Wiener v. AXA Equitable Life Insurance Company

District Court, W.D. North Carolina·Decided August 24, 2020·No. 3:18-cv-00106·Unknown

Opinion

UNITED STATES DISTRICT COURT WESTERN DISTRICT OF NORTH CAROLINA CHARLOTTE DIVISION 3:18-cv-00106-RJC-DSC

MALCOLM WIENER, ) ) Plaintiff, ) ) v. ) ) ORDER AXA EQUITABLE LIFE INSURANCE ) COMPANY, ) ) Defendant. ) )

THIS MATTER comes before the Court on Defendant’s motions in limine, (Doc. Nos. 71 to 73), Defendant’s motion to exclude expert testimony, (Doc. No. 74), and Plaintiff’s motion to compel and strike, (Doc. No. 92). I. BACKGROUND1 Defendant is an insurance company and member of the Medical Information Bureau (“MIB”), a corporation owned by its member life and health insurance companies. The MIB serves as an information exchange in that its member companies contribute to the MIB database information about insurance applicants that was obtained during the underwriting process, which is then available to other member companies. When an MIB member completes the underwriting of an insurance application, it must report to the MIB information involving impairments listed in the MIB coding manual that it obtained during its underwriting of the

1 The background of this case is more fully set forth in the Court’s summary judgment order. (Doc. No. 63.) individual’s application. Any codes reported by an MIB member about an applicant are maintained in MIB’s database and are available to other MIB members who obtain the applicant’s authorization to use the MIB as an information source.

In 1986 and 1987, Plaintiff purchased from Defendant three life insurance policies. On December 2, 2013, Defendant notified Plaintiff by letter that the policies had terminated but could be reinstated subject to Defendant’s approval. Plaintiff submitted reinstatement applications along with the materials required by Defendant for medical evidence of insurability. After underwriting Plaintiff’s reinstatement applications, Defendant reported several MIB codes signifying different physical and mental conditions reflected in Plaintiff’s medical records.2

Defendant ultimately denied Plaintiff’s reinstatement applications. The termination of the policies is the subject of an earlier lawsuit pending in the Southern District of New York, Case No. 1:16-cv-04019-ER (“the SDNY action”). In this action, Plaintiff challenges the reasonableness of Defendant’s assessment of Plaintiff’s medical history and conditions and subsequent reporting of such information to the MIB. Following summary judgment, the sole claim proceeding to

trial is Plaintiff’s negligence claim. Defendant filed three motions in limine to exclude (1) argument and evidence that any life insurance company rejected Plaintiff’s application for life insurance based on its review of MIB codes reported by Defendant, (Doc. No. 71); (2) evidence regarding the circumstances surrounding Defendant’s termination of Plaintiff’s

2 There is conflicting evidence as to which MIB codes Defendant reported. policies and denial of Plaintiff’s reinstatement applications, (Doc. No. 72); and (3) argument and evidence that damages should be awarded based on an increase in the cost of life insurance, (Doc. No. 73). Defendant also filed a motion under Federal Rule

of Evidence 702 to exclude the testimony of Plaintiff’s expert, Stephen C. Burgess, as well as any expert testimony of Dr. Ori Ben-Yehuda and Dr. Barry Boyd. (Doc. No. 74.) Plaintiff filed a motion to compel production and to strike the declaration of Jonathan Sager, the MIB’s Executive Vice President and General Counsel. (Doc. No. 92.) In the alternative, Plaintiff moves to exclude evidence or testimony from the MIB and Sager at trial. The motions have been fully briefed and are ripe for adjudication.

II. DEFENDANT’S MOTIONS A. Motion to Exclude Evidence that any Life Insurance Company Rejected Plaintiff’s Application for Life Insurance Based on Its Review of MIB Codes Reported by Defendant

After Defendant denied Plaintiff’s reinstatement applications, Plaintiff engaged Sanford Robbins, an insurance agent, to seek a replacement policy. On Plaintiff’s behalf, Robbins submitted at least three informal applications for life insurance. Defendant contends that because there is no evidence that any life insurance company rejected Plaintiff’s application based on the MIB codes, Plaintiff should be precluded from arguing or offering such evidence at trial. The Court agrees with Defendant. There is no evidence that any life insurance company rejected Plaintiff’s application based on its review of the MIB codes reported by Defendant. Indeed, in his response in opposition to Defendant’s motion, Plaintiff does not argue that any life insurance company rejected Plaintiff’s application based on its review of Plaintiff’s MIB file or otherwise. (See Doc. No. 89.) John Hancock, to whom Robbins sent an informal application, declined Plaintiff’s application but did

so based only on its review of the medical records, not Plaintiff’s MIB file. Principal Life Insurance Company reviewed only Plaintiff’s medical records and tentatively approved his informal application at a Table 4 rating subject to a full underwriting and MIB check upon receipt of a formal application, which Plaintiff never submitted. Robbins also submitted an informal application to Security Mutual Life Insurance Company of New York, and there is conflicting evidence as to whether Security Mutual reviewed Plaintiff’s MIB file in considering Plaintiff’s informal application.

Nevertheless, Security Mutual did not deny Plaintiff’s application, but instead tentatively approved it at a Table 4 rating, and Plaintiff never submitted a formal application. Therefore, the Court grants Defendant’s motion and excludes argument and evidence that any life insurance company rejected Plaintiff’s application for life insurance based on its review of MIB codes reported by Defendant.3

3 This ruling is limited to excluding argument and evidence that any life insurance company rejected Plaintiff’s application for life insurance based on its review of Plaintiff’s MIB file. As discussed above, Security Mutual tentatively approved Plaintiff’s application at a Table 4 rating, and there is conflicting evidence as to whether Security Mutual reviewed Plaintiff’s MIB file in considering Plaintiff’s application. B. Motion to Exclude Evidence Regarding the Circumstances of Defendant’s Termination of Plaintiff’s Policies and Denial of Plaintiff’s Reinstatement Applications

Defendant argues that evidence regarding the circumstances surrounding Defendant’s termination of Plaintiff’s policies and denial of Plaintiff’s reinstatement applications in 2013 should be excluded because such evidence (1) is not relevant, (2) would serve only to confuse or mislead the jury, and (3) would needlessly lengthen the trial. Plaintiff argues that he should be allowed to provide the background and context necessary for the jury to understand his relationship and history with Defendant and the basis for his reinstatement applications. The Court concludes that evidence regarding the circumstances surrounding Defendant’s termination of Plaintiff’s policies and denial of Plaintiff’s reinstatement applications in 2013 is not relevant. Evidence is relevant if it has any tendency to make a fact of consequence more or less probable than it would be without the evidence. Fed. R. Evid. 401. Plaintiff’s negligence claim concerns only Defendant’s reasonableness in assessing Plaintiff’s medical history and conditions and subsequent reporting of that information to the MIB. The allegedly wrongful

termination of Plaintiff’s policies is the subject of the SDNY action.

Free access — add to your briefcase to read the full text and ask questions with AI

Wiener v. AXA Equitable Life Insurance Company, (W.D.N.C. 2020).

Wiener v. AXA Equitable Life Insurance Company (Wiener v. AXA Equitable Life Insurance Company) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

Related

Daubert v. Merrell Dow Pharmaceuticals, Inc.
509 U.S. 579 (Supreme Court, 1993)
Kumho Tire Co. v. Carmichael
526 U.S. 137 (Supreme Court, 1999)
United States v. Patrick Leroy Crisp
324 F.3d 261 (Fourth Circuit, 2003)
Westberry v. Gislaved Gummi AB
178 F.3d 257 (Fourth Circuit, 1999)
Yates v. Ford Motor Co.
113 F. Supp. 3d 841 (E.D. North Carolina, 2015)
United States v. Hammoud
381 F.3d 316 (Fourth Circuit, 2004)
United States v. Wilson
484 F.3d 267 (Fourth Circuit, 2007)
SMD Software, Inc. v. Emove, Inc.
945 F. Supp. 2d 628 (E.D. North Carolina, 2013)
Kopf v. Skyrm
993 F.2d 374 (Fourth Circuit, 1993)