Harris v. Transamerica Life Insurance

533 F. Supp. 2d 696, 2007 U.S. Dist. LEXIS 68456, 2007 WL 4867577
CourtDistrict Court, W.D. Texas
DecidedMarch 19, 2007
Docket2:06-cr-00196
StatusPublished
Cited by1 cases

This text of 533 F. Supp. 2d 696 (Harris v. Transamerica Life Insurance) is published on Counsel Stack Legal Research, covering District Court, W.D. Texas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Harris v. Transamerica Life Insurance, 533 F. Supp. 2d 696, 2007 U.S. Dist. LEXIS 68456, 2007 WL 4867577 (W.D. Tex. 2007).

Opinion

MEMORANDUM OPINION AND ORDER

WALTER S. SMITH, JR., Chief Judge.

Before the Court are Plaintiffs Motion for Partial Summary Judgment, Defendant’s Cross-Motion for Summary Judgment, and responses and replies to both motions. Having reviewed the motions, responses, replies, and the applicable legal authority, the Court finds that Plaintiffs Motion should be denied and that Defendant’s Cross-Motion for Summary Judgment should be granted in part and denied in part.

I. PROCEDURAL HISTORY

On June 14, 2006, Olaf Harris, as next friend of O’Belle Polete 1 (“Plaintiff’) filed suit against Transamerica Life Insurance Company (“Defendant”) in the 220th District Court of Bosque County, Texas. In her petition, Plaintiff asserts four causes of action: (1) breach of an insurance contract, (2) violations of the Texas Deceptive Trade Practices Act (DTPA), (3) common law fraud, and (4) violations of chapter 451 of the Texas Insurance Code. Plaintiffs Original Petition at 4-6. All four causes of action relate to the Defendant’s refusal to pay convalescent care benefits to Plaintiff pursuant to a Convalescent Care Policy issued by Defendant. Id. at 2-3.

On July 14, 2006, Defendant timely removed the case to this Court. Notice of Removal at 1, 4. Defendant then filed its Original Answer on July 18, 2006. Defendant Transamerica Life Insurance Company’s Original Answer at 1, 6. On December 22, 2006, Plaintiff filed her Motion for Partial Summary Judgment (“Plaintiffs Motion”). Defendant thereafter moved on December 27, 2006 for an extension of time to respond to Plaintiffs Motion. Defendant’s Unopposed Motion for Extension of Time to File Response to Plaintiffs Motion for Partial Summary Judgment at 1, 3. The Court granted the Defendant’s motion on December 28, 2006, making Defendant’s response due no later than January 19, 2007 at 11:59 p.m. Order Granting Defendant’s Unopposed Motion for Extension of Time (n.p.). On January 19, 2007, Defendant filed its Cross-Motion for Summary Judgment and Response to Plaintiffs Motion for Partial Summary Judgment (“Defendant’s Motion”), with accompanying Appendix in Support of Its Cross-Motion for *700 Summary Judgment and Response to Plaintiffs Motion for Partial Summary Judgment ■ (“Defendant’s Appendix”). Plaintiff filed her Response to Defendant’s Cross-Motion for Summary Judgment and Reply to Defendant’s Response to Plaintiffs Motion for Partial Summary Judgment (“Plaintiffs Response and Reply”) on January 30, 2007. On February 7, 2007, Defendant filed its Reply to Plaintiffs Response to Its Cross-Motion for.Summary Judgment (“Defendant’s Reply”).-

II. UNDISPUTED FACTS

Harry Polete (“Polete”) purchased an insurance policy (“Policy”) from Defendant 2 in April 1989. Plaintiffs Motion at 3 ¶ 4. app. at 22, 49; Defendant’s Motion at 3 ¶ 1; Defendant’s Appendix at 19. Po-lete is the named insured and his spouse, Plaintiff, is a covered dependent. Plaintiffs Motion app. at 22; Defendant’s Appendix at 19. The Policy provides, inter alia, that Defendant will pay $1500 per month to Plaintiff as a “Convalescent Care Benefit” while Plaintiff is confined in a “Convalescent Care Facility.” Plaintiffs Motion at 3 ¶ 4, app. at 22, 27-28; Defendant’s Motion at 34t ¶ 2; Defendant’s Appendix at 19, 25. The Policy further provides that the Convalescent Care Benefit will continue as long as Plaintiff is confined until a certain maximum benefit period has elapsed. Plaintiffs Motion at 3 ¶ 4, app. at 22, 27-28; Defendant’s Motion at 3-4 ¶ 2; Defendant’s Appendix at 19, 25. On September 16, 2001, Plaintiff began receiving convalescent care at a nursing home that qualified as a Convalescent Care Facility under the Policy. Plaintiffs Motion app. at 50. Plaintiff submitted claims to Defendant, and Defendant paid benefits due under the Policy to Plaintiff until December 23, 2005, when the Defendant discontinued the payment of benefits. Id. Defendant did not discontinue benefit payments because of non-payment of premiums by Plaintiff; indeed, all premiums due under the policy were paid from April 1989 until December 2005. Id. Instead, Defendant claims that it was only obligated to pay benefits to Plaintiff for a total of four years. Id. app. at 51; Defendant’s Motion at 1. Plaintiff, to the contrary, claims that Defendant was obligated to pay benefits to Plaintiff for a total of eight years. Plaintiffs Motion at 2. At the time that Defendant halted benefit payments, it had paid a total of 48 months (four years) of benefits to Plaintiff. 3 Plaintiffs Motion app. at 50.

III. STANDARDS OF REVIEW

A. Summary Judgment

A movant seeking summary judgment must inform the court of the basis of his motion and point out those portions of the pleadings, depositions, answers to interrogatories, and admissions on file, together with affidavits, if any, that 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. Fed.R.Civ.P. 56(c); Celotex Corp. v. Catrett, 477 U.S. 317, 325, 106 S.Ct. 2548, 91 L.Ed.2d 265 (1986). “[I]f the movant bears the burden of proof on an issue, *701 either because he is the plaintiff or as a defendant he is asserting an affirmative defense, he must establish beyond peradventure all of the essential elements of the claim or defense to warrant judgment in his favor.” Fontenot v. Upjohn Co., 780 F.2d 1190, 1194 (5th Cir.1986). The substantive law governing the suit identifies the essential elements of the claims at issue and therefore indicates which facts are material; i.e., only disputes over facts that might affect the outcome of the suit under the governing law will properly preclude the entry of summary judgment. Anderson v. Liberty Lobby, 477 U.S. 242, 256-57, 106 S.Ct. 2505, 91 L.Ed.2d 202 (1986). The movant need not negate the opposing party’s claims nor produce evidence showing the absence of a genuine issue of fact, but may rely on the absence of evidence to support essential elements of the opposing party’s claims. Celotex, 477 U.S. at 323-25, 106 S.Ct. 2548. However, “ ‘[o]n summary judgment the inferences to be drawn from the underlying facts ... must be viewed in the light most favorable to the party opposing the motion.’ ” Matsushita Elec. Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 587-88, 106 S.Ct. 1348, 89 L.Ed.2d 538 (1986) (quoting United States v. Diebold, Inc., 369 U.S. 654, 655, 82 S.Ct. 993, 8 L.Ed.2d 176 (1962)).

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533 F. Supp. 2d 696, 2007 U.S. Dist. LEXIS 68456, 2007 WL 4867577, Counsel Stack Legal Research, https://law.counselstack.com/opinion/harris-v-transamerica-life-insurance-txwd-2007.