Leach v. Northwestern Mutual Insurance

262 F. App'x 455
CourtCourt of Appeals for the Third Circuit
DecidedJanuary 29, 2008
Docket06-4786, 06-5081
StatusUnpublished
Cited by15 cases

This text of 262 F. App'x 455 (Leach v. Northwestern Mutual Insurance) is published on Counsel Stack Legal Research, covering Court of Appeals for the Third Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Leach v. Northwestern Mutual Insurance, 262 F. App'x 455 (3d Cir. 2008).

Opinion

OPINION OF THE COURT

JORDAN, Circuit Judge.

Mark J. Leach (“Leach”) appeals from the November 16, 2006 and November 28, 2006 final judgments of the District Court entering judgment in favor of Northwestern Mutual Life Insurance Company (“Northwestern”) following a jury trial in this breach of contract case. The jury returned a verdict against Leach on his breach of contract claim, and in favor of Northwestern on its claims for breach of contract, unjust enrichment, misrepresentation and fraud. The District Court also awarded attorneys’ fees and costs to Northwestern. Jurisdiction in the District Court was predicated on 28 U.S.C. § 1332(a), and we have jurisdiction pursuant to 28 U.S.C. § 1291. 1 We will affirm the final order and judgment of the District Court.

I.

This is a dispute over whether Leach is entitled to continue to receive total disability benefits under an insurance contract with Northwestern. Leach purchased the policy on October 2, 1987 (the “Policy”). The Policy provided for certain benefits in the event of total disability and a different level of benefits in the event of partial disability. To prove total disability, Leach had to prove, by a preponderance of the evidence, that he was unable to perform the principal duties of his occupation and that he was not gainfully employed in any occupation.

Leach suffered a heart attack in May 1991 and began receiving total disability benefits under the Policy in September of that year. At some point, he claimed and received total disability benefits based *458 upon a muscle condition and exhaustion, as opposed to his heart attack. In mid-1998, Northwestern began a detailed review of Leach’s claims. As a result of the investigation, it concluded that Leach was no longer totally disabled, as defined by the Policy. Northwestern had discovered that, during Leach’s period of alleged disability, he became an owner and manager of a restaurant and a marina, that he owned and operated a fishing boat, that he traveled to Russia to negotiate an oil contract, and that he performed paid consulting work for M & K Electrical, his former company.

Northwestern stopped paying disability benefits to Leach in April 2001, and it demanded that Leach reimburse it in the amount of $219,271.60 for benefits paid from September 1998 through March 2001. Leach then filed a complaint against Northwestern, seeking damages based on breach of contract, bad faith, and deceptive business practices. Northwestern counterclaimed for breach of contract, fraud, misrepresentation, unjust enrichment and declaratory judgment. The parties engaged in extensive fact discovery and filed cross motions for summary judgment. On December 22, 2005, the District Court issued an opinion and order denying Leach’s motion for summary judgment and granting in part Northwestern’s motion on Leach’s bad faith and deceptive business practices claims. The case went to trial in September 2006, resulting in a jury verdict in favor of Northwestern on all claims.

II.

Leach raises three arguments on appeal. First, he says that the District Court abused its discretion by denying his motion for leave to amend his complaint. Second, he claims that the District Court committed legal error in granting summary judgment to Northwestern on his bad faith and deceptive business practices claims. Finally, he argues that the District Court erred in submitting amended special interrogatories to the jury after it first returned a set of inconsistent answers. We address each argument in turn.

III.

Leach claims that the District Court abused its discretion by denying his motion to amend his complaint to add a claim for partial disability. Leach did not assert a claim for partial disability in his complaint or in his reply to Northwestern’s counterclaim. On December 22, 2005, the District Court issued its opinion and order on summary judgment, which stated, “[t]he plaintiff does not claim partial disability,” (App.234) 2 ; “[a]t the heart of this case is whether the plaintiff qualified for benefits because he was totally disabled as defined in the policy,” (App.239-40); and “[tjhere is no record evidence that either the plaintiff or the defendant discussed payments for partial disability, and the plaintiff testified that he is seeking payment in this action only for full, not partial, disability.” (App.241).

During the pretrial conference on September 5, 2006, the morning of trial, the District Court confirmed on the record that the parties were “strictly talking about a claim for complete disability during the period in question.” (App.78.) Northwestern’s counsel responded in the affirmative, and Leach’s counsel stated, “When I—I’m going to preserve my objection on the record, and I oppose that ruling based on the fact that we should have leave [to amend]. Our pleadings do reflect Mr. Leach’s subsequent employment after filing the complaint. So, we object to the ruling. Thank you.” (App.78-9.)

The docket and record reflect that Leach never filed a motion to amend his *459 complaint to add a claim of partial disability, nor do Leach’s pleadings reflect such a claim, contrary to counsel’s statements. The District Court issued an opinion that clearly states, at least three times, that Leach’s claim was only for total disability. Leach does not even attempt to explain why he did not seek leave to amend his complaint to add a claim of partial disability after the District Court issued its opinion and prior to trial. His argument on appeal appears to be nothing more than a post hoc attempt to amend his complaint. We cannot say that the District Court abused its discretion in denying a motion to amend because such a motion was never actually before the District Court.

IV.

Leach next argues that the District Court committed legal error in granting partial summary judgment to Northwestern on the issues of bad faith and deceptive business practices. He claimed that Northwestern had acted in violation of Pennsylvania’s bad faith statute, 42 Pa. C.S. § 8871. To sustain such a claim, Leach needed to prove by clear and convincing evidence that (1) the insurer lacked a reasonable basis to deny benefits under the policy; and (2) the insurer knew or recklessly disregarded its lack of a reasonable basis. Klinger v. State Farm Mut. Auto. Ins. Co., 115 F.3d 230, 233 (3d Cir.1997). The District Court found that Leach failed to meet his burden, and it further held that he had presented no competent evidence from which a reasonable jury could find that the insurer acted in bad faith. In particular, the District Court determined that Northwestern provided ample documentation showing that it had conducted an extensive evaluation into Leach’s claim and had a reasonable basis for denying benefits. We agree.

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Bluebook (online)
262 F. App'x 455, Counsel Stack Legal Research, https://law.counselstack.com/opinion/leach-v-northwestern-mutual-insurance-ca3-2008.