Summary
denying summary judgment where plaintiff submitted statements that he never received the information that would have put him on notice of insurance policy's limitations
Summary of this case from Stirrup v. Educ. Mgmt. LLCOpinion
No. CV-04-0659-PHX-FJM.
May 1, 2006
ORDER
This court has before it defendants' Motion for Summary Judgment (doc. 47), plaintiff's Response (doc. 54), and defendants' Reply (doc. 58). We also have before us plaintiff's Motion to Strike Opposition to Controverting Statement of Facts and Affidavit of Susan Roe (doc. 61), defendants' Response (doc. 63), and plaintiff's Reply (doc. 65). For the reasons set forth below, we deny both motions.
I
In May 2001, plaintiff Kenneth LaMarr filled out an enrollment card for life insurance for himself in the amount of $50,000, and for his alleged common law wife, Dedra De Sorrells, in the amount of $100,000, both with an effective date of July 1, 2001. The insurance was offered by defendant American Bankers Life Assurance Company of Florida ("American Bankers") and was administered by defendant Association Group Insurance Administrators, Inc. ("AGIA").
Plaintiff signed his name and De Sorrells' name to the enrollment form directly above two provisions certifying (1) that he and Ms. De Sorrells were in good health and that neither had been diagnosed with certain specified medical conditions; and (2) that "[b]y signing this enrollment, I/we acknowledge receipt and understanding of all disclosures accompanying this letter and enrollment." DSOF, Exhibit B.
On October 5, 2002, De Sorrells was killed by a self-inflicted gunshot wound. On October 21, 2002, plaintiff informed AGIA of De Sorrells' death and made a claim on the life insurance policy. On January 6, 2003, American Bankers denied plaintiff's claim and informed him — he claims for the first time — that the policy he purchased did not provide for death benefits where death was self-inflicted and occurred within two years of the effective date of the policy. Plaintiff now contends that he was never informed of the suicide exclusion, and therefore this provision cannot serve to exclude coverage.
II
The central issue presented in this case is whether plaintiff knew of the suicide exclusion such that benefits based on Ms. De Sorrells' suicide are properly denied. On the one hand, plaintiff claims that he never received any information about the policy prior to Ms. De Sorrells' death, that he was unaware of the suicide exclusion, that he reasonably expected that coverage existed, and therefore coverage cannot be denied on this basis. Specifically, plaintiff alleges that he applied for life insurance when he visited a Redding, California branch of Wells Fargo Bank while on a business trip and was verbally solicited for life insurance coverage. He claims that he was given an enrollment card by a bank employee, which he filled out on behalf of himself and Ms. De Sorrells, but he did not receive any other information about the policy. He claims that at no time prior to De Sorrells death did he receive any further documentation from AGIA, American Bankers or Wells Fargo explaining the terms or limitations of the policy.
Defendants alternatively argue that no valid, binding contract was ever formed because Ms. De Sorrells did not personally sign the enrollment card and certify that she was in good health. Defendants fail to cite any authority for the proposition that a person is unable to obtain life insurance for his or her spouse, or to certify that one's spouse is in good health. Further, while defendants raise the issue of whether Ms. De Sorrells was in fact plaintiff's common law wife, there is no analysis of relevant law from which we could decide the issue. These arguments are insufficient to warrant summary judgment in defendants' favor.
Defendants contend, on the other hand, that substantial evidence establishes that plaintiff in fact received coverage and exclusion information on numerous occasions, and therefore plaintiff must have known about the suicide exclusion. Defendants contend that plaintiff could not have simply walked into a Wells Fargo branch in California and filled out an enrollment form, because the form plaintiff submitted was preprinted with his name and address in Winnemucca, Nevada. According to defendants, plaintiff's enrollment form must have been received by plaintiff as part of a mass mailing sent to Wells Fargo customers, a mailing which contained a preprinted enrollment form, as well as a two-page summary of the insurance coverage, including an explanation of the suicide exclusion. Plaintiff does not explain why the enrollment form he submitted contained his preprinted name and address.
Defendants also argue that plaintiff's receipt of coverage information is demonstrated by AGIA's standard practice of sending a certificate of insurance to all insureds upon enrollment. AGIA's records indicate that this information was sent to plaintiff on June 13, 2001, two weeks after enrollment, and again on December 21, 2001, after plaintiff contacted AGIA and advised them of a change of address. Defendants note that if plaintiff had received no information about the policy other than what was printed on the enrollment form, as plaintiff alleges, he would not have known to contact AGIA to submit change of address information because AGIA is not mentioned anywhere on the enrollment form. Again, plaintiff does not attempt to refute or explain this conflicting evidence.
On a motion for summary judgment under Rule 56, Fed.R.Civ.P., the moving party carries the initial burden of demonstrating the absence of a genuine issue of material fact. Celotex Corp. v. Catrett, 477 U.S. 317, 323, 106 S. Ct. 2548, 2553 (1986). When the moving party has satisfied this initial burden, the burden then shifts to the nonmoving party to establish that a genuine issue of material fact exists. Id. at 324, 106 S. Ct. at 2553-54; Fed.R.Civ.P. 56(e). "In the language of the Rule, the nonmoving party must come forward with specific facts showing that there is a genuine issue for trial." Matsushita Elec. Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 587, 106 S. Ct. 1348, 1356 (1986) (emphasis in original).
"Where the nonmoving party in a motion for summary judgment has come forward with direct evidence contrary to that offered by the movant, a credibility issue is raised." Hanon v. Dataproducts Corp., 976 F.2d 497, 507 (9th Cir. 1992); see also McLaughlin v. Liu, 849 F.2d 1205, 1207-08 (9th Cir. 1988). These credibility determinations are for the trier of fact, and therefore may not be resolved by summary judgment. McLaughlin, 849 F.2d at 1207 (citing Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 255, 106 S. Ct. 2505, 2513 (1986)). Although in reviewing a motion for summary judgment we are entitled to discount unreasonable inferences arising from circumstantial evidence, we must treat direct evidence, including the nonmovant's own sworn testimony, as if it were true. Id. at 1207-08 (holding that sworn statements are considered direct evidence of a fact in dispute); Hanon, 976 F.2d at 507. "[T]he court may not assess the credibility of [direct] evidence nor weigh against it any conflicting evidence presented by the moving party." McLaughlin, 849 F.2d at 1209.
Here, plaintiff's deposition testimony is direct evidence of a central fact in dispute: whether plaintiff received information regarding the policy coverage and exclusions. Although plaintiff's account of the facts relating to enrollment may appear on its face to be unlikely given the unexplained inconsistencies in his testimony, his claims are not thereby rendered altogether implausible. Even if plaintiff used a preprinted enrollment form, it does not necessarily follow that he also received coverage and exclusion information. This remains a disputed issue of material fact. It is for the trier of fact to determine the credibility of plaintiff's testimony. Accordingly, we conclude that plaintiff has raised a genuine issue of material fact which precludes summary judgment.
III
Plaintiff filed a motion to strike defendants' opposition to plaintiff's controverting statement of facts and affidavit of Susan Roe as untimely and improper. Based on the foregoing, this motion is rendered moot, and is accordingly denied (doc. 61).
IT IS THEREFORE ORDERED DENYING defendants' motion for summary judgment (doc. 47). IT IS FURTHER ORDERED DENYING plaintiff's motion to strike (doc. 61).