Saldi v. Paul Revere Life Ins.

224 F.R.D. 169, 2004 U.S. Dist. LEXIS 16318, 2004 WL 1858403
CourtDistrict Court, E.D. Pennsylvania
DecidedAugust 13, 2004
DocketNo. CIV.A. 99-6563
StatusPublished
Cited by119 cases

This text of 224 F.R.D. 169 (Saldi v. Paul Revere Life Ins.) is published on Counsel Stack Legal Research, covering District Court, E.D. Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Saldi v. Paul Revere Life Ins., 224 F.R.D. 169, 2004 U.S. Dist. LEXIS 16318, 2004 WL 1858403 (E.D. Pa. 2004).

Opinion

MEMORANDUM AND ORDER

SURRICK, District Judge.

Plaintiff, Thomas Saldi, (“Plaintiff’) commenced this action against Defendants Paul Revere Life Insurance Company, Provident Companies, Inc., Provident Life and Accident Insurance Company of America and Affiliates, and UnumProvident Corporation (collectively, “Defendants”), alleging that Defendants’ termination of Plaintiffs disability benefits was unreasonable and in bad faith, constituting a breach of Plaintiffs insurance contract (Count 1), a breach of the covenant of utmost fair dealing (Count 2), a violation of Pennsylvania’s Unfair Trade Practices and Consumer Protection Law, 73 PA. STAT. ANN. § 201-1, et seq. (Count 3), and a violation of Pennsylvania’s Bad Faith statute, 42 PA. CONS. STAT. ANN. § 8371 (Count 4). Presently before the Court are Defendants’ Objections (Doc. Nos. 52 and 59) to Magistrate Judge Arnold C. Rapoport’s Orders dated January 3, 2001 and March 6, 2001 (Doc. Nos. 49 and 57) pursuant to 28 U.S.C. § 636(b)(1)(A), and Defendants’ fifth Motion for a Protective Order (Doc. No. 80), which requests a protective order with respect to Plaintiffs Fourth Set of Requests for Production of Documents, Plaintiffs Third Set of Requests for Admissions, and Plaintiffs Fourth Set of Interrogatories pursuant to Federal Rule of Civil Procedure 26(c). See LOCAL R. CIV. P. 72.1(IV)(a). For the following reasons, we will affirm the Discovery Orders (Doc. Nos. 52 and 59) as modified herein and we will grant the Fifth Motion for Protective Order (Doc. No. 80) in part and deny it in part as provided herein.

1. Factual and Procedural Background1

Plaintiff alleges that he purchased an “own occupation” private long-term disability insurance policy from Paul Revere Insurance Company (“Paul Revere”) in 1990. (PL Compl.HH 19-20.) At that time, Plaintiff was the general manager of Bucks County Roses, a large, commercial rose grower. (Id. ¶ 21.) In or about January of 1992, Plaintiff was diagnosed with multiple sclerosis (“MS”), a progressive, degenerative disease of the central nervous system. (Id. ¶ 25.) On or about April of 1996, Plaintiff stopped working at Bucks County Roses, allegedly because his MS prevented him from working in the elevated temperature and humidity of the greenhouse. Id. K¶ 26. On or about June 6, 1996, Plaintiff applied for long-term disability benefits under his policy, claiming that he was totally disabled in his own occupation. (Id. ¶ 27.) Paul Revere determined that he was entitled to such benefits and began payments. (Id. ¶ 28.) Provident Companies (“Provident”) acquired Paul Revere and completed its merger with Paul Revere in March 1997.2 Id. 115. In 1998, Unum Life Insurance Company of America acquired and merged with Provident to create Defendant UnumProvident Corporation (“UnumProvident”). (Id. ¶ 11.) After approximately seventeen months of paying benefits, Plaintiffs benefits were terminated on or about February 17, 1998. (Id. ¶31.)

[173]*173Plaintiff alleges that the decision to terminate his benefits was made by Paul Revere, Provident and PL & A, acting jointly as part of a national pattern and practice to boost corporate profitability by terminating valid disability benefits for pretextual reasons. (Id. ¶ 38.) At the time, Defendants explained that they based their decision on an investigation by Genex Services, Inc. (“Genex”), which concluded that Plaintiff was no longer totally disabled because his doctor had said that he was capable of performing all of the duties of his occupation. (Id. ¶¶ 31-32.) Plaintiff alleges that Genex is a wholly owned subsidiary of Provident and UnumProvident, and that the Genex investigation was replete with factual inaccuracies and material misrepresentations that the Defendants either knew about or recklessly disregarded.3 (Id. ¶¶ 33-34.) Specifically, Plaintiff argues that the Genex investigator misrepresented the temperature and humidity of the greenhouse and the amount of time Plaintiff had to spend in the greenhouse in order to establish that Plaintiff was able to return to his former occupation, despite his doctor’s insistence that he could not work in elevated temperatures. (Id. ¶ 35.)

In his submissions, Plaintiff alleges that in the late 1990s Defendants’ profits were suffering due to poor management decisions in them past pricing and structuring of insurance policies. (Pl. Resp., Doc. No. 19, at 8.) Plaintiff explains that from the mid 1980s to the early 1990s, insurance companies, including Provident and Paul Revere, were involved in an intense competition for the sale of individual disability policies, and had “poorly underwritten and underpriced” their non-cancelable, guaranteed renewable, own occupation policies, such as Plaintiffs policy. (Id.) Those insurance companies found that after a peak in 1990, their profits began to fall because claims were being made and depleting their reserves. (Id.) Plaintiff alleges that as a result, companies started redesigning and repricing their policies, as well as changing their claims processes. (Id. at 8-9.) Plaintiff alleges that Provident went from a “claim payment” orientation to a “claim management” orientation, meaning that Provident set a budget for claim payments and focused on terminating claims in order to keep payments within the budget. (Id. at 9.) Plaintiff supports these assertions of the underpricing of policies and its effects by providing this Court with a number of documents obtained from Provident in other similar litigation. (Id.)

Plaintiff also cites evidence obtained through other litigation that Provident attempted to increase claim terminations by brainstorming grounds for termination at “roundtables” and by shifting its use of Independent Medical Examinations (“IME”) from their previous role of evaluating claims fairly to a new role as part of the claim termination process. (Id. at 10.) Plaintiff also alleges that Provident attempted to terminate Plaintiffs policy by redefining Plaintiffs occupation to an occupation that Plaintiff was still capable of performing. (Id.) Plaintiff has offered evidence that Provident attempted this same technique to terminate another individual’s disability benefits. See Brosnan v. Provident Life and Accident Ins. Co., 31 F.Supp.2d 460, 464 (E.D.Pa.1998) (considering Provident’s argument that the plaintiff, who had applied for benefits as a anesthesiologist, was not totally disabled because he could still work as a general practitioner to be “disingenuous at best”).

Following correspondence with Defendants and the apparent decline of Plaintiffs health4, Plaintiff filed the instant lawsuit on December 27, 1999. Defendants reinstated Plaintiffs benefits “subject to a reservation of rights” in June of 2000. On June 30, 2000, Defendants’ counsel informed the Court during a hearing that the only reservation was that Plaintiff undergo an independent physi[174]*174eian examine to determine that he was totally-disabled under the policy. (Hearing Trans, at 26-7, Doc. No.

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Bluebook (online)
224 F.R.D. 169, 2004 U.S. Dist. LEXIS 16318, 2004 WL 1858403, Counsel Stack Legal Research, https://law.counselstack.com/opinion/saldi-v-paul-revere-life-ins-paed-2004.