Mike Howisey v. Transamerica Life Ins. Co.

CourtCourt of Appeals for the Ninth Circuit
DecidedMarch 21, 2019
Docket17-36045
StatusUnpublished

This text of Mike Howisey v. Transamerica Life Ins. Co. (Mike Howisey v. Transamerica Life Ins. Co.) is published on Counsel Stack Legal Research, covering Court of Appeals for the Ninth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Mike Howisey v. Transamerica Life Ins. Co., (9th Cir. 2019).

Opinion

NOT FOR PUBLICATION FILED UNITED STATES COURT OF APPEALS MAR 21 2019 MOLLY C. DWYER, CLERK U.S. COURT OF APPEALS FOR THE NINTH CIRCUIT

MIKE HOWISEY, as attorney in fact for No. 17-36045 Wallace E. Howisey, an incapacitated person and WALLACE HOWISEY, an D.C. No. 2:17-cv-00009-RSM incapacitated person,

Plaintiffs-Appellants, MEMORANDUM*

v.

TRANSAMERICA LIFE INSURANCE COMPANY, a foreign corporation organized under laws of the State of Iowa,

Defendant-Appellee.

Appeal from the United States District Court for the Western District of Washington Ricardo S. Martinez, Chief Judge, Presiding

Argued and Submitted March 4, 2019 Seattle, Washington

Before: GOULD and PAEZ, Circuit Judges, and BASHANT,** District Judge.

Mike Howisey, attorney-in-fact for his father, Wallace E. Howisey

* This disposition is not appropriate for publication and is not precedent except as provided by Ninth Circuit Rule 36-3. ** The Honorable Cynthia A. Bashant, United States District Judge for the Southern District of California, sitting by designation. (“Howisey”), appeals various district court orders in a dispute arising from the long-

term care insurance policy (the “Policy”) Howisey held with Transamerica Life

Insurance Company (“Transamerica”).1 This dispute involves two Policy benefits:

(1) the Nursing Home Benefit, which covers the cost of care in a state-licensed

nursing home and (2) the separate Assisted Living Facility (“ALF”) Benefit, which

covers the cost of care in a licensed ALF.

Beginning in October 2014, Howisey received care for Alzheimer’s at Aegis

of Kirkland (“Aegis”), a facility licensed by the state of Washington as an assisted

living facility. Howisey submitted a Policy coverage claim for his Aegis stay, which

Transamerica approved for the ALF Benefit. After exhausting his ALF Benefit in

March 2016, Howisey claimed entitlement to the Nursing Home Benefit to cover his

Aegis stay. Transamerica investigated and ultimately denied Howisey’s second

claim because it determined that Aegis was not a state-licensed nursing home, nor

substantially like one under the Policy. Howisey rejected an alternate care plan

Transamerica offered to cover his Aegis stay pursuant to the Policy and filed this

suit instead. In relevant part, Howisey raised claims for breach of contract and

common law and statutory bad faith. He sought damages and declaratory relief.

Transamerica moved for summary judgment on all of Howisey’s claims and

1 We grant the motion by United Policyholders to file an amicus curiae brief in support of Howisey. Dkt. No. 17-1.

2 17-36045 Howisey cross-moved on his coverage claim. The district court granted summary

judgment for Transamerica, denied Howisey’s Rule 56(d) request for additional

discovery, and denied Howisey’s subsequent motion for reconsideration of summary

judgment. Howisey appeals the district court’s summary judgment order and denial

of his Rule 56(d) request.2 We have jurisdiction pursuant to 28 U.S.C. § 1291 and

we affirm.

We review de novo a district court’s grant of summary judgment.

Campidoglio LLC v. Wells Fargo & Co., 870 F.3d 963, 973 (9th Cir. 2017). We

view the evidence in the light most favorable to the nonmovant and inquire “whether

there are any genuine issues of material fact and whether the district court correctly

applied the relevant substantive law.” Oswalt v. Resolute Indus., Inc., 642 F.3d 856,

859 (9th Cir. 2011) (citation omitted). Washington law applies in this diversity

action. Stanford Ranch v. Md. Cas. Co., 89 F.3d 618, 624 (9th Cir. 1996). We may

affirm the district court’s order “for any reason supported by the record.” Travelers

Prop. Cas. Co. of Am. v. ConocoPhillips Co., 546 F.3d 1142, 1145 (9th Cir. 2008).

2 We deem waived Howisey’s appeal of the reconsideration order because Howisey’s opening brief failed to identify the applicable review standard or argue why the order fails under that standard. See Lolli v. Cty. of Orange, 351 F.3d 410, 415 (9th Cir. 2003). We will not consider arguments related to the order raised for the first time in reply. United States v. Alcan Elec. & Eng’g, Inc., 197 F.3d 1014, 1019 (9th Cir. 1999). Howisey’s opening brief does not address the summary judgment rulings on his negligent retention and hiring and intentional misrepresentation claims. Those claims are therefore waived, and we do not address them. Miller v. Fairchild Indus., Inc., 797 F.2d 727, 738 (9th Cir. 1986).

3 17-36045 We review a denial of a Rule 56(d) request for abuse of discretion. Tatum v. City &

Cty. of San Francisco, 441 F.3d 1090, 1100 (9th Cir. 2006).

1. The district court did not err in granting summary judgment for

Transamerica on Howisey’s coverage claim because the Policy’s Nursing Home

Benefit does not cover Howisey’s Aegis stay. “The court examines the terms of an

insurance contract to determine whether under the plain meaning of the contract

there is coverage.” Kitsap Cty. v. Allstate Ins. Co., 964 P.2d 1173, 1178 (Wash.

1998). “If terms are defined in a policy, then the term should be interpreted in

accordance with that policy definition.” Id. The Policy expressly defines the term

“Nursing Home” to mean a state-licensed nursing home and the Policy’s Nursing

Home Benefit provisions use this defined term. Aegis was undisputedly not a state-

licensed nursing home. Thus, pursuant to the Nursing Home definition’s

unambiguous language, the Nursing Home Benefit does not embrace Howisey’s

Aegis stay.3 The district court properly determined that the Nursing Home Benefit’s

3 We reject Howisey’s arguments that certain Washington law principles of insurance policy interpretation applicable to coverage and exclusion provisions warrant a different result. In addition to incorporating the Nursing Home definition, the Policy’s Nursing Home Benefit coverage and exclusion provisions expressly require care in a state-licensed nursing home. We cannot ignore the plain language of these provisions to import meanings the provisions preclude. See Quadrant Corp. v. Am. States Ins. Co., 110 P.3d 733, 737 (Wash. 2005) (holding that strict application of an insurance exclusion provision “should not trump the plain, clear language of an exclusion”); State Farm Mut. Auto. Ins. Co. v. Ruiz, 952 P.2d 157, 159 (Wash. 1998) (“[C]ourts must liberally construe inclusionary clauses in

4 17-36045 substantial compliance provision is not at issue because Transamerica’s personal

care advisor did not agree that Aegis substantially complies with the Policy’s

Nursing Home definition.

We reject Howisey’s arguments that Washington’s Long-Term Care

Insurance Act and implementing regulations render invalid the Policy’s state-

licensed nursing home requirement. See Wash. Rev.

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