CCPA claims, and DENY Dr. Halprin’s motion for partial summary judgment regarding entitlement to contract benefits.

I. Facts

The following facts are undisputed unless otherwise noted. Doctor Arthur Halprin (“Dr. Halprin”) was privately employed as a gastroenterologist by the Southern Colorado Clinic, P.C. (“SCC”) in Pueblo, Colorado from 1979 until his 1999 termination. Dr. Halprin’s practice included performance of surgery such as colo-noscopies, liver biopsies, and gastrosco-pies.

SCC provided a comprehensive package of insurance to its physicians that included health, life and group disability insurance. SCC’s Finance Committee and its Board of Directors addressed issues concerning that insurance, which was provided by Standard Insurance Company (“Standard Plan”). The Standard Plan was mandatory for physicians, and was paid from a shareholder income distribution pool.

Certain physicians carried additional individual disability insurance policies. One such policy — that of Dr. Halprin — is the subject of dispute here. Dr. Halprin’s additional disability policy, like that of several of his colleagues, is administered by Equitable.

Some time in the early 1980’s, Robert Redwine — an Equitable insurance agent— *1033 met with SCO’s Clinic Administrator regarding such individual policies. Mr. Red-wine and the Administrator agreed on a plan that would be offered to all doctors at the SCC. Mr. Redwine eventually participated in a meeting with the SCC Board of Directors at which he discussed the proposed policy. The Board then selected Mr. Redwine’s offered plan, and a group of policies were subsequently issued to all SCC doctors, including Dr. Halprin.

In the following three to four years, SCC replaced the first Equitable plan with a competing policy from Lincoln National. Then, in 1989, Mr. Redwine again worked with the Clinic Administrator and designed another replacement group of policies from Equitable (the “Equitable Policy” or “Equitable Plan”). Thereafter, Equitable issued replacement policies to SCC physicians. The Equitable Plan consisted of nineteen individual policies issued together to nineteen SCC doctors. Dr. Halprin and the other physicians received a ten to twenty percent “group discount” on the premiums for the Equitable Policy.

Though SCC’s involvement was limited, SCC issued checks for the doctors’ premium payments. The payments were deducted from each shareholder’s income distribution pool and debited from what would otherwise have been paid to them. The physicians’ premiums are after-tax payments and are included on the physicians’ W-2 forms. No evidence suggests that SCC held out the opportunity to acquire the Equitable Policy as part of its compensation package, and SCC was not involved in the addition of newly hired doctors to the Equitable Plan.

Some time in 1997, Dr. Halprin was accused of improper sexual relations and improper examinations. Around that same time, Dr. Halprin began exhibiting symptoms of severe depression. Dr. Halp-rin began seeing John Hardy, M.D., for psychiatric care. Shortly thereafter, Dr. Halprin ceased practicing medicine. In 1998, Dr. Halprin requested benefits under his Equitable Policy. Equitable denied Dr. Halprin’s request based upon its conclusion that the request lacked proof that Dr. Halprin was under a doctor’s “regular care.” Equitable also concluded that the information Dr. Halprin submitted did not objectively support Dr. Hardy’s diagnosis of depression. This suit followed.

II. Equitable’s Motion for Judgment on the Pleadings

Equitable first moves for judgment on the pleadings dismissing Dr. Halprin’s second claim for willful and wanton breach of contract and fifth claim for negligence.

In support of its assertion regarding Dr. Halprin’s “willful and wanton” claim, Equitable asserts that claim to be indistinguishable from Dr. Halprin’s first claim for breach of contract. I agree.

Dr. Halprin argues to the contrary, asserting that a distinct willful and wanton breach of contract claim was recognized in Giampapa v. Am. Family Mut. Ins. Co., 64 P.3d 230 (Colo.2003), and Decker v. Browning-Ferris Indust., 931 P.2d 436 (Colo.1997). As Dr. Halprin accurately notes, the Colorado Supreme Court concluded that if a willful and wanton breach of contract is proven, the claimant may receive all non-economic damages that were foreseeable at the time of contracting and are a natural and probable result of the breach. Giampapa, 64 P.3d at 238. However, Giampapa and Decker contemplate the extent of damages available for a breach of contract when such a breach is willful and wanton. The cases do not create a distinct cause of action separate from common law breach of contract.

The language of Giampapa shows as much. For instance, Giampapa’s introduction explains that the plaintiff sought recovery for “three types of actions”: *1034 “contract law, tort law, and the Colorado Auto Accident Reparations Act.” Id. at 284. The Court stated, “[u]nder the contract claim specifically, the jury awarded Giampapa $ 900,000 in economic and non-economic ‘special damages’ for American Family’s willful-and-wanton breach of contract.” Id. It continued, “[o]n appeal today is the issue of whether Giampapa may recover complete non-economic damages under his common law contract claim.” Id. (emphasis added). The Court referred to willful and wanton breach of contract and common law breach of contract interchangeably. The claims are one and the same. Because Dr. Halprin asserts a willful and wanton breach of contract claim and a claim premised on common law breach of contract, I grant Equitable’s motion for judgment on the pleadings with respect to Dr. Halprin’s second claim for willful and wanton breach of contract. That claim is therefore dismissed.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Acuna v. Connecticut General Life Insurance
572 F. Supp. 2d 713 (E.D. Texas, 2008)
Town of Carbondale v. GSS PROPERTIES, LLC
169 P.3d 675 (Supreme Court of Colorado, 2007)
Town of Carbondale v. GSS PROPERTIES, LLC
140 P.3d 53 (Colorado Court of Appeals, 2005)
Kidneigh v. UNUM Life Insurance Co. of America
345 F.3d 1182 (Tenth Circuit, 2003)

Cite This Page — Counsel Stack

Bluebook (online)
267 F. Supp. 2d 1030, 30 Employee Benefits Cas. (BNA) 2999, 2003 U.S. Dist. LEXIS 10299, Counsel Stack Legal Research, https://law.counselstack.com/opinion/halprin-v-equitable-life-assurance-society-of-the-united-states-cod-2003.