DOUGLAS HARPOOL, District Judge.
Before the Court is Defendants' Motion in Limine (Doc. 70). After full and careful consideration, the Court hereby
This case involves claims for breach of contract and vexatious refusal to pay stemming from Defendants' denial of disability benefits to Plaintiff under a policy of disability insurance. The record shows that Plaintiff filed a disability claim with Defendants in May of 2012 and alleged disability beginning in December of 2011. Defendants rendered a decision initially denying Plaintiff's disability claim. Plaintiff appealed that decision and, on October 22, 2013, Defendants issued a final decision that upheld the denial of benefits. Plaintiff commenced suit on April 28, 2014. Defendants now move the Court for an order precluding Plaintiff "from offering evidence at trial regarding Defendants' conduct or Plaintiff's alleged disability after October 22, 2013, the date of Defendants' final denial of Plaintiff's disability claim."
Defendants argue that any evidence regarding Plaintiff's disability and Defendants' conduct after October 22, 2013 is irrelevant to Plaintiff's claims because: (1) the events that occurred subsequent to final claim denial do not bear on whether Plaintiff was disabled at the time of final claim denial, which is the time of the alleged breach; (2) to the extent Plaintiff seeks to introduce post-denial evidence to demonstrate that he became disabled after final claim denial, Plaintiff may not pursue that argument in this litigation because the policy prohibits suit until 60 days after proof of loss is filed (i.e. Plaintiff must file a new claim with Defendants and wait 60 days until after he provides proof of loss for that subsequent time period before filing suit);
Plaintiff argues, conversely, that post-denial evidence should be admitted because Plaintiff's ongoing disability up to the time of trial is relevant to Plaintiff's breach of contract claim and Defendants' continued refusal to pay benefits after suit commenced is relevant to Plaintiff's vexatious refusal claim. Plaintiff states these matters are "directly at issue in this case." As to Plaintiff's ongoing disability, Plaintiff argues such evidence is relevant because: (1) the policy provides monthly benefits, for life, for the time period during which Plaintiff suffers a total work disability and, therefore, the jury must decide whether Plaintiff is disabled through the date of trial; and (2) evidence of Plaintiff's ongoing medical treatment is relevant to the issue of Plaintiff's disability at the time of claims denial because Plaintiff's disability "has continued to get worse" and "he has received additional medication treatment which has confirmed the disabling conditions from which he suffered at the time of claim denial." Plaintiff further argues that evidence related to Defendants' post-denial conduct is admissible because, under Missouri law, an insurer's conduct in refusing/delaying payment is not necessarily confined to the insurer's actions prior to filing suit; rather, an insurer can be liable for vexatious refusal where the insurer persists in its refusal to pay after it becomes aware that it has no meritorious defense, which is what Plaintiff alleges happened in this case.
The Court finds evidence related to Plaintiff's ongoing disability is admissible only for the purpose of calculating damages on Plaintiff's breach of contract claim. It is inadmissible under Federal Rule of Evidence 402 and/or 403 for the other purposes cited by Plaintiff.
Evidence concerning Plaintiff's disability status that was submitted after October 22, 2013 is not relevant to whether Defendants breached the parties' contract on October 22, 2013
Nonetheless, the post-denial evidence of Plaintiff's ongoing disability is relevant to damages on Plaintiff's breach of contract claim. In a breach of contract action, the insured may recover disability payments owed through the time of trial. See generally Smith ex rel. Stephan v. AF & L Ins. Co., 147 S.W.3d 767, 779 (Mo. Ct. App. 2004). Because Plaintiff is entitled to monthly disability payments under the policy only for months that he suffers a total work disability, to recover benefits through the date of trial, Plaintiff must show that his total work disability began prior to final claim denial and continued through the date of trial. Both parties agree that Plaintiff's ongoing disability is relevant to damages.
Under Missouri law, whether or not an insurance company's refusal to pay is considered vexatious depends on "how willful and unreasonable the insurer's refusal was as the facts appeared to a reasonable and prudent person at the time the insurer was asked for coverage." Wunsch v. Sun Life Assur. Co. of Canada, 92 S.W.3d 146, 154 (Mo. Ct. App. 2002) (quoting string of cases). Thus, the relevant time period for a vexatious refusal claim is "the time the insurer was asked for coverage." See id.; see also Tauvar v. Am. Family Mut. Ins. Co., 269 S.W.3d 436, 439 (Mo. Ct. App. 2008) ("[T]he issue of whether a refusal was vexatious must be based on the `facts as presented at the time the insurer was asked to pay under the insurance policy.'"); Russell v. Farmers & Merchants Ins. Co., 834 S.W.2d 209, 221 (Mo. Ct. App. 1992) ("Thus, whether a refusal to pay is vexatious or not must be determined by the situation as presented to the insurer at the time it was called on to pay.").
Missouri law further states that an insurance company "that persists in its refusal to pay after becoming aware that it has no meritorious defense is subject to penalty for vexatious refusal." Russell, 834 S.W.2d at 221; see also Wunsch, 92 S.W.3d at 154; Hopkins v. Am. Econ. Ins. Co., 896 S.W.2d 933, 939 (Mo. Ct. App. 1995). In accordance with such, the Supreme Court of Missouri has considered an insurance company's actions in defending litigation and refusing to timely settle the litigation as evidence of bad faith refusal to pay where the insurance company was advised by its attorney prior to commencement of the lawsuit that the insured was entitled to coverage. Dhyne v. State Farm Fire & Cas. Co., 188 S.W.3d 454, 458 (Mo. 2006). The case law makes clear, however, that "[i]f there is an open question of fact or law determinative of the insurer's liability, the insurer, acting in good faith, may insist upon a judicial determination of such questions without being penalized." See Morris v. J.C. Penney Life Ins. Co., 895 S.W.2d 73, 76 (Mo. Ct. App. 1995); see also Macheca Transp. v. Philadelphia Indem. Ins. Co., 649 F.3d 661, 674 (8th Cir. 2011). Moreover, once suit is filed, "[t]he [insurer] has the right to defend an action with all the weapons at its command so long as it has reasonable grounds to believe its defense is meritorious." See id. at 78 (emphasis added). "Again, the issue is one of reasonableness." Wunsch, 92 S.W.3d 154.
Based on the foregoing and considering Plaintiff's allegations, the Court cannot say at this time that Defendants' post-denial conduct is necessarily inadmissible. Such evidence is relevant to Plaintiff's vexatious refusal to pay claim because Defendants' post-denial conduct may show Defendants persisted in an unmeritorious defense. See Fed. R. Evid. 401.
Based on the foregoing, Defendants' Motion in Limine (Doc. 70) is hereby