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Hamilton v. Prudential Insurance Company of America

January 15, 2010

ROBERT HAMILTON, PLAINTIFF,
v.
THE PRUDENTIAL INSURANCE COMPANY OF AMERICA, DEFENDANT.



The opinion of the court was delivered by: Morrison C. England, Jr. United States District Judge

MEMORANDUM AND ORDER

Through the present action, Plaintiff Ronald Hamilton ("Plaintiff") seeks redress from an alleged breach of contract and breach of the covenant of good faith and fair dealing arising from Defendant The Prudential Insurance Company of America ("Defendant") terminating Plaintiff's benefits under his long-term disability insurance plan. Presently before the Court is Defendant's Motion for Summary Judgment, or in the Alternative Summary Adjudication of Issues, pursuant to Federal Rule of Civil Procedure 56. For the following reasons, Defendant's Motion for Summary Judgment is denied.

BACKGROUND

During the late 1980s, Plaintiff purchased a long-term disability policy ("Policy") issued by Defendant. Under the policy, Plaintiff may qualify for $3,000 in monthly benefits in the event of "total disability" after a 26-week elimination period. The Policy defines "total disability" as follows:

"Total Disability" exist when Prudential determines that both of these conditions are met.

1) Due to sickness or accidental bodily injury, he cannot perform for wage or profit the material and substantial duties of his occupation.

2) He is not engaged in any gainful occupation and is not confined in prison or other house of correction due to a conviction in a court of law.

Plaintiff was a self-employed CPA who submitted a claim form to Defendant on June 25, 1999 claiming disability since August 1, 1998 due to alcoholism. After a review of his case, on February 1, 1999 Defendant began paying Plaintiff a monthly benefit of $3,000.

Defendant continued to find Plaintiff to be disabled within the meaning of the policy until November 1, 2005, at which point it deemed Plaintiff "no longer disabled." Twice before this final determination Defendant sought to terminate his payments, but both times Plaintiff was reinstated following appeal based upon a finding that Plaintiff was still disabled.

ANALYSIS

The Federal Rules of Civil Procedure provide for summary judgment when "the pleadings, the discovery and disclosure materials on file, and any affidavits show that there is no genuine issue as to any material fact and that the movant is entitled to a judgment as a matter of law." Fed. R. Civ. P. 56(c). One of the principal purposes of Rule 56 is to dispose of factually unsupported claims or defenses. Celotex Corp. v. Catrett, 477 U.S. 317, 323-324 (1986).

Rule 56 also allows a court to grant summary adjudication on part of a claim or defense. See Fed. R. Civ. P. 56(a) ("A party claiming relief may move...for summary judgment on all or part of the claim."); see also Allstate Ins. Co. v. Madan, 889 F. Supp. 374, 378-79 (C.D. Cal. 1995); France Stone Co., Inc. v. Charter Township of Monroe, 790 F. Supp. 707, 710 (E.D. Mich. 1992).

The standard that applies to a motion for summary adjudication is the same as that which applies to a motion for summary judgment. See Fed. R. Civ. P. 56(a), 56(c); Mora v. ChemTronics, 16 F. Supp. 2d. 1192, 1200 (S.D. Cal. 1998).

A party seeking summary judgment 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," ...


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