Richardson v. Guardian Life Insurance Co. of America

984 P.2d 917, 161 Or. App. 615, 1999 Ore. App. LEXIS 1218
CourtCourt of Appeals of Oregon
DecidedJuly 7, 1999
Docket9608-06418; CA A101063
StatusPublished
Cited by23 cases

This text of 984 P.2d 917 (Richardson v. Guardian Life Insurance Co. of America) is published on Counsel Stack Legal Research, covering Court of Appeals of Oregon primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Richardson v. Guardian Life Insurance Co. of America, 984 P.2d 917, 161 Or. App. 615, 1999 Ore. App. LEXIS 1218 (Or. Ct. App. 1999).

Opinion

*617 BREWER, J.

Plaintiff appeals from summary judgment for defendants on each of his multiple tort, contract, statutory, and other claims in this action relating to the interpretation of two business overhead disability insurance policies. Defendants are his insurer and insurance agent. Plaintiffs overarching contentions are that the trial court erred in dismissing his primary claims that the policies covered overhead expenses incurred after he sold his dental practice or, alternatively, that the insurer is estopped from denying coverage after its agent stated that coverage existed. Therefore, plaintiff asserts that his other claims, each of which depends heavily on one or the other of his primary claims, remain viable as well. For the reasons that follow, we affirm.

On appeal from summary judgment, we view the facts and all reasonable inferences drawn from those facts in the light most favorable to plaintiff, the nonmoving party. Jones v. General Motors Corp., 325 Or 404, 420, 939 P2d 608 (1997). Plaintiff was the sole shareholder of Bruce L. Richardson, D.M.D., P.C. (the corporation), the professional corporation through which he practiced dentistry. In 1987, plaintiff purchased two business overhead expense policies from defendant, The Guardian Life Insurance Company of America (Guardian), through an insurance agent, defendant Clifford Bailey. Each policy covered up to $2,000 per month in overhead expenses of plaintiffs business should he become disabled. The policies identically defined covered expenses as follows:

“Covered expenses mean regular business expenses:
“• which you normally incur in the conduct of your business or profession;
“• which require a cash payment; and
“• which the United States Internal Revenue Service accepts as tax deductible business overhead expenses.
“As part of your proof of loss while you are disabled, you must give us a written statement of the covered expenses you incur each month.” 1

*618 Each policy defined “total disability” as the inability “to perform the major duties of your occupation.” The policies also provided that the insured “may” cancel should he or she discontinue practice. According to a pamphlet accompanying the policies to qualify for coverage, the insured either was required to own 20 percent of the practice or to “have a contractual obligation” to pay the overhead expenses of the business.

In March 1996, plaintiffs health began to deteriorate. In April of that year, he entered into negotiations to sell all of his stock in the corporation to one of its employees, Dr. Keys. Plaintiff retained an experienced and qualified attorney to advise him and to document the transaction. By May 8, plaintiff was no longer able to work as a dentist and was totally disabled within the meaning of the policies. In early May, Keys became concerned that she would not be able to pay all of the overhead expenses of the corporation while she was building up her clientele. Plaintiff informed Bailey of the plan to sell his practice, and plaintiff claims that Bailey told him that the policies might cover his overhead expenses. Plaintiff’s attorney analyzed the policies and provided plaintiff with legal advice concerning the prospects for coverage of overhead expenses under the policies following the sale of plaintiffs stock. On May 20, plaintiffs attorney asked Bailey whether the policies would cover the overhead expenses under those circumstances. According to plaintiffs attorney, Bailey told him that the policies would provide that *619 coverage. The attorney recommended that plaintiff enter into the stock purchase agreement, including a provision binding plaintiff to pay one year’s overhead expenses. Plaintiff and Keys executed the agreement on or about May 23. The agreement was expressly made retroactive, effective May 8. On June 25, plaintiff submitted a notice of disability claim to Guardian under the policies. The notice stated that plaintiff had been disabled since May 8. Guardian denied coverage, and plaintiff filed this action to recover damages, including the overhead expenses that he agreed to pay on behalf of Keys.

Plaintiff made six claims against Guardian. Those claims allege breach of contract, estoppel to deny coverage, unfair claim settlement practices, bad faith denial of coverage, breach of the implied covenant of good faith and fair dealing, and intentional infliction of emotional distress. Plaintiff sought damages and attorney fees as remedies. Plaintiff alleged three claims against Bailey, including negligence, breach of the covenant of good faith and fair dealing, and intentional infliction of emotional distress. Guardian filed its first motion for summary judgment against the breach of contract and estoppel claims. The trial court granted summary judgment on the breach of contract claim but initially denied summary judgment on the estoppel claim. Guardian later filed a second motion for summary judgment, this time challenging the unfair claims settlement practices, bad faith denial of coverage, breach of the covenant of good faith and fair dealing, and attorney fees claims. The trial court granted Guardian’s second summary judgment motion as to all claims moved against except the attorney fee claim. Finally, Guardian filed a third motion for summary judgment on plaintiffs remaining claims, including estoppel and intentional infliction of emotional distress. Bailey also moved for summary judgment on each of plaintiffs claims against him. The trial court granted the motions in their entireties and entered final judgment dismissing all of plaintiffs claims.

Plaintiffs first assignment of error contests the trial court’s conclusion that the policies did not cover his claim for business overhead expenses and, therefore, that Guardian’s denial of coverage was not a breach of contract. Guardian *620 argues that the trial court correctly concluded that there was no coverage, because the policies only covered expenses plaintiff incurred in conducting his business or profession. Guardian asserts that the claimed expenses were incurred in Keys’ business at a time when plaintiff no longer conducted a business. Plaintiff counters that the policy language is ambiguous and that the phrase “which you normally incur in the conduct of your business or profession” must be examined in light of the policies as a whole. Plaintiff argues that the term “business or profession” applies to his circumstances because, consistent with the example in the policy pamphlet, he remains contractually obligated to pay Keys’ overhead expenses. He also relies on the policies’ definition of “total disability”:

“Total disability means that, because of sickness or injury, you are not able to perform the major duties of your occupation.
“Occupation means your regular occupation or profession at the time you become totally disabled.” (Emphasis added and in original.)

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Bluebook (online)
984 P.2d 917, 161 Or. App. 615, 1999 Ore. App. LEXIS 1218, Counsel Stack Legal Research, https://law.counselstack.com/opinion/richardson-v-guardian-life-insurance-co-of-america-orctapp-1999.