James Fortune v. Unum Life Insurance Company of America

360 S.W.3d 390, 2010 Tenn. App. LEXIS 643, 2010 WL 3984705
CourtCourt of Appeals of Tennessee
DecidedOctober 12, 2010
DocketW2009-01395-COA-R3-CV
StatusPublished
Cited by18 cases

This text of 360 S.W.3d 390 (James Fortune v. Unum Life Insurance Company of America) is published on Counsel Stack Legal Research, covering Court of Appeals of Tennessee primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
James Fortune v. Unum Life Insurance Company of America, 360 S.W.3d 390, 2010 Tenn. App. LEXIS 643, 2010 WL 3984705 (Tenn. Ct. App. 2010).

Opinion

OPINION

DAVID R. FARMER, J.,

delivered the opinion of the Court,

in which ALAN E. HIGHERS, P.J., W. S., and HOLLY M. KIRBY, J., joined.

This appeal arises out of an alleged wrongful denial of long term disability benefits. The plaintiff/appellant filed suit asserting multiple causes of action against an insurance company that contracted to provide long term disability insurance to employees of the City of Germantown. The defendants/appellees, the insurance company and its parent corporation, moved for summary judgment arguing, inter alia, that the applicable statutory and contractual limitations periods barred each of the plaintiffs causes of action. The trial court agreed and granted summary judgment in favor of the defendants. We affirm.

I. Background and Procedural History

The following facts are undisputed. Unum Life Insurance Company of America (“Unum Life”) issued a group long term disability policy to the City of Ger-mantown, Tennessee on June 1, 1994. James Fortune (“Fortune”) was insured under this policy when he became disabled on or about June 15, 1999. Unum Life paid long term disability benefits to Fortune for a period but terminated his claim after concluding he was ineligible to receive continued benefits. Unum Life informed Fortune’s then counsel of the termination by letter dated October 19, 2001, explaining that Fortune’s benefits would cease on October 81, 2001.

More than three years later, Unum Life entered into a “Regulatory Settlement Agreement” (“RSA”) with state insurance regulators, including the Commissioner of the Tennessee Department of Commerce and Insurance, and the United States Department of Labor. The RSA, among other things, created a “plan of corrective action” to address a number of regulatory and statutory concerns raised regarding prior claim assessments. It also instituted improved claim handling procedures for future claim assessments. Pertinent to this appeal, the RSA established a claim reassessment process through which an identified class of claimants could receive de novo review of prior assessments. Importantly, however, the RSA specifically stated that neither it “nor any of the relief to be offered under this Agreement shall be interpreted to alter in any way the contractual terms of any policy, or to constitute a novation of any policy.”

On January 13, 2005, the Claim Reassessment Unit of Unum Life’s parent corporation, UnumProvident Corporation (now known as “Unum Group”), mailed Fortune notice that his claim for long term disability benefits was eligible for reassessment under the terms of the RSA. Fortune soon thereafter executed a “Re *393 quest to Participate” form indicating his desire to participate in the claim reassessment process. After receiving further correspondence regarding his claim, Fortune executed a waiver and release containing the following language:

[A]ny applicable statute of limitations is tolled during the pendency of the reassessment of my claim; however, I understand that my participation in this Claim Reassessment Process will not revive or reinitiate the statute of limitations with respect to the previous claim decision.

The Claim Reassessment Unit thereafter initiated a review of Fortune’s claim, eventually informing Fortune’s present counsel by letter dated April 11, 2006, that it concurred in the original decision to deny Fortune continued disability benefits because he did not meet the definition of disability contained in the policy after October 31, 2001.

Fortune commenced this action against Unum Life in October 2006. 1 Fortune alleged in his complaint and amended complaint that: (1) Unum engaged in unfair and deceptive acts or practices in violation of the Tennessee Consumer Protection Act (“TCPA”) when it denied and continued to deny Fortune’s claim; (2) Unum knowingly, intentionally, and in bad faith denied and continued to deny Fortune’s claim; (3) Unum engaged in fraud and misrepresentation when it denied and continued to deny Fortune’s claim; (4) Unum knowingly concealed and continued to conceal relevant information from Fortune regarding his claim; and (5) Unum committed breach of contract when it denied Fortune’s claim in October 2001 and again intentionally violated the terms of the policy in April 2006. Fortune alleged that he incurred losses and injuries as a result of Unum’s actions including but not limited to loss of past due benefits plus interest, loss of his life insurance policy, loss of retirement benefits due to his forced early retirement, pain and suffering, and emotional distress. He requested compensatory damages and punitive damages, as well as treble damages and attorney’s fees for the alleged violation of the TCPA.

Unum subsequently filed a motion for summary judgment arguing, inter alia, that each cause of action asserted in Fortune’s complaint was time-barred. Unum argued that the lengthiest statutory or contractual limitations period applicable to the alleged causes of action was three years and that Fortune had filed his complaint nearly five years after his claims accrued. The trial court conducted a hearing on the motion and granted summary judgment in favor of Unum, finding “no genuine issue as to any material fact, and that Defendants are entitled to judgment *394 as a matter of law because all claims contained in Plaintiffs complaint are barred by the applicable contractual and statutory periods of limitations.” Fortune, as substituted by bankruptcy trustee Bettye Bedwell (“the Trustee”), later filed a motion to alter, amend, or vacate the court’s judgment, which the trial court denied. 2 Following denial of the motion, the Trustee timely appealed.

II.Issues Presented

The issues before this Court, as we perceive them, are:

(1) Whether Unum alleged undisputed facts to establish that an agreed three-year limitations period bars Fortune’s claim for breach of contract where Unum did not allege undisputed facts establishing that it apprised Fortune of the policy’s limitations provision;
(2) Whether the reassessment of Fortune’s claim revived his claim, renewed his policy, or otherwise constituted a new policy of insurance such that his breach of contract action did not accrue until the Claim Reassessment Unit concluded its review in April 2006; and
(3) Whether Unum presented undisputed facts to establish that the applicable statutes of limitations barred Fortune’s statutory and tort causes of action where Fortune filed a sworn affidavit stating that he learned of these causes of action within one year of the filing of his complaint.

III.Standard of Review

This Court reviews a trial court’s decision on a motion for summary judgment de novo with no presumption of correctness. Martin v. Norfolk S. Ry. Co., 271 S.W.3d 76, 84 (Tenn.2008) (citing Blair v. W. Town Mall,

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Cite This Page — Counsel Stack

Bluebook (online)
360 S.W.3d 390, 2010 Tenn. App. LEXIS 643, 2010 WL 3984705, Counsel Stack Legal Research, https://law.counselstack.com/opinion/james-fortune-v-unum-life-insurance-company-of-america-tennctapp-2010.