Lloyd Wickboldt v. Massachusetts Mutual Life Insurance Company

CourtCourt of Appeals for the Eleventh Circuit
DecidedDecember 1, 2020
Docket19-14032
StatusUnpublished

This text of Lloyd Wickboldt v. Massachusetts Mutual Life Insurance Company (Lloyd Wickboldt v. Massachusetts Mutual Life Insurance Company) is published on Counsel Stack Legal Research, covering Court of Appeals for the Eleventh Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Lloyd Wickboldt v. Massachusetts Mutual Life Insurance Company, (11th Cir. 2020).

Opinion

USCA11 Case: 19-14032 Date Filed: 12/01/2020 Page: 1 of 10

[DO NOT PUBLISH]

IN THE UNITED STATES COURT OF APPEALS

FOR THE ELEVENTH CIRCUIT ________________________

No. 19-14032 ________________________

D.C. Docket No. 6:17-cv-02208-JA-EJK

LLOYD WICKBOLDT,

Plaintiff - Appellant,

versus

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY, A foreign corporation,

Defendant - Appellee.

________________________

Appeal from the United States District Court for the Middle District of Florida ________________________

(December 1, 2020)

Before MARTIN, LUCK, and BRASHER, Circuit Judges.

MARTIN, Circuit Judge: USCA11 Case: 19-14032 Date Filed: 12/01/2020 Page: 2 of 10

Lloyd Wickboldt appeals the District Court’s order denying him summary

judgment and granting summary judgment to Massachusetts Mutual Life Insurance

Co. (“MassMutual”). He claims the terms of his disability policy, and attached

riders and other documents, entitle him to a cost of living adjustment in addition to

his monthly disability benefit for the rest of his life. After careful consideration,

and with the benefit of oral argument, we affirm the District Court’s order.

I. FACTUAL BACKGROUND In 1985, Dr. Wickboldt, then a 33-year-old dermatologist, bought a

disability insurance policy from MassMutual’s predecessor. 1 Dr. Wickboldt

purchased a basic policy (the “Basic Policy”) as well as a Cost of Living Rider (the

“COLA Rider”). One year later he bought a Lifetime Total Disability Benefits

Rider (the “Lifetime Rider”). We’ll refer to these documents collectively as the

“policy documents.”

In 2000, when he was 48 years old, Dr. Wickboldt became totally disabled.

MassMutual began paying Dr. Wickboldt $8,000 per month under the Basic

Policy. After one year, MassMutual also began paying Dr. Wickboldt an

additional sum under the COLA Rider. From May 2015 to August 2017, Dr.

Wickboldt was receiving about $16,000 per month in disability benefits under the

1 The fact that the disability policy was originally issued by a different company (which MassMutual acquired) has no impact on this case.

2 USCA11 Case: 19-14032 Date Filed: 12/01/2020 Page: 3 of 10

Basic Policy and the COLA Rider. But after September 1, 2017, and according to

its interpretation of the policy documents, MassMutual stopped paying Dr.

Wickboldt monthly benefits under the Basic Policy as modified by the COLA

Rider. It then started paying Dr. Wickboldt’s monthly payments of $8,000, which

was the new calculation of benefits provided under the Lifetime Rider. Dr.

Wickboldt, however, claims he is entitled to the additional COLA Rider benefits

for the rest of his life. He filed suit to recover those benefits.

In December 2018, Dr. Wickboldt filed for summary judgment.

MassMutual opposed Dr. Wickboldt’s motion. A few months later, the District

Court issued an order denying Dr. Wickboldt’s motion for summary judgment and

directing the clerk to enter judgment for MassMutual. The District Court found

that the policy documents were not ambiguous and the plain language indicated

that, “after September 1, 2017, Dr. Wickboldt is entitled to receive $8,000 in

benefits under the Lifetime Rider but is not entitled [to] benefits under the Basic

Policy or to past or future benefit increases under the COLA Rider.” The District

Court’s finding was based on a termination provision in the COLA Rider, which

the District Court said made “clear that benefit increases would not be paid beyond

September 1, 2017—the policy Anniversary on or after Dr. Wickboldt’s 65th

birthday.” The District Court thus rejected each of Dr. Wickboldt’s theories of

interpretation.

3 USCA11 Case: 19-14032 Date Filed: 12/01/2020 Page: 4 of 10

II. THE POLICY DOCUMENTS

The Basic Policy sets forth several definitions that apply with equal force to

the terms in the attached riders. For example, “Maximum Benefit Period” is

defined as “The maximum length of time we’ll pay benefits, whether for total

disability, residual disability or a combination of both.” The Basic Policy pays out

benefits for Total Disability, but MassMutual will “only pay up to the maximum

benefit period.”

The COLA Rider describes itself as “provid[ing] monthly benefit increases

while you’re totally or residually disabled.” In relevant part, the COLA Rider

provides:

When We’ll Pay Monthly Benefit Increases. We’ll pay monthly benefit increases while you’re receiving total or residual disability benefits.

...

How Long We’ll Pay Benefit Increases. While you’re totally or residually disabled, we’ll pay benefit increases until the earliest of:

• the date your total or residual disability ends; • the date the maximum benefit period under this rider ends; [or] • the anniversary on or after your 65th birthday. ...

Termination. This rider will end on the earliest of the following dates:

• 31 days after the due date of any unpaid premium;

4 USCA11 Case: 19-14032 Date Filed: 12/01/2020 Page: 5 of 10

• as of the next premium due date upon your written request; • the anniversary on or after your 65th birthday; [or] • the date that your policy ends.

The Lifetime Rider says it “provides monthly total disability benefits to be

paid beyond the Anniversary on or after your 65th birthday. Benefits will be paid

for life.” The Lifetime Rider also includes the following terms:

When We’ll Pay Monthly Total Disability Benefits. If you’re eligible,2 your monthly benefits under this rider will start after the Anniversary on or after your 65th birthday. We’ll make the first payment 1 month after that Anniversary. We’ll continue to make monthly payments as long as you remain totally disabled.

Monthly Total Disability Benefit. The largest amount of monthly benefit you will receive under this rider is shown on the current Coverage Page of your policy. ...

Termination. This rider will end on the earliest of the following dates.

• 31 days after the due date of any unpaid premium, • as of the next premium due date upon your written request, • the Anniversary on or after your 65th birthday, 3 [or] • the date that your policy ends.

2 There is no dispute that Dr. Wickboldt is eligible for benefits under the Lifetime Rider. 3 We do not read this termination provision as being in conflict with the provision describing when benefits begin. Because the purpose of the Lifetime Rider “is to provide benefits . . . beyond the age of 65,” this termination provision makes clear that the Lifetime Rider terminates at age 65 if the insured does not become totally disabled before the age of 65. See Oral Argument Recording at 29:15–31:03 (Nov. 18, 2020).

5 USCA11 Case: 19-14032 Date Filed: 12/01/2020 Page: 6 of 10

Finally, the “Coverage Page” referred to in the Monthly Total Disability

Benefit under the Lifetime Rider sets forth, in pertinent part:

EFFECTIVE COVERAGE MONTHLY MAXIMUM * BENEFIT ANNUAL DATE BENEFIT PERIOD PREMIUM SEP 01 1985 BASIC MONTHLY $8,000 TO 65 $1,940.20 BENEFIT WITH THEREAFTER $3,049.00 ADJUSTABLE BENEFIT SEP 01 1985 PARTIAL DISABILITY $4,000 $360.00 SEP 01 1986 LIFETIME $8,000 $475.20 ACCIDENT/SICKNESS SEP 01 1985 COST OF LIVING RIDER $763.20 MAXIMUM 7.50%

SEP 01 1985 OWN OCCUPATION/ $8,000 THEREAFTER $220.00 PRESUMPTIVE DIS $368.80 RIDER

YOUR MAXIMUM MONTHLY BENEFIT IS $8,000

The asterisk in Maximum Benefit Period refers to the statement that “[y]our

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Bluebook (online)
Lloyd Wickboldt v. Massachusetts Mutual Life Insurance Company, Counsel Stack Legal Research, https://law.counselstack.com/opinion/lloyd-wickboldt-v-massachusetts-mutual-life-insurance-company-ca11-2020.