Long v. Time Insurance

572 F. Supp. 2d 907, 2008 U.S. Dist. LEXIS 79212, 2008 WL 3200847
CourtDistrict Court, S.D. Ohio
DecidedAugust 7, 2008
Docket1:06-cv-00701
StatusPublished
Cited by11 cases

This text of 572 F. Supp. 2d 907 (Long v. Time Insurance) is published on Counsel Stack Legal Research, covering District Court, S.D. Ohio primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Long v. Time Insurance, 572 F. Supp. 2d 907, 2008 U.S. Dist. LEXIS 79212, 2008 WL 3200847 (S.D. Ohio 2008).

Opinion

*909 OPINION AND ORDER

EDMUND A. SARGUS, JR., District Judge.

This matter is before the Court for consideration of Defendant Time Insurance Co.’s Motion for Summary Judgment (Doc. 65) and Defendant State Farm’s Motion for Summary Judgment (Doc. 78). For the reasons that follow, Defendants’ Motions for Summary Judgment are GRANTED.

I.

Plaintiff Frederick W. Long, IE, now deceased, filed an Amended Complaint on July 19, 2007, asserting claims against Defendant Time Insurance Company (f/k/a Fortis Insurance Company) (hereinafter, “Time”) for breach of contract, failure to act in good faith, and violation of Ohio Revised Code § 3923.14. Plaintiff asserted claims of negligent misrepresentation, professional negligence, negligence, negligent infliction of emotional distress, and breach of fiduciary duty against both Defendants Time and State Farm Insurance Company. The Estate of Frederick W. Long, HI has been substituted as the Plaintiff in this case (see Order, Doc. 86). 1 This Court has jurisdiction over Plaintiffs claims under 28 U.S.C. § 1332.

The undisputed facts, based upon the admissible evidence in the record, are as follows. Plaintiffs claims arise out of a short-term medical insurance policy, # ST6121980, issued to Plaintiff by Time, with an effective date of March 1, 2004. The policy was issued based on an application dated March 1, 2004, submitted to Time by insurance agent Amy Cunningham and prepared with the assistance of health care specialist Emily Bunts who was associated with Cunningham. Cunningham was the State Farm Agent for Plaintiffs homeowners’ insurance, which is file only connection between Plaintiff and Defendant State Farm.

On August 18, 2004, Plaintiff underwent surgery for replacement of an aortic valve, and submitted a claim for coverage of his medical expenses. Time denied coverage, after a routine investigation revealed that Plaintiff had been treated for a heart or circulatory system condition within the five years prior to applying for insurance. Question 3 in the application for his insurance policy asked:

[wjithin the last five (5) years, have you, your spouse or any dependent to be covered, ever received any medical or surgical consultation, advice, or treatment including medication for: heart or circulatory system disorder including heart attack or chest pain; stroke; diabetes; cancer or tumor; immune system disorder including acquired immune deficiency syndrome (AIDS); alcoholism or alcohol abuse; drug abuse or chemical dependency?

(Application, Doc. 65, Ex. 2). The application stated that Time would not issue a policy if the answer to Question 3 was “yes”; the answer to Question 3 on Plaintiffs application is “no.” (Id.) According to the affidavit and deposition testimony of the health insurance specialist who prepared Plaintiffs electronic application, Plaintiff verbally provided all of the information and answers that went into the application. He also reviewed and approved the information, and authorized his signature to be typed on the form and submitted. (See excerpts from the deposition transcript of Emily Bunts, Doc. 78, pp 21, 34-43, and Affidavit of Emily Bunts, Doc. 65, Ex. 38). Directly above Plaintiffs electronic signature, the application states:

The undersigned applicant and the agent acknowledge ... that the applicant has read, or has had read to him, the completed application. The appli *910 cant realizes that any false statement or misrepresentation in the application may result in claim denial or contract rescission ....

(Application, Doc. 65, Ex. 2).

Following Plaintiffs surgery in 2004, Time discovered that within the five-year period preceding March 1, 2004, Plaintiff received medical treatment, consultation and advice related to his pacemaker, an aneurysm, hypertension, aortic valve disorder, heart murmur, and underwent echo-cardiograms, CAT scans, and stress tests. As a result of this information, Time rescinded Plaintiffs Policy on January 7, 2005. (Doc. 65-34). Time’s letter to Plaintiff explained that the Policy was rescinded “based upon medical records provided by Dr. Held for the dates of service June 23, 2000, and January 2, 2001”. The June 23, 2000 record (Doc. 65-17) relates to a check-up for Plaintiffs pace-maker. The January 2, 2001 record (Doc. 65-15) is a letter from Dr. Streicher regarding the results of a CT scan which states: “yours is a precarious position. You are at risk for a catastrophe and a re-do surgery, although very risky, is our recommendation.”

As a result of the rescission, no coverage was in effect at the time of Plaintiffs August, 2004 surgery. Time’s decision to rescind the Policy was upheld by the Ohio Department of Insurance on January 26, 2006. (Doc. 65, Ex. 37). Plaintiffs lawsuit followed.

II.

A. Standard of Review and Burden on Summary Judgment

Summary judgment is proper where “the pleadings, the discovery and disclosure materials on file, and any affidavits show that there is no genuine issue as to any material fact and that the movant is entitled to judgment as a matter of law.” Fed.R.Civ.P. 56(c). The moving party bears the initial burden of demonstrating the absence of any genuine issue of material fact, and all inferences should be made in favor of the nonmoving party. Celotex Corp. v. Catrett, 477 U.S. 317, 323, 106 S.Ct. 2548, 91 L.Ed.2d 265 (1986).

To support its motion, the moving party may show “that there is an absence of evidence to support the nonmoving party’s case.” Id. at 325, 106 S.Ct. 2548. While all inferences must be drawn in favor of the nonmoving party, this Court is under no obligation to imagine favorable facts where the nonmoving party has alleged none. Avery v. Joint Twp. Dist. Mem’l Hosp., 2008 U.S.App. LEXIS 14078, 2008 WL 2596211 (6th Cir.Ohio 2008). “The mere existence of a scintilla of evidence in support of the plaintiffs position will be insufficient; there must be evidence on which the jury could reasonably find for the plaintiff.” Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 252, 106 S.Ct. 2505, 91 L.Ed.2d 202 (1986).

In opposing summary judgment, Plaintiff has an affirmative duty to “set out specific facts showing a genuine issue for trial.” Celotex, 477 U.S. at 324, 106 S.Ct. 2548. Conclusory statements, arguments, assertions, and pleadings are not facts, and do not constitute “evidence” under Rule 56. See 11 Moore’s Fed. Practice § 66.1[7][c] (3d ed.2007). Further, Rule 56 requires that affidavits and other evi-dentiary materials set forth facts that would be admissible at trial. Fed.R.Civ.P. 56(e)(1).

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572 F. Supp. 2d 907, 2008 U.S. Dist. LEXIS 79212, 2008 WL 3200847, Counsel Stack Legal Research, https://law.counselstack.com/opinion/long-v-time-insurance-ohsd-2008.