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Bailey v. National Union Fire Insurance Co. of Pittsburgh, Pa.

United States District Court, N.D. Alabama, Eastern Division

April 24, 2015

CHRISTOPHER BAILEY, Plaintiff,
v.
NATIONAL UNION FIRE INSURANCE CO. OF PITTSBURGH, PA., Defendant.

MEMORANDUM OPINION

KARON OWEN BOWDRE, District Judge.

Plaintiff Christopher Bailey, a truck-driver, suffered a back injury as a result of an automobile accident on July 6, 2009, leaving him unable to continue driving semi-trucks. Prior to the accident, Mr. Bailey had purchased an insurance policy with Defendant National Union Fire Insurance Company of Pittsburgh, Pennsylvania. Because the accident left Mr. Bailey unable to continue driving semi-trucks, National Union began paying Mr. Bailey Temporary Total Disability Benefits under the Policy and continued to do so for the maximum time period provided for under the Policy-104 weeks. On July 4, 2011, the 104-week period ended, and Mr. Bailey became eligible to receive Continuous Total Disability Benefits. National Union, however, determined that Mr. Bailey did not qualify for Continuous Total Disability Benefits and sent him a letter explaining its denial of his claim. Mr. Bailey subsequently brought suit against National Union for breach of contract and bad faith.[1]

This matter is now before the court on the parties' cross motions for summary judgment (docs. 38 & 40) and National Union's "Motion to Strike Portions of the Declaration of Christopher Bailey" (doc. 45). For the reasons discussed below, the court will DENY both parties' motions for summary judgment as to the breach of contract claim. The court will GRANT National Union's motion for summary judgment as to the bad faith claim and DENY Mr. Bailey's motion for summary judgment on the bad faith claim. Finally, because Mr. Bailey's declaration does not alter the outcome of the parties' motions for summary judgment, this court will DENY National Union's motion to strike the declaration as MOOT.

I. STANDARD OF REVIEW

Summary judgment allows a trial court to decide cases when no genuine issues of material fact are present and the moving party is entitled to judgment as a matter of law. See Fed.R.Civ.P. 56. When a district court reviews a motion for summary judgment, it must determine two things: (1) whether any genuine issues of material fact exist; and if not, (2) whether the moving party is entitled to judgment as a matter of law. Fed.R.Civ.P. 56(c).

The moving party "always bears 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, 477 U.S. 317, 323 (1986) (quoting Fed.R.Civ.P. 56). Once the moving party meets this burden, the burden shifts to the non-moving party "to demonstrate that there is indeed a material issue of fact that precludes summary judgment." Clark v. Coats & Clark, Inc., 929 F.2d 604, 608 (11th Cir. 1991).

In reviewing the evidence submitted, the court must "view the evidence presented through the prism of the substantive evidentiary burden, " to determine whether the nonmoving party presented sufficient evidence on which a jury could reasonably find in its favor. Anderson, 477 U.S. at 254; Cottle v. Storer Commc'n, Inc., 849 F.2d 570, 575 (11th Cir. 1988). In doing so, all evidence and reasonable inferences drawn from the underlying facts must be viewed in the light most favorable to the non-moving party. See Graham v. State Farm Mut. Ins. Co., 193 F.3d 1274, 1282 (11th Cir. 1999). After both parties have addressed the motion for summary judgment, the court must grant the motion if no genuine issues of material fact exist and if the moving party is entitled to judgment as a matter of law. Fed.R.Civ.P. 56.

The applicable Rule 56 standard is not affected by the filing of cross motions for summary judgment. See, e.g., Gerling Global Reinsurance Corp. of Am. v. Gallagher, 267 F.3d 1228, 1233 (11th Cir. 2001). When parties file cross motions for summary judgment, "each side must still establish the lack of genuine issues of material fact and that it is entitled to judgment as a matter of law." Busby v. JRHBW Realty, Inc., 642 F.Supp.2d 1283, 1288 (N.D. Ala. 2009). "The fact that both parties simultaneously are arguing that there is no genuine issue of fact... does not establish that a trial is unnecessary thereby empowering the court to enter judgment as it sees fit." Id. (internal quotation marks omitted). Nonetheless, "cross-motions may be probative of the non-existence of a factual dispute when... they demonstrate a basic agreement concerning what legal theories and material facts are dispositive." United States v. Oakley, 744 F.2d 1553, 1555-56 (11th Cir. 1984).

II. STATEMENT OF FACTS

In June of 2007, Central Hauling, Inc. hired Mr. Bailey to work as an interstate truck driver. Mr. Bailey began leasing a truck from Central Hauling and, as part of the leasing package, purchased an accidental occupational insurance policy from National Union. Among other coverages, the Policy provided for both Temporary Total Disability coverage and Continuous Total Disability coverage.

Temporary Total Disability

Under the Policy, Mr. Bailey was entitled to 104 weeks of Temporary Total Disability benefits if he suffered an injury resulting in a Temporary Total Disability. The Policy provides the following definition for a Temporary Total Disability: "Temporarily Totally Disabled means disability that: (1) prevents an Insured Person from performing the duties of his or her regular, primary occupation; and (2) requires that, and results in, the Insured Person receiving Continuous Care." (Doc. 41-1, at 91).

Continuous Total Disability Benefits

The Policy also provides for Continuous Total Disability Benefits following the 104 week Temporary Total Disability Benefit period so long as the insured qualifies. The following provision governs whether an insured person qualifies for Continuous Total Disability Benefits:

Continuous Total Disability Benefit

If Injury to the Insured Person, resulting in Temporary Total Disability, subsequently results in Continuous Total Disability, the Company will pay the Continuous Total Disability Benefit..., provided:
1. benefits payable for a Temporary Total Disability Covered Loss ceased solely because the Maximum Benefit Period shown in the Schedule for Temporary Total Disability has been reached, but the Insured Person remains disabled;
2. the Insured Person is under the age 65 at the day after the Maximum Benefit Period shown in the Schedule for Temporary ...

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