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Jeffrey L. Wissot, Dds v. Great-West Life and Annuity Insurance Co. and American Dental

December 12, 2012

JEFFREY L. WISSOT, DDS, PLAINTIFF,
v.
GREAT-WEST LIFE AND ANNUITY INSURANCE CO. AND AMERICAN DENTAL ASSOCIATION, DEFENDANTS.



The opinion of the court was delivered by: Honorable Ronald S.W. Lew Senior, U.S. District Court Judge

Statement of Uncontroverted Facts and Conclusions of Law Re: Defendant's Motion for Summary Judgment [18]

After consideration of the papers and arguments in support of and in opposition to Defendant Great-West Life and Annuity Insurance Company's ("Defendant") Motion for Summary Judgment Regarding Choice of Law Issue [18], the Court makes the following findings of fact and conclusions of law.

UNCONTROVERTED FACTS

1. The American Dental Association ("ADA") sponsors group insurance plans for the benefit of its members. Goodreau Decl. ¶ 1.

2. In 1992, the ADA contracted with Defendant to

administer and insure a group disability income protection plan in order to insure qualifying ADA members. Id. at ¶¶ 5-6.

3. In relevant part, the 1992 version of the group policy stated that the policy was "subject to the laws of the State of Illinois" (Id. at Ex. 2, p. 28) and, under the heading "Conformity With Statutes," that it was "amended to comply at all times with the minimum requirements of the State of Illinois which apply to Group Long Term Disability Insurance" (Id. at Ex. 2, p. 51).

3. An essentially identical version of the "Conformity With Statutes" provision was included in corresponding individual certificates issued to insured members. Id. at Ex. 3, p. 69.

4. On July 27, 1996, Plaintiff, a member of the ADA, became insured with Defendant under the group policy. Wissot Decl. ¶ 1.

5. The ADA and Defendant subsequently changed some of the features of the group policy, effective May 1, 1997. Goodreau Decl. ¶ 7. A replacement policy document and replacement individual certificates were issued to all covered members. Id. at ¶¶ 7-8, Exhs. 4,

6. In relevant part, the 1997 version of the group policy stated that the group policy was "subject to the laws of the State of Illinois." Id. at Ex. 4, p. 89. Furthermore, the 1997 version of the policy provided that "[t]his [group] policy and any dispute between a Member and the Company arising in connection therewith are subject to and governed by and shall be construed in accordance with Illinois law." Id. at Ex. 4, p. 116 (emphasis in original).

7. An essentially identical version of the latter provision was included under the heading "Conformity With Statutes" in the individual replacement certificates issued to covered members, including Plaintiff. Id. at ¶ 7, Ex. 5, p. 140.

8. In 2003, Plaintiff filed a claim with Defendant for total disability benefits, which was approved. However, in August 2012, upon Plaintiff reaching age sixty-five, Defendant ...


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