Unum Life Insurance Co. of America v. Edwards

210 S.W.3d 84, 362 Ark. 624, 2005 Ark. LEXIS 384
CourtSupreme Court of Arkansas
DecidedJune 16, 2005
Docket04-468
StatusPublished
Cited by37 cases

This text of 210 S.W.3d 84 (Unum Life Insurance Co. of America v. Edwards) is published on Counsel Stack Legal Research, covering Supreme Court of Arkansas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Unum Life Insurance Co. of America v. Edwards, 210 S.W.3d 84, 362 Ark. 624, 2005 Ark. LEXIS 384 (Ark. 2005).

Opinions

Betty C. Dickey, Justice.

Frances Edwards (Edwards) worked as a medical technologist at the University of Arkansas for Medical Sciences (UAMS) where she had disability insurance with Unum Life Insurance Company of America (Unum). In 1994, Edwards was struck by a car while riding her bicycle and sustained serious head injuries, but did not lose consciousness. Edwards spent one night in the hospital for observation and was released the following day. She returned to work afterwards, but experienced cognitive impairments both at work and at home. Edwards’ ability to return to work was, according to medical-care professionals, due to the rote nature of the laboratory testing procedures her job involved and her vast experience in performing these procedures.

According to Edwards, changes in medical technology and continuing education requirements, as well as advances in hospital facilities and equipment, drastically changed her work environment. Because her condition did not improve, she was unable to adapt to these changes. As a result, her continuing memory and cognitive deficiencies caused her to make critical fife care errors at work. After Edwards’ employer noticed mistakes, her supervisor, Sue Scott, wrote to Edwards’ neurologist, Dr. Lee Archer, to inquire about Edwards’ continued ability to perform critical job functions. In March of 2000, Dr. Archer determined that Edwards could not continue to work due to the safety risk she posed to patients.

Edwards filed a disability claim with Unum, and on October 9, 2000, she received a letter from Unum indicating that they would initiate payment on her claim, but that it had not made a final determination of her eligibility. In January 2001, Unum denied her claim, indicating that her condition should not prevent Edwards from performing her occupational duties. Unum’s letter falsely stated that Edwards had been working in a lab that closed in February of2000, and Unum also later admitted that the letter used a definition of disability different from the one contained in Edwards’ policy.

Edwards appealed Unum’s decision to deny her claim, and provided Unum with her medical and employee records, including Dr. Archer’s. On June 7, 2001, Unum issued a final denial of her claim, declaring that Edwards had exhausted all administrative remedies, and no additional information would be reviewed. Unum determined that her bicycle accident did not cause a decrease in physical or cognitive function sufficient to quit her job and that she was still capable of performing her job duties; therefore, she did not meet the policy’s definition of “disabled.”

Unum erroneously identified Edwards as a Laboratory Technician although she was a Certified Technologist II, and claimed they had forwarded Edwards’ medical records to two in-house medical professionals for review when, in fact, Unum sent only portions of the records to three physicians, and omitted entirely the results of one of those reviews.

Edwards sued Unum in Pulaski County Circuit Court, seeking benefits under her disability policy, alleging that Unum breached the insurance contract and committed the tort of bad faith. Edwards did not specify the amount that she claimed was due under the insurance contract.

Before trial, Unum moved for partial summary judgment on the tort of bad faith, and at a hearing on June 3, 2003, the trial court withheld its ruling on the motion, pending depositions scheduled for June 20 and 23, 2003. On August 15, 2003, four days before trial, Edwards supplemented her response to the motion for partial summary judgment. On the morning of trial, the court denied Unum’s motion for partial summary judgment. Unum then moved to strike Edwards’ supplemental response as untimely, and because it raised a new theory of bad faith for which Unum had not had the opportunity to develop a defense. Unum also moved for a continuance or, alternatively, to bifurcate the bad faith claim. The trial court denied all motions.

Unum also filed a pretrial motion in limine to preclude any reference to Edwards’ medical conditions and symptoms arising after the date of denial of her disability benefits. Edwards had been diagnosed with rheumatoid arthritis. The trial court granted the motion, but later a witness, Jack Tyler, Edwards’ roommate and advisor, told the jury that Edwards’ physical problems resulted from the denial of her insurance claim. This testimony contradicted .his deposition, in which he testified that arthritis, not the insurance denial, caused Edwards’ physical condition. Unum moved for mistrial, and the trial court, after taking the matter under advisement, denied the motion.

When the plaintiff rested, and again at the conclusion of its case, Unum moved for directed verdict on the bad faith claim. The trial court denied both motions. The jury found that: Edwards was disabled; Unum breached its contract with Edwards; and, she was entitled to $43,943 in benefits as a result of Unum’s breach, a finding which is not being challenged in this appeal. Because Edwards had not specified the amount due under the contract, Unum objected to any award of penalty or attorney’s fees, saying that she failed to recover within 20% of the amount sought as required by Ark. Code Ann. § 23-79-208 (Repl. 2001). The trial court granted Edwards’ motion for statutory penalty and attorney’s fees. The jury also awarded her $225,000 in compensatory damages on her bad faith claim.

Unum raises four points on appeal, arguing that the trial court should have: directed a verdict on the tort claim for bad faith; bifurcated or continued the trial after Edwards, the day before trial, supplemented the summary judgment record regarding the bad faith claim; declared a mistrial following prejudicial testimony by one of Edwards’ witnesses, which was intentionally volunteered in violation of a court order; and, not awarded penalty and attorney’s fees.

In determining whether a directed verdict should have been granted, we review the evidence in the light most favorable to the party against whom the verdict is sought and give it its highest probative value, taking into account all reasonable inferences deducible from it. Mangrum v. Pigue, 359 Ark. 373, 198 S.W.3d 496 (2004). A motion for directed verdict should be granted only if there is no substantial evidence to support a jury verdict. Id.; Woodall v. Chuck Dory Auto Sales, Inc., 347 Ark. 260, 61 S.W.3d 835 (2001). Substantial evidence is defined as evidence of sufficient force and character to compel a conclusion one way or the other with reasonable certainty; it must force the mind to pass beyond mere suspicion or conjecture. Cadillac Cowboy, Inc. v. Jackson, 347 Ark. 963, 69 S.W.3d 383 (2002). In determining whether substantial evidence exists, we have stated that we will rely upon two crucial principles to avoid invading the province of the jury. Wheeler Motor Co. v. Roth, 315 Ark. 318, 867 S.W.2d 446 (1993). First, the court will consider only the evidence favorable to the successful party below, and second, the court will defer to the jury’s resolution of the issue unless we can say that there is no reasonable probability to support the version of the successful party below. Id.

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Bluebook (online)
210 S.W.3d 84, 362 Ark. 624, 2005 Ark. LEXIS 384, Counsel Stack Legal Research, https://law.counselstack.com/opinion/unum-life-insurance-co-of-america-v-edwards-ark-2005.