Williams v. Ohio Nat'l Life Assurance Co.

364 F. Supp. 3d 605
CourtDistrict Court, W.D. North Carolina
DecidedJanuary 30, 2019
DocketCIVIL ACTION NO. 5:17-CV-00126-GCM
StatusPublished
Cited by3 cases

This text of 364 F. Supp. 3d 605 (Williams v. Ohio Nat'l Life Assurance Co.) is published on Counsel Stack Legal Research, covering District Court, W.D. North Carolina primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Williams v. Ohio Nat'l Life Assurance Co., 364 F. Supp. 3d 605 (W.D.N.C. 2019).

Opinion

Graham C. Mullen, United States District Judge *608THIS MATTER COMES before this Court on Defendant Ohio National Life Assurance Company's ("Defendant") Motion for Summary Judgment. (Doc. No. 22). Plaintiff Paul Williams ("Plaintiff") filed a response (Doc. No. 27) to which Defendant replied. (Doc. No. 32). As such, this matter is ripe for disposition.

I. FACTUAL BACKGROUND

This case involves an insurance dispute between Plaintiff and Defendant. Plaintiff worked as a dentist for his professional career. (Doc. No. 23, p. 2). Plaintiff owned his own practice and operated under the name Paul H. Williams, DDS, PLLC. (Id. ). Defendant sold Plaintiff a business overhead expense insurance policy (the "Policy") in 1999. (Id. ). The Policy provided insurance coverage in the event Plaintiff became disabled. (Doc. 1-1).

a. Insurance Policy

The Policy issued by Defendant provided Plaintiff with insurance for "covered business expenses" in the event of disability. (Id. ). The Policy described covered business expenses as those expenses that are "normal and customary business expenses that you regularly incur in your business. They are the kind of expenses that the Internal Revenue Code allows as income tax deductions." (Id. ). In the "Definitions" section of the Policy, covered business expenses are defined as:

These are normal and customary business expenses regularly incurred by you in your Business. A Covered Business Expense must be of the type that the Internal Revenue Code allows as an income tax deduction. They include but are not limited to:
(1) Rent;
(2) Electricity;
(3) Telephone;
(4) Mortgage Interest;
(5) Mortgage Principal or Property Depreciation;
(6) Equipment Loan Interest;
(7) Equipment Loan Principal or Equipment Depreciation;
(8) Other Loan Principal;
(9) Other Interest Payments;
(10) Heat and Water;
(11) Property Taxes;
(12) Equipment Rental;
(13) Employees' Wages and Benefits;
(14) Insurance (Malpractice and E & O);
(15) Insurance (Fire, Casualty, Liability, etc.
(16) Business Laundry;
(17) Equipment Maintenance;
(18) Subscriptions - Professional Journals;
(19) Membership Dues - Association;
(20) Accountants' Fees;
(21) Legal Fees.

(Id. at 8.).

Plaintiff claimed total disability on October 2, 2015. (Doc. No. 23). The Parties do not contest that Plaintiff is in fact disabled.1 On the same date that Plaintiff *609claimed disability, Plaintiff sold the assets and goodwill of his dental practice to Dr. Jakub Skowronski ("Buyer"). (Id. ). At the time of the sale, Plaintiff stopped practicing dentistry. (Id. ). Plaintiff's business accounts were utilized to process accounts receivables and pay the interest and principal of a business loan that survived the sale of the practice. (Id. ).

b. Loans and Sale Arrangement

When Plaintiff sold his dental practice to Buyer, the practice had two outstanding business loans secured by the practice's equipment. (Doc. No. 23-4, 5.). Plaintiff received both loans through Peoples Bank. (Id. ). One loan had a balance of $ 129,793.57 ("129 Loan"). The second loan had a balance of $ 326,762.03 ("327 loan"). (Id. ). At closing, Buyer wired $ 129,793.57 to Peoples Bank which identified the beneficiary as the 129 Loan. (Doc. No. 23-13). The loan history shows that money was used to pay off the 129 Loan. (Id. ). Buyer also wired $ 326,762.03 to Peoples Bank with the beneficiary as the 327 Loan. (Id. ). Rather than using those funds to payoff the 327 Loan, Peoples Bank placed those funds in the savings account of the practice. The rest of the proceeds from the sale of the practice were wired into the practice's checking account.

After the sale, Plaintiff opened a new checking account. (Doc. 23-15). Bank records show that a $ 327,000 withdrawal was made from the practice's savings account that contained the money designated for the 327 Loan. (Doc. No. 23-14, 16). The same day the withdrawal was made, bank records also show a $ 327,000 deposit into Plaintiff's new checking account. (Id. ). Subsequently, the practice's savings account was closed. (Id. ). Plaintiff was the signatory on the new checking account, but he did not have access to it. (Doc. No. 23). Rather, Peoples Bank made the monthly payments on the 327 Loan directly from the account. (Id. ).

After the sale of the goodwill and assets of the practice, Plaintiff filed a claim under the Policy to cover the payments associated with the 327 Loan. (Doc. No. 23-20). Defendant requested several forms of documentation to support Plaintiff's claim under the Policy. (Doc. No. 23, p. 8). The entirety of Defendant's review process of Plaintiff's claim took at least one full year to complete. (Doc. No. 23-21). After Defendant completed its review, Defendant denied Plaintiff's claim. Plaintiff brought suit in this Court alleging (1) breach of contract, (2) bad faith, and (3) unfair and deceptive trade practices.

II. STANDARD OF REVIEW

Summary judgment shall be granted "if the movant shows that there is no genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law." Fed. R. Civ. P. 56(a). A factual dispute is genuine "if the evidence is such that a reasonable jury could return a verdict for the nonmoving party." Anderson v. Liberty Lobby, Inc. , 477 U.S. 242, 248, 106 S.Ct. 2505, 91 L.Ed.2d 202 (1986). A fact is material only if it might affect the outcome of the suit under governing law. Id.

The movant has the "initial responsibility of informing the district court of the basis for its motion, and identifying those portions of the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any, which it believes demonstrate the absence of a genuine issue of material fact." Celotex Corp. v. Catrett

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Bluebook (online)
364 F. Supp. 3d 605, Counsel Stack Legal Research, https://law.counselstack.com/opinion/williams-v-ohio-natl-life-assurance-co-ncwd-2019.