Provident Life & Accident Insurance v. Adie

176 F.R.D. 246, 1997 U.S. Dist. LEXIS 15046, 1997 WL 610046
CourtDistrict Court, E.D. Michigan
DecidedSeptember 29, 1997
DocketNo. 95-40183
StatusPublished
Cited by13 cases

This text of 176 F.R.D. 246 (Provident Life & Accident Insurance v. Adie) is published on Counsel Stack Legal Research, covering District Court, E.D. Michigan primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Provident Life & Accident Insurance v. Adie, 176 F.R.D. 246, 1997 U.S. Dist. LEXIS 15046, 1997 WL 610046 (E.D. Mich. 1997).

Opinion

MEMORANDUM OPINION AND ORDER REGARDING DEFENDANT’S MOTIONS IN LIMINE

GADOLA, District Judge.

This action involves a dispute as to whether Dr. James A. Adie (“Dr.Adie”) is entitled to benefits under a disability income policy (“Policy”) issued by Provident Life and Accident Insurance Company (“Provident”). Dr. Adie has submitted the following four motions in limine:

1. Motion in limine to preclude Provident from raising two additional policy defenses not asserted by Provident when it initially denied Dr. Adie coverage under the Policy.

2. Motion in limine to exclude from trial any evidence that Dr. Adie is not “totally disabled” within the meaning of the Policy.

3. Motion in limine to exclude any evidence regarding whether Dr. Adie was required to bring errors and/or discrepancies in his application to Provident’s attention.

4. Motion in limine to exclude any evidence of Dr. Adie’s income and employment after the date he signed his application for insurance.

FACTUAL BACKGROUND

On April 29,1993, Dr. Adie signed an offer to purchase the dental practice of Robert R. Olson, D.D.S., in Southfield, Michigan. Prior to entering the contract to purchase Dr. Olson’s practice, Dr. Adie received a Practice Summary. This summary contained a wealth of information, including a schedule of Dr. Olson’s wages and operating expenses for 1989-1991 and an “Income and Expense Projection,” wherein it was estimated that Dr. Adie’s adjusted gross income after expenses in his first year of ownership would be $87,-658.

On May 12, 1993, Dr. Adie contacted an independent insurance agent, Dale Weston, to purchase insurance for his new practice. Consequently, Dr. Adie signed an application for disability insurance (“Application”) with Provident. Part I, section 3(a) of the Application required Dr. Adie to provide Provident with his “Annual Earned Income From [His] Occupation for Federal Tax Purposes (After Business Expenses, if any).” More specifically, Part I, section 3(a) directed Dr. Adie to provide his “Current Annual Rate of Earned Income ” and his annual earned income for the “Actual Prior Calendar Year ” and the “Actual Year Prior to the Last Calendar Year." Dr. Adie stated that his “Current Annual Rate of Earned Income” was $80,000, his annual earned income for the “Actual Prior Calendar Year” (1992) was $60,000, and his annual earned income for the “Actual Year Prior to the Last Calendar Year” (1991) was $45,000.1

Upon signing the Application, Dr. Adie certified that:

To the best of [his] knowledge and belief, all of the foregoing statements [made in Part I] and all of those in Part II, if any, of this Application [were] true, complete, and correctly stated. They [were] offered to Provident Life and Accident Insurance Company as the basis for any insurance issued or th[e] Application.

[248]*248Approximately two weeks after the meeting with Weston, Dr. Adie was contacted via phone by a provident employee in Chattanooga, Tennessee to verify the answers he previously provided on his Application. Once again, Dr. Adie proclaimed that his “Current Annual Rate of Earned Income” was projected at $80,000 and that he had earnings of $60,000 and $45,000 for the prior two years, respectively.

Provident ultimately issued disability policy number 06-337-B-4098261 to Dr. Adie. The Policy became effective June 1, 1993. On June 2, 1993, the day after the Policy’s effective date, Dr. Adie began working at the newly acquired dental practice he purchased from Dr. Olson. Shortly thereafter, Dr. Olson demanded rescission of the purchase agreement. Two months after taking over the practice, on August 19, 1993, Dr. Adie entered into a settlement agreement with Dr. Olson that rescinded the prior purchase agreement. On August 30, 1993, Dr. Adie became employed at a dental office in Sterling Heights, Michigan, earning approximately $1,000 a week.

In June, 1994,2 Dr. Adie, who is right-handed, allegedly injured two fingers on his right hand while using a hand saw. He filed a Notice of Claim with Provident. Since the Notice of Claim was filed within the two year contestable period of the Policy, Provident initiated a routine claim investigation.3 The investigation revealed a discrepancy between the income representations Dr. Adie made in Part I, section 3(a) of the Application and the income Dr. Adie actually earned. Dr. Adie’s tax returns disclosed that actual earned income for 1993, 1992 and 1991 was $28,6394 $46,956 and $27,886, respectively. Dr. Adie had represented on his application that his projected income for 1993 was $80,000 and his actual 1992 and 1991 income was $60,000 and $45,000, respectively. Provident then denied Dr. Adie disability benefits claiming that Dr. Adie made material misrepresentations regarding his income. In a letter sent to Dr. Adie dated October 5, 1994, Provident stated, “[t]he Underwriter indicated that Provident relied on the information revealed on the application and the undisclosed information was material to the acceptance of the risk and policy [sic] would not have been issued as applied for if accurate [income] history had been revealed.”

PROCEDURAL HISTORY

On or about May 31, 1995, Provident filed the instant action for a declaratory judgment that the Policy issued to Dr. Adie is null and void and that Provident has no obligation under it whatsoever. On July 13, 1995, Dr. Adie filed his answer and a counter-claim. Dr. Adie’s counter-claim alleges that Provident wrongfully denied him benefits and seeks damages for this wrongful denial.

On June 24, 1996, Provident filed a motion for summary judgment, arguing that there is no genuine issue of material fact that Dr. Adie made material misrepresentations regarding his past and future income on his application for the Policy, and that Provident therefore correctly denied Dr. Adie benefits. Dr. Adie, on June 24, 1996, filed a cross-motion for summary judgment contending that there is no genuine issue of material fact that he did not make any material misrepresentations on his insurance application and is thus entitled to coverage under the Policy.

This court, in a memorandum opinion and order dated November 1, 1996, denied both parties’ motions for summary judgment. This court found:

1. Dr. Adie’s 1991 and 1992 income representations to Provident were misrepresentations, but there was a genuine issue of material fact as to whether they were material misrepresentations; the misrepresentations were material if Provident [249]*249would not have issued the same exact policy had Dr. Adie not made the misrepresentations.

2. There was a genuine issue of material fact as to whether Dr. Adie’s 1993 income projection was a misrepresentation. Assuming that his 1993 income projection was a misrepresentation, it was most certainly a material misrepresentation.

3. Provident relied on Dr. Adie’s statements regarding all three income representations.

This court held that the issues which remained to be litigated at trial are:

1. Whether Dr. Adie’s misrepresentations of his 1991 and 1992 income were material.

2. Whether Dr. Adie misrepresented his 1993 income.

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176 F.R.D. 246, 1997 U.S. Dist. LEXIS 15046, 1997 WL 610046, Counsel Stack Legal Research, https://law.counselstack.com/opinion/provident-life-accident-insurance-v-adie-mied-1997.