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Unum v. First Unum Life Insurance Company

United States District Court, D. Columbia
Apr 13, 2005
Civil Action No. 04-723 (RMC) (D.D.C. Apr. 13, 2005)

Opinion

Civil Action No. 04-723 (RMC).

April 13, 2005


MEMORANDUM OPINION


Plaintiff here, appearing pro se, filed a lengthy complaint with numerous claims arising from a disability insurance policy obtained in the State of New York. The Court earlier dismissed all defendants except the Continental Casualty Company and Hartford Life Group Insurance Company ("Insurance Companies"), but ordered Plaintiff to provide a more definite statement of his claims. Unum v. First Unum Life Ins. Co., 04-723 (RMC), slip op. (D.D.C. Jan. 14, 2005). Plaintiff filed an amended complaint and the Insurance Companies filed a motion to dismiss or, in the alternative, for summary judgment. The Court issued a " Fox/Neal" Order directing Plaintiff to respond with affidavits or sworn statements or the Court may treat the motion as conceded. Unum v. First Unum Life Ins. Co., 04-723 (RMC), Order, (D.D.C. Feb. 15, 2005). Plaintiff having now filed pleadings he has labeled "Suppliment [sic] to the Complaint" and "Additional evidence [sic]," the Court will address the merits of the motion.

See Fox v. Strickland, 837 F.2d 507, 509 (D.C. Cir. 1988), Neal v. Kelly, 963 F.2d 453, 456 (D.C. Cir. 1992).

BACKGROUND

The background to this dispute was described in detail in the Court's previous memorandum opinion and will not be repeated in full here. During the time frame of the conduct alleged in the amended complaint, Plaintiff was a licensed physician and neurologist practicing under the name Michael John Mazzeo with offices in New York, New York. He applied for long-term disability insurance in 1995. The insurance was underwritten by First Unum Life Insurance Company until November 1, 1996, when it was cancelled by First Unum and transferred to Continental Casualty Company. The policies provided that in order to receive disability benefits, the insured must be continuously unable to perform the substantial and material duties of his occupation and be under the regular care of a licensed physician.

Plaintiff filed a claim for long-term disability benefits on August 15, 1999, based on an injury he sustained to his right foot on July 18, 1999. In medical reports filed with Continental Casualty, Plaintiff's doctor indicated that he had imposed limited restrictions for only three months total. Continental Casualty requested that Plaintiff provide statements of income from his medical practice and expense information. This information was not timely provided and Continental Casualty denied the claim on April 10, 2000 on the grounds that Plaintiff had not provided requested information and that the medical reports had not demonstrated an inability to return to full-time work.

Plaintiff then consulted with two orthopedic specialists who diagnosed a nerve tenderness in his right leg and suggested possible surgery in the future. These reports were submitted by Plaintiff to Continental Casualty's Appeals Committee, which, on August 24, 2000, affirmed the initial denial of Plaintiff's claim. Plaintiff and Continental Casualty then engaged in multiple telephone conversations by which Plaintiff complained of this result. By letter dated October 26, 2000, the insurance company advised him to put his concerns in writing.

On March 27, 2002, Plaintiff sent a list of handwritten questions by facsimile to Continental Casualty. One asked: "Should a controlled study of insurance companies, health maintenance organizations etc. be done to reduce the degree of harm and contain damages?" Another asked: "What are the names of the congressmen in your district?" By letter dated April 3, 2002, Continental Casualty responded, informing Plaintiff that his questions did not include specific details concerning his claim and that if he wanted to submit additional information he could do so, but that his claim had been denied and that denial had been upheld by the Appeals Committee.

Plaintiff filed this lawsuit on May 3, 2004. He admits that, prior to filing the suit, he had "[c]ontinual contact with . . . the defendant's [sic] over the past three and one half to four years, without success, mediation, or dispute resolution." Am. Compl. ¶ 4; see also id. ¶ 29 ("Obstinate behavior was received by the entire process over three and a half to four year's [sic], almost like I should not be injured, damaged, or bothering them for assistance.").

LEGAL STANDARD

Summary judgment is appropriate when the record shows "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(c); Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 247 (1986). This procedural device is not a disfavored legal shortcut; rather, it is a reasoned and careful way to resolve cases fairly and expeditiously. Celotex Corp. v. Catrett, 477 U.S. 317, 327 (1986). In determining whether there is a genuine issue of material fact, the Court must view the underlying facts and draw all reasonable inferences in favor of the non-moving party. See Matsushita Elec. Indus. Co., Ltd. v. Zenith Radio, 475 U.S. 574, 587 (1986); Washington Post Co. v. U.S. Dep't of Health and Human Servs., 865 F.2d 320, 325 (D.C. Cir. 1989). Once the moving party shows that there is a lack of evidence supporting the opponent's case, the burden shifts to the non-movant to demonstrate, through affidavits or otherwise, the existence of a material issue for trial. See Kingman Park Civic Ass'n v. Williams, 348 F.3d 1033, 1041 (D.C. Cir. 2003); Laningham v. U.S. Navy, 813 F.2d 1236, 1241 (D.C. Cir. 1987).

The Insurance Companies also moved to dismiss the complaint. Under Rule 12(b) of the Federal Rules of Civil Procedure if, on a motion to dismiss for failure to state a claim, "matters outside the pleading are presented to and not excluded by the court, the motion shall be treated as one for summary judgment and disposed of as provided in Rule 56. . . ." FED. R. CIV. P. 12(b). The court's "authority to turn a motion to dismiss into one for summary-judgment is not wholly unbridled. When a motion to dismiss is converted into a motion for summary judgment, Rule 12(b) provides that `all parties shall be given reasonable opportunity to present all materials made pertinent to such a motion by Rule 56.'" Hollis v. Dep't of Army, 865 F.2d 1541, 1543 (D.C. Cir. 1988) (citing FED. R. CIV. P. 12(b)). Plaintiff had the opportunity to respond and present relevant materials in opposition to Defendants' motion to dismiss or for summary judgment. Accordingly, consideration of materials outside the complaint is appropriate even on the motion to dismiss.

ANALYSIS

The Insurance Companies argue that Plaintiff's amended complaint should be dismissed because it fails to comply with the Court's Order to provide a short and plain statement of the facts and also because it is barred by the statute of limitations. The Court agrees that the amended complaint is unsatisfactory and "replete with scurrilous comments and unfounded accusations." Memorandum in Support of Motion of Defendants Continental Casualty Company and Hartford Group to Dismiss Amended Complaint Or, In the Alternative, For Summary Judgment at 2. Because Plaintiff is proceeding pro se and because the amended complaint reveals on its face that his suit is untimely, the Court will rule on the merits and not on procedural niceties.

In cases based on diversity jurisdiction, as here, the courts apply the choice-of-law rules of the forum. Ideal Elect. Sec. Co. v. Int'l Fid. Ins. Co., 129 F.3d 143, 148 (D.C. Cir. 1997); Bradley v. Nat'l Ass'n of Sec. Dealers Dispute Resolution, 245 F. Supp. 2d 17, 20 (D.D.C. 2003). Therefore, in cases such as the present action, the District of Columbia statute of limitation applies. See Material Supply Int'l, Inc. v. Sunmatch Indus. Co., Ltd., 146 F.3d 983, 991-92 (D.C. Cir. 1998) (finding that D.C. law governs statute of limitations in a contract case); A.I. Trade Fin., Inc. v. Petra Int'l Banking Corp., 62 F.3d 1454, 1458 (D.C. Cir. 1995) (finding that D.C. treats statute of limitations as procedural and applies its own rule).

The District of Columbia has a three-year statute of limitations on insurance claims. See D.C. Code § 12-301(7) (2001); Partnership Placements, Inc. v. Landmark Ins. Co., 722 A.2d 837, 841 (D.C. 1998). An insurance action accrues when the insurer denies coverage. Saylab v. Hartford Mut. Ins. Co., 271 F. Supp. 2d 112, 118 (D.D.C. 2003). It is undisputed that Plaintiff made his disability claim in August 1999. On August 24, 2000, Continental Casualty denied the claim after appeal. Plaintiff filed this cause of action on May 3, 2004.

Assuming the most generous interpretation of the facts, Plaintiff's claim against the Insurance Companies accrued on August 24, 2000. His complaint was filed over three years later. The claims against the Insurance Companies are, therefore, time-barred and the Court will grant summary judgment in their favor.

The Insurance Companies did not earlier move to dismiss on statute of limitations grounds.

CONCLUSION

For the reasons stated, the amended complaint will be dismissed because the statute of limitations has passed and the initial complaint was time-barred when it was filed. A separate order accompanies this memorandum opinion.


Summaries of

Unum v. First Unum Life Insurance Company

United States District Court, D. Columbia
Apr 13, 2005
Civil Action No. 04-723 (RMC) (D.D.C. Apr. 13, 2005)
Case details for

Unum v. First Unum Life Insurance Company

Case Details

Full title:BRUNO UNUM, Plaintiff, v. FIRST UNUM LIFE INSURANCE COMPANY, et al.…

Court:United States District Court, D. Columbia

Date published: Apr 13, 2005

Citations

Civil Action No. 04-723 (RMC) (D.D.C. Apr. 13, 2005)