Filed: Mar. 31, 2014
Latest Update: Mar. 31, 2014
Summary: ORDER GRANTING DEFENDANTS' MOTION FOR SUMMARY JUDGMENT JANET BOND ARTERTON, District Judge. In this diversity case, Defendants filed their Motion for Summary Judgment on August 5, 2013 [Doc. # 72] (with accompanying Memorandum of Law, Local Rule 56(a)1 Statement and supporting documents, including the 1994 Individual Disability Income Policy No. 15-6134451 and related correspondence, medical records and correspondence, claims review and appeal file, tax returns, reports by Defendants' retained
Summary: ORDER GRANTING DEFENDANTS' MOTION FOR SUMMARY JUDGMENT JANET BOND ARTERTON, District Judge. In this diversity case, Defendants filed their Motion for Summary Judgment on August 5, 2013 [Doc. # 72] (with accompanying Memorandum of Law, Local Rule 56(a)1 Statement and supporting documents, including the 1994 Individual Disability Income Policy No. 15-6134451 and related correspondence, medical records and correspondence, claims review and appeal file, tax returns, reports by Defendants' retained ..
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ORDER GRANTING DEFENDANTS' MOTION FOR SUMMARY JUDGMENT
JANET BOND ARTERTON, District Judge.
In this diversity case, Defendants filed their Motion for Summary Judgment on August 5, 2013 [Doc. # 72] (with accompanying Memorandum of Law, Local Rule 56(a)1 Statement and supporting documents, including the 1994 Individual Disability Income Policy No. 15-6134451 and related correspondence, medical records and correspondence, claims review and appeal file, tax returns, reports by Defendants' retained reviewing psychiatrist and certified public accountant, affidavits and Plaintiff's deposition). Plaintiff's two motions for extension of time [Doc. ## 75, 78] were granted and Plaintiff's opposition was to be filed by September 30, 2013. No opposition was filed, and no additional extension of time within which to respond has been sought by Plaintiff.1
After full review of the motion and supporting record, Defendants' Motion for Summary Judgment is granted. The record shows that Plaintiff has not met her burden of showing by medical documentation submitted by Plaintiff's medical treatment providers that she was unable to substantially perform the essential functions of her employment from May 25, 2006 to May 2009. Plaintiff claims depression-related total disability starting May 25, 2006, associated with her husband's death. She first communicated her diagnosis to Defendants by telephone on July 1, 2009, and filed her claim for long-term disability benefits on July 20, 2009, outside the policy claim deadline.2 The record shows lack of clarity with respect to the frequency, duration and severity of Plaintiff's symptoms of depression and anxiety during the claimed three-year period, compared with her prior depressive condition during which she was able to work, as well as the gaps and shortcomings in the records of the medical professionals who treated Plaintiff which were provided to MetLife. Defendants' claim of prejudice was identified by MetLife personnel involved in processing Plaintiff's claims to include being unable to interview co-workers and clients from the pre-May 2006 period, when Plaintiff also suffered from depression, or to obtain adequate contemporaneous medical information for this three-year period. While Plaintiff's primary physician, who treated Plaintiff for more than three decades, noted her chronic state of depression and dysfunction, Plaintiff's reason given for her untimely claim was not that she had been too incapacitated, but that she did not want to "open herself up and fight" with the insurance company as she anticipated would be necessary. She also did not know if she had coverage for mental conditions because she did not have a copy of her policy and MetLife initially would not tell her if mental disability was covered under her policy and said it would charge her $20 for a replacement copy, which she eventually purchased. Based on Defendants' unrebutted evidence it has proven by a preponderance of the evidence that it was prejudiced by Plaintiff's late notice. See Arrowood, 304 Conn. at 201.
Plaintiff's self-described symptoms in her statements to Senior Field Representative Randy Guillen about her degree of disability contrast with the Affidavit of Peter Slavin (Defendant Metropolitan Life's Senior Financial Service Executive), from whom Plaintiff sought assistance in obtaining health insurance starting in August, 2006, after her husband's death. Slavin described normal contacts through February 2009 and no mention by Plaintiff of being disabled or unable to work, including contact with two potential clients between November 2008 and January 2009 with whom Slavin put her in touch.
Inasmuch as Defendants' reasons for denial—untimely claims and insufficient medical records until May 2009 are supported by the evidence, Plaintiff's breach of contract claim fails, as does the associated claim of breach of good faith and fair dealing. Her Connecticut Unfair Insurance Practices Act ("CUIPA") claim is not a cognizable stand-alone claim, see Lander v. Hartford Life & Annuity Ins. Co., 251 F.3d 101, 118 (2d Cir. 2001) ("[CUIPA] does not provide a private cause of action."), and there is an inadequate record to support a Connecticut Unfair Trade Practices claim arising from the claimed CUIPA violation including the extended claim processing time by MetLife resulting from the three-year medical and work history at issue.
It is unnecessary for the Court to address whether the terms of the original policy, in "lapse pending" status in January were revived by Plaintiff's voluntary change in coverage to decrease the monthly benefits and benefit period.
Conclusion
Defendants' Motion for Summary Judgment [Doc. # 72] is GRANTED. Judgment shall enter in favor of Defendants and the Clerk is directed to close this case.
IT IS SO ORDERED.
