Wagner v. Certain Underwriters at Lloyd London

CourtAppellate Court of Illinois
DecidedJune 26, 2026
Docket1-25-1140
StatusPublished

This text of Wagner v. Certain Underwriters at Lloyd London (Wagner v. Certain Underwriters at Lloyd London) is published on Counsel Stack Legal Research, covering Appellate Court of Illinois primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Wagner v. Certain Underwriters at Lloyd London, (Ill. Ct. App. 2026).

Opinion

2026 IL App (1st) 251140 FIFTH DIVISION June 26, 2026

No. 1-25-1140

NOTICE: This order was filed under Supreme Court Rule 23 and is not precedent except in the limited circumstances allowed under Rule 23(e)(1). ___________________________________________________________________________

IN THE APPELLATE COURT OF ILLINOIS FIRST DISTRICT ___________________________________________________________________________

JEFFREY WAGNER, ) ) Appeal from the Plaintiff-Appellee, ) Circuit Court of ) Cook County. v. ) ) No. 2022 CH 08189 CERTAIN UNDERWRITERS AT LLOYD’S ) LONDON, ) Honorable ) Neil H. Cohen, Defendant-Appellant. ) Judge Presiding.

JUSTICE MIKVA delivered the judgment of the court. Justices Oden Johnson and Wilson concurred in the judgment.

ORDER

¶1 Held: Circuit court’s judgment in favor of the insured regarding the amount of a lump sum payment due under a disability policy is affirmed in part and reversed in part. The insured was entitled to an increased payment, but not in the amount awarded.

¶2 The named insured in this insurance coverage dispute sought an increased lump sum

disability benefit based on his increased earnings after issuance of the policy but before the onset

of his disability. Following a bench trial on the documentary evidence, the trial court entered

judgment in favor of the insured, awarding him the requested increase plus pre- and post-judgment

interest. The insurer now appeals, arguing (1) the insured failed to prove that conditions in the No. 1-25-1140

endorsement entitling him to the increase were satisfied; (2) the awarded amount, based on the

court’s conclusion that ambiguities should be construed against insurer as the endorsement’s

drafter, was far too high; and (3) the insured was either not entitled to prejudgment interest or was

entitled to it at a lower rate. For the reasons given below, we affirm in part and reverse in part.

¶3 I. BACKGROUND

¶4 A. The Disability Policy and Endorsement

¶5 The plaintiff in this matter, Jeffrey Wagner, was the named insured and loss payee of a

disability insurance policy (certificate No. 1582372-7), issued to his employer, the Chicago law

firm Kaye Scholer, LLP (n/k/a Arnold & Porter, Kaye Scholer, LLP), by the defendant, Certain

Underwriters at Lloyd’s, London (Underwriters), through its coverholder, Petersen International

Underwriters (PIU). The policy, covering the period from June 1, 2015, through May 31, 2020,

provided that, if Mr. Wagner suffered a total disability as a result of sickness or injury, he would

be entitled to monthly disability benefits equal to 65% of his earned income, or $32,100 (“Monthly

Benefit Amount”), paid over the lesser of a period of 60 months or until Mr. Wagner reached the

age of 70. It also provided, following a period of 66 months and a finding of permanent total

disability, that he would receive a lump sum payment (“Principal Sum Amount”) of $5,000,800.

¶6 Attached as an optional rider to the policy was an “Automatic Benefit Increase

Endorsement” that provided as follows:

“If you are not currently on claim and you can document that you have had an

increase in your Earned Income, once received and agreed to by Underwriters, the Monthly

Benefit Amount may be increased up to the Maximum Benefit Participation Limit, not to

exceed the Maximum Monthly Benefit Guaranteed Issue Limit.

If applicable, the Principal Sum Amount may be increased, not to exceed the

2 No. 1-25-1140

Maximum Principal Sum Benefit Participation Limit, not to exceed the Maximum

Principal Sum Benefit Guaranteed Issue Limit.

Any increase for the Monthly Benefit Amount or the Principal Sum Amount,

premium increases will be on a monthly pro-rata basis effective from the first of the month,

in the month for which Underwriters agreed to the increase.

Maximum Monthly Benefit Participation Limit hereby stated as 65%.

Maximum Monthly Benefit Guaranteed Issue Limit hereby stated as $250,000.00

per month.

Maximum Principal Sum Benefit Participation Limit hereby stated as 5 times

annual income.

Maximum Principal Sum Benefit Guaranteed Issue Limit Hereby stated as

$10,000,000.00.”

¶7 “Earned Income” was defined in the policy as “(1) Salary and fees (gross income less

business expenses, but before income taxes); (2) Commissions and bonuses; and (3) Non-passive

income reported on [the employee’s] personal tax return.”

¶8 B. Mr. Wagner’s Allegations

¶9 Mr. Wagner filed this declaratory judgment action against Underwriters on August 19,

2022. He alleged that on November 7, 2016, while the disability policy was in effect, he became

permanently and totally disabled. He submitted a claim to Underwriters, it was approved, and he

began to receive monthly disability benefits. Mr. Wagner alleged that although increases in his

earnings had been reported to Underwriters by Kaye Scholer before the onset of his disability, the

“Principal Sum Amount for the Lump Sum Payment was not adjusted” as called for in the

Automatic Benefit Increase Endorsement.

3 No. 1-25-1140

¶ 10 Mr. Wagner further alleged that at no time did Underwriters contact him to inform him that

the increase was not in fact automatic but required a separate application by him and approval by

Underwriters. At the conclusion of the applicable elimination period, Underwriters paid Mr.

Wagner the Principal Sum Amount of $5,000,800, but “refused to pay any additional amount

commensurate with his increased earnings following the issuance of the [policy] and prior to the

onset of his Permanent Total Disability.” Mr. Wagner asked the circuit court to find he was entitled

to “an additional payment from [Underwriters] equal to five times his earnings at the time he

became Permanently Totally Disabled, less the indemnity already paid,” and to assess penalties

and attorney fees against Underwriters under section 155 of the Illinois Insurance Code (215 ILCS

5/155 (West 2022)), for refusing in bad faith to pay him what he was due under the policy.

¶ 11 Underwriters answered, asserting the affirmative defense of payment, and Mr. Wagner

later dismissed his claim for penalties and attorney fees under section 155 of the Insurance Code.

¶ 12 C. Summary Judgment

¶ 13 The parties filed cross motions for summary judgment. Mr. Wagner argued that on June

16, 2016—before he became disabled or submitted a claim—Underwriters received a census report

from Kaye Scholer showing that his annual income had increased from $1,330,276 to $1,350,000.

Per the endorsement, Underwriters was obligated to automatically increase the Principal Sum

Amount but had refused to pay him anything more than the initial lump sum of $5,000,800. Mr.

Wagner contended that because the only formula in the endorsement for calculating the increased

amount was the specification that it could not exceed five times his annual income, or $6,750,000,

that was the amount the company was obligated to pay him. Underwriters thus owed him an unpaid

balance of $1,749,200, and prejudgment interest at 9% per annum under section 357.9 or 357.9a

of the Illinois Insurance Code (Code) (215 ILCS 5/357.9, 357.9a (West 2024)).

4 No. 1-25-1140

¶ 14 Underwriters argued in response that Mr. Wagner did not qualify for an increased Principal

Sum Amount because there was “no number [it] had ever acknowledged, or otherwise agreed to”

as Mr.

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