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Brawley v. Northwestern Mutual Life Insurance Company

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

December 21, 2018

GLEN L. BRAWLEY, DMD, Plaintiff,
v.
NORTHWESTERN MUTUAL LIFE INSURANCE COMPANY, et al., Defendants.

          MEMORANDUM OPINION AND ORDER

          ANNEMARIE CARNEY AXON, UNITED STATES DISTRICT JUDGE

         Plaintiff Glen Brawley, an orthodontist, had five disability income policies with Defendant Northwestern Mutual Life Insurance Company (“Northwestern”). (Doc. 1-1 at ¶¶ 7-12). After he severely injured his dominant hand in a brush saw accident, Dr. Brawley filed a claim under each of the policies. (Id. at ¶¶ 19-25, 34). Until January 1, 2015, Northwestern paid Dr. Brawley disability benefits under all five policies, but in February 2015, it reassessed his condition and discontinued all disability payments. (Id. at ¶¶ 34-40). Dr. Brawley timely filed an appeal of the denial, which Northwestern denied. (Id. at ¶¶ 41-42). In March 2016, Dr. Brawley submitted a second claim for disability benefits. (Doc. 1-1 at ¶ 43). After its review of the second request, Northwestern determined it was “unable to re-open [Dr. Brawley's] prior claim or approve a new claim.” (Doc. 32-4). This lawsuit followed.

         Currently pending before the court is Northwestern's motion for partial summary judgment. (Doc. 27). Northwestern argues that Counts II through V of Dr. Brawley's complaint are time-barred under either Alabama's twenty-year rule of repose or the applicable statute of limitations. (Doc. 28 at 6). For the reasons explained below, the court GRANTS IN PART AND DENIES IN PART Northwestern's motion.

         I. STANDARD OF REVIEW

         “The court shall grant summary judgment 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). The court views the evidence in the light most favorable to the non-moving party. Baas v. Fewless, 886 F.3d 1088, 1091 (11th Cir. 2018).

         II. FACTUAL BACKGROUND

         Dr. Brawley purchased five disability income policies from Northwestern. The first policy was issued on April 10, 1981 (the “1981 Policy”). (Doc. 1-1 at ¶ 7). The second policy was issued on November 10, 1987 (the “1987 Policy”). (Id. at ¶ 11). The third policy was issued on January 10, 1990 (the “1990 Policy”). (Id. at ¶ 12). The fourth and fifth policies were issued on March 1, 2002 (collectively, the “2002 Policies”). (Id. at ¶ 14). All five of the policies remained in effect at all relevant times. (Doc. 1-1 at ¶¶ 7, 11, 12, 14).

         Dr. Brawley did not actually read any of the disability policies; he “looked” at the 1981, 1987, and 1990 Policies “close enough to verify the premium and benefits were as represented” and relied on the Northwestern agent's representations about the terms of the 2002 Policies. (Doc. 1-1 at ¶ 15; Doc. 11 at 12-13). Based on discussions he had with the Northwestern agent who sold him the policies, Dr. Brawley believed that the 1987 Policy provided “true ‘own occupation'” protection in the event he “could not perform, on a full-time basis, the primary activities of his specific specialty (orthodontics).” (Doc. 1-1 at ¶¶ 9-11). He believed the 1990 Policy was “virtually identical” to the 1981 and 1987 Policies (id. at ¶ 12), and when he purchased the 2002 Policies, he understood them to be “essentially the same as the three previous policies” (id. at ¶ 15). Dr. Brawley did not compare the language in the 2002 Policies to the three earlier policies. (Id.).

         In 2013, after a severe injury to his dominant hand impacted his ability to work, Dr. Brawley applied for disability benefits under all five policies. (Doc. 1-1 at ¶¶ 19, 34). Northwestern approved the claim, subject to continuing proof of disability requirements, and paid Dr. Brawley monthly disability benefits under the policies through January 2015. (See Id. at ¶¶ 34, 35). In February 2015, Northwestern denied Dr. Brawley's claim for disability benefits beyond what had already been paid. (Id. at 40).

         In February 2016, Dr. Brawley sold his orthodontics practice and stopped practicing. (Id. at ¶¶ 43, 47). He then submitted, in March 2016, a second claim based on his updated employment status and included additional medical records regarding a condition in his right elbow. (Doc. 1-1 at ¶ 43).

         In April 2016, Northwestern sent Dr. Brawley a letter acknowledging receipt of the claim and informing him that Northwestern would “be re-evaluating [his] claim from [the] original submission in 2013 to see if [it] can change that decision and, if not, [determine] whether [it] can establish a current period of disability.” (Doc. 32-3). In June 2016, Northwestern concluded its “review of [Dr. Brawley's] claim both with regard to [his] current limitations and possible limitations continuing from [the] original claim.” (Doc. 32-4). Based on its review, Northwestern determined that it was “unable to either re-open [Dr. Brawley's] prior claim or approve a new claim.” (Id.).

         Dr. Brawley sued Northwestern and two insurance agents in state court, asserting various state law claims. (Doc. 1-1). The Defendants removed the case to this court based on diversity jurisdiction. (Doc. 1 at ¶ 6). The court (Hopkins, J.) dismissed the two insurance agents as fraudulently joined, concluding that the rule of repose barred some of the claims against them and the statute of limitations barred the rest. (Doc. 19 at 2-3, 36-37).

         The only remaining Defendant is Northwestern. Count I alleges Northwestern breached the terms and provisions of all five policies issued to Dr. Brawley. (Doc. 1-1 at ¶ 51). Counts II, III, and IV assert claims with respect to the 1987, 1990, and 2002 Policies. (Id. at ¶¶ 54, 58, 61). Count V alleges Northwestern twice denied Dr. Brawley's disability claims in bad faith. (Id. at ¶ 69).

         III. ...


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