Troeger v. Minnesota Life Insurance Co.

200 F. Supp. 3d 745, 2016 WL 4203306, 2016 U.S. Dist. LEXIS 104427
CourtDistrict Court, C.D. Illinois
DecidedAugust 9, 2016
DocketCase No. 14-1083
StatusPublished

This text of 200 F. Supp. 3d 745 (Troeger v. Minnesota Life Insurance Co.) is published on Counsel Stack Legal Research, covering District Court, C.D. Illinois primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Troeger v. Minnesota Life Insurance Co., 200 F. Supp. 3d 745, 2016 WL 4203306, 2016 U.S. Dist. LEXIS 104427 (C.D. Ill. 2016).

Opinion

ORDER AND OPINION

James E. Shadid, Chief United States District Judge

This matter is now before the Court on Defendant’s Motion [15] for Summary Judgment. For the reasons set forth below, Defendant’s Motion [15] is Denied.

Background

The following facts are not in dispute. On July 20, 2002, Michael Mitchell fractured his neck after falling head-first into Kickapoo Creek. The fracture resulted in quadriplegia, or paralysis of all four extremities. In September 2005, Michael became a resident at Rose Garden Care Center (“Rose Garden”), a residential care facility in Peoria Heights, Illinois. He developed several medical conditions after his paralysis, including seizure disorder, depression, hypertension, obesity, dysli-pidemia, bowl mobility disorder, gastroeso-phageal reflux disease (“GERD”), deep venous thrombosis, spasticity and chronic pain.

On at least four occasions between 2005 and 2006, Michael was found “non-responsive” by caretakers at Rose Garden. On June 24, 2006, Michael was admitted to the intensive care unit at Proctor Hospital for respiratory failure after he became unresponsive and stopped breathing during ambulance transport to the hospital. In August 2006, Michael was transferred to OSF Saint Francis Medical . Center (“OSF”) when he was found unresponsive and caretakers were unable to feel a pulse. Michael was again found unresponsive by Rose Garden caretakers and transferred to OSF in September 2006. On each occasion he was successfully resuscitated.

On July 28, 2007, Michael began “actively seizing” at Rose Garden. He was initially breathing on his own, but stopped breathing. Rose Garden called paramedics, and Advanced Medical Transport (“AMT”) transferred Michael to OSF Hospital. AMT • paramedics documented Michael’s condition during transport, noting “no evidence of trauma” in any location and an “unremarkable” physical examination.1 [748]*748ECF Doc. 16, ¶ 22. When paramedics attempted to intubate Michael, they suctioned his airway and aspirated foreign material. ECF Doc. 28, at 13. Michael could not be resuscitated and died at OSF Hospital. Dr. Richard C. Frederick was the emergency room physician who treated Michael at OSF on July 28, 2007. Dr. Frederick signed the medical records prepared by a resident which noted, under the heading of Initial Physical Exam, “General—no evidence of trauma ... Head/ Neck—atraumatic ... Extremities—no signs of trauma.” See ECF Doc. 16-10. Those records also indicated that Michael had vomit on his face. On October 18, 2007, a Coroner’s Inquest into Michael’s death was held by Peoria County Coroner John-na Ingersoll. The jury found that Michael’s death was “natural” from “seizure disorder.”

Michael, as a former employee of the State of Illinois, obtained life insurance coverage under a group policy for state employées. The life insurance policy was issued by Minnesota Life Insurance Company (“Minnesota Life”) and included Accidental Death and Dismemberment (“AD&D”) coverage. Minnesota Life paid Michael’s wife, Gayle Mitchell, $156,500 pursuant to the policy’s Basic Life and Optional Life coverage. However, Minnesota Life declined to pay the additional $156,500 under the AD&D double indemnity provision. The AD&D provision of the policy states:

Accidental death or dismemberment by accidental injury as used in this supplement means that your death or dismemberment results, directly and independently of disease or bodily infirmity, from an accidental injury which is unexpected and unforeseen.
ECF Doc. 16, ¶ 10.

The policy also stated “injury must occur while your coverage under this supplement is in force” and “death or dismemberment must occur within 365 days after the date of the injury and while your coverage under this supplement is in force.” Id.; ECF Doc. 16-1, at 27. The AD&D policy further provided that “[i]n no event will [Minnesota Life] pay the accidental death or dismemberment benefit where your death or dismemberment results from or is caused directly by any of the following ... (3) bodily or mental infirmity, illness or disease; or (4) medical or surgical treatment ....” Id.

Legal Standard

Under Rule 56 of the Federal Rules of Civil Procedure, summary judgment is proper “if the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any, show that there is no genuine issue as to any material fact and that the moving party is entitled to judgment as a matter of law.” Fed. R. Civ. P. 56; Celotex Corp. v. Catrett, 477 U.S. 317, 323, 106 S.Ct. 2548, 91 L.Ed.2d 265 (1986). Summary judgment is mandated “after adequate time for discovery and upon motion, against a party who fails to make a showing sufficient to establish the existence of an element essential to that party’s case, and on which that party will bear the burden of proof at trial.” Id. at 322-23, 106 S.Ct. 2548. However, “[t]he burden on the non-movant is not onerous.” Waldridge v. American Hoechst Corp., 24 F.3d 918, 921 (7th Cir.1994); Rather, the non-movant “need only come forward with appropriate evidence demonstrating that there is a pending dispute of material fact” and “may rely on affidavits or any other materials of the kind identified in Rule 56(c).” Id.

[749]*749“The interpretation of an insurance policy is a matter of state law.” Westfield Ins. Co. v. Vandenberg, 796 F.3d 773, 777 (7th Cir.2015). In Illinois, “an insurance policy is a contract, and the general rules governing the interpretation of other types of contracts also, govern the interpretation of insurance policies.” Id., citing Hobbs v. Hartford Ins. Co. of the Midwest, 214 Ill.2d 11, 17, 291 Ill.Dec. 269, 823 N.E.2d 561 (2005). When the language in an insurance policy is unambiguous, “the policy will be applied as written, unless it contravenes public policy.” Hobbs, 214 Ill.2d at 17, 291 Ill.Dec. 269, 823 N.E.2d 561. However, when the language of an insurance policy is subject to more than one reasonable interpretation, the policy is ambiguous. Id. “Although policy terms that limit an insurer’s liability will be liberally construed in favor of coverage, this rule of construction only comes into play when the policy is ambiguous.” Id. When a policy is ambiguous, “and if, after considering the contract language in light of parol evidence and rules of construction, doubt still remains as to the meaning of the contract, then the question of interpretation must be left to the trier of fact.” Bourke v. Dun & Bradstreet Corp., 159 F.3d 1032, 1037 (7th Cir.1998) (citing Countryman v. Indus. Com’n, 292 Ill.App.3d 738, 741, 226 Ill.Dec. 712, 686 N.E.2d 61 (1997)).

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Cite This Page — Counsel Stack

Bluebook (online)
200 F. Supp. 3d 745, 2016 WL 4203306, 2016 U.S. Dist. LEXIS 104427, Counsel Stack Legal Research, https://law.counselstack.com/opinion/troeger-v-minnesota-life-insurance-co-ilcd-2016.