Hunter v. Massachusetts Mutual Life Insurance Company

53 F. Supp. 3d 86, 2014 WL 3427195, 2014 U.S. Dist. LEXIS 95808
CourtDistrict Court, District of Columbia
DecidedJuly 1, 2014
DocketCivil Action No. 2012-1144
StatusPublished

This text of 53 F. Supp. 3d 86 (Hunter v. Massachusetts Mutual Life Insurance Company) is published on Counsel Stack Legal Research, covering District Court, District of Columbia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Hunter v. Massachusetts Mutual Life Insurance Company, 53 F. Supp. 3d 86, 2014 WL 3427195, 2014 U.S. Dist. LEXIS 95808 (D.D.C. 2014).

Opinion

UNDER SEAL

MEMORANDUM OPINION

EMMET G. SULLIVAN, United States District Judge

John Hunter brings this lawsuit alleging that Massachusetts Mutual Life Insurance Company (“MassMutual”) breached an insurance contract by failing to pay him the correct amount of monthly disability benefits and commencing payment on the wrong date. Pending before the Court is defendant’s motion for summary judgment. Upon consideration of the motion, the responses and replies thereto, the applicable law, the oral argument, and the entire record, the Court GRANTS defendant’s motion.

I. BACKGROUND

A. The Disability-Insurance Policy

Dr. Hunter, a dentist, has practiced in Washington, D.C. since 1985. Defi’s Statement of Material Facts (“Def.’s SMF”), ECF No. 22-1 ¶¶ 1-2. On October 5, 1992, he obtained a disability-insurance policy (“the Policy”) from MassMutual. Id. ¶ 3. The Policy provides a maximum monthly benefit of $3,000 and an additional $1,000 monthly maximum if Dr. Hunter does not receive other disability benefits. See Ex. 1 to Def.’s Mot. for Summ. J. (“Mot.”), ECF No. 24 at 3, 23. 1 The amount of benefits to be paid each month is tied to Dr. Hunter’s “loss of earned income,” which is the difference between his average monthly income during the twelve months preceding the onset of his disability and his income during the current month. See id. at 7-8.

Benefits may be paid only after a waiting period, which lasts for sixty days after the onset of the disability. Id. at 3-4, 9. Benefits are then available “subject to certain notice and proof of disability requirements.” Id. at 13. The insured must provide “notice” by indicating in writing that he “is disabled and that a claim may be made,” and must do so “before the end of 20 days after the Waiting Period, or as soon afterwards as it is reasonably possible to do so.” Id. He must also submit “proof of claim ... before the énd of 90 days after the end of each monthly period” for which he claims benefits. Id. “[I]f it is not reasonably possible to give ... proof within this time limit, then proof may be given as soon thereafter as it is reasonably possible to do so.” Id. This extension is limited to one year, “[u]nless the delay is due to legal incapacity.” Id.

B. Dr. Hunter’s Injury and Insurance Claim

On July 17, 2004, Dr. Hunter was involved in a motorcycle accident. See Pl.’s Opp. to Mot. for Summ. J. (“Opp.”), ECF No. 27 at 2. He did not contact MassMu-tual about the accident until March 4, 2011, when he provided notice of a claim. See Ex. 2 to Mot., ECF No. 22-5 at 1-2. That day, MassMutual sent him a claim package and asked him to complete certain forms. Ex. 3 to Mot., ECF No. 22-6 at 1. On April 12, 2011, Dr. Hunter submitted' his forms and listed various medical conditions as resulting from the accident. See Ex. 4 to Mot., ECF No. 24-1 at 5.

MassMutual wrote Dr. Hunter on April 21, 2011 to request that he “explain, in *89 detail, why he filed a claim more than 6 years after the date on which he is claiming Partial Disability.” Ex. 5 to Mot., ECF No. 22-8 at 2. Dr. Hunter replied on June 3, 2011, and attached a letter from a doctor stating that the conditions resulting from the accident “caused [Dr. Hunter] to not pursue or understand the option of pursuing disability coverage since 2004.” Ex. 2 to Opp., ECF No. 28-1 at 3.

On October 20, 2011, MassMutual approved Dr. Hunter’s claim for disability benefits and assigned him a “temporary disability date of January 3, 2011.” Ex. 6 to Mot., ECF No. 22-9 at 1. On February 14, 2012, MassMutual wrote to Dr. Hunter to inform him of its conclusion that his “permanent date of disability” for the purpose of calculating his entitlement to benefits would be January 3, 2011. See Ex. 7 to Mot., ECF No. 22-10. Among other reasons for this decision, MassMutual stated:

[W]e did not receive notice of claim from Dr. Hunter until March 4, 2011 and we did not receive the initial Proof of Loss until April 6, 2011. It is important to note that this is more than 6 [é years after Dr. Hunter’s reported date of disability. As a result of the late notice of claim and proof of loss submission, MassMutual’s rights have been severely prejudiced .... As such, we are unable to make an accurate assessment of any benefits to which Dr. Hunter may be eligible for prior to January 3, 2011.

Id. at 3 (emphasis added).

C. Procedural History

Dr. Hunter filed this lawsuit on July 9, 2012, alleging that MassMutual breached the insurance contract by failing to pay disability benefits to cover the period from July 17, 2004 to January 2, 2011, and by calculating his prospective benefits based on his average monthly income from the twelve months preceding January 3, 2011, rather than July 17, 2004. See Compl., ECF No. 3 ¶¶ 23-29. He was initially granted leave to proceed under the pseudonym John Doe. See Order, ECF No. 2.

On September 10, 2012, MassMutual filed two motions to dismiss. The first claimed that Dr. Hunter violated Federal Rule of Civil Procedure 10(a) by filing his ' complaint under a pseudonym. See Mem. in Supp. of Mot. to Dismiss, ECF No. 4-1. The second motion sought dismissal of various claims and forms of relief. See Mem. in Supp. of Mot. to Dismiss, ECF No. 5-1. After a hearing, the Court ordered Dr. Hunter to proceed under his real name, and dismissed certain of his claims and requests for relief. See Minute Order of May 2, 2013.

On September 9, 2013, MassMutual moved for summary judgment. See Mem. in Supp. of Mot. (“Mem.”), ECF No. 22-2. Dr. Hunter filed his opposition on November 18, 2013. See Opp. MassMutual filed its reply on December 6, 2013. See Def.’s Reply (“Reply”), ECF No. 29. The Court held a hearing on May 21, 2014, and subsequently ordered the parties to file supplemental briefs. See Pl.’s Suppl. Br., ECF No. 33; Defi’s Suppl. Br., ECF No. 35. The motion for summary judgment is now ripe for decision.

II. STANDARD OF REVIEW

Pursuant to Federal Rule of Civil Procedure 56, summary judgment should be granted only if the moving party has shown that there are no genuine issues of material fact and that it is entitled to judgment as a matter of law. See Fed. R. Civ. P. 56; Celotex Corp. v. Catrett, 477 U.S. 317, 322, 106 S.Ct. 2548, 91 L.Ed.2d 265 (1986).

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

Related

Klaxon Co. v. Stentor Electric Manufacturing Co.
313 U.S. 487 (Supreme Court, 1941)
Anderson v. Liberty Lobby, Inc.
477 U.S. 242 (Supreme Court, 1986)
Smith-Haynie, J. C. v. Davis, Addison
155 F.3d 575 (D.C. Circuit, 1998)
Athridge v. Aetna Casualty & Surety Co.
351 F.3d 1166 (D.C. Circuit, 2003)
United States v. Lawrence P. Robinson
459 F.2d 1164 (D.C. Circuit, 1972)
Diamond Service Co. v. Utica Mutual Insurance
476 A.2d 648 (District of Columbia Court of Appeals, 1984)
Seabra v. PURITAN LIFE INSURANCE COMPANY
369 A.2d 652 (Supreme Court of Rhode Island, 1977)
Carey Canada, Inc. v. California Union Insurance
748 F. Supp. 8 (District of Columbia, 1990)
Cameron v. USAA Property & Casualty Insurance
733 A.2d 965 (District of Columbia Court of Appeals, 1999)
Potomac Electric Power Co. v. California Union Insurance
777 F. Supp. 968 (District of Columbia, 1991)
Starks v. North East Insurance Co.
408 A.2d 980 (District of Columbia Court of Appeals, 1979)
Travelers Indemnity Co. v. United Food & Commercial Workers International Union
770 A.2d 978 (District of Columbia Court of Appeals, 2001)
Greycoat Hanover F Street Ltd. Partnership v. Liberty Mutual Insurance
657 A.2d 764 (District of Columbia Court of Appeals, 1995)
Miller v. Rosenker
578 F. Supp. 2d 67 (District of Columbia, 2008)
National Railroad Passenger Corp. v. Lexington Insurance
445 F. Supp. 2d 37 (District of Columbia, 2006)

Cite This Page — Counsel Stack

Bluebook (online)
53 F. Supp. 3d 86, 2014 WL 3427195, 2014 U.S. Dist. LEXIS 95808, Counsel Stack Legal Research, https://law.counselstack.com/opinion/hunter-v-massachusetts-mutual-life-insurance-company-dcd-2014.