Searching over 5,500,000 cases.


searching
Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.

Wissot v. Great-West Life and Annuity Insurance Co.

United States District Court, Ninth Circuit

June 12, 2013

Jeffrey L. Wissot, DDS, Plaintiff,
v.
Great-West Life and Annuity Insurance Co. and American Dental Association, Defendants.

Statement of Uncontroverted Facts and Conclusions of Law Re: Defendant Great-West Life & Annuity Insurance Company's Motion for Summary Judgment [42]

RONALD S.W. LEW, Senior District Judge.

After consideration of the papers and arguments in support of and in opposition to Defendant Great-West Life & Annuity Insurance Company's ("Defendant") Motion for Summary Judgment [42], 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. Defendant's Proposed Stmt. of Uncontroverted Facts and Conclusions of Law ¶ 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.

3. Plaintiff, a member of the ADA, became insured with Defendant under the group policy. Id . ¶¶ 3, 4.

4. In relevant part, the 1992 version of the group policy defined "Total Disability" as "that due to an accident or sickness, an insured Member is unable to perform the duties of his profession or occupation." Id . ¶ 1. The 1992 individual certificate issued to Plaintiff contained the following policy language describing the long-term benefits available under the plan:

[1]

Id. ¶ 3.

5. The ADA and Defendant subsequently changed some of the features of the group policy, effective May 1, 1997. Id . ¶ 4. A new group policy document and new individual certificates were issued to all covered members. Id . In April 1997, Defendant mailed a letter from the ADA's Chairman of Council on Insurance to insured members to provide notice of the changes to the group insurance plan. Id.

6. In July 1996, Plaintiff, then forty-eight-years-old, was struck by a car while riding his bicycle, resulting in a torn ligament in Plaintiff's right (dominant) hand. Compl. ¶ 18; SUF ¶ 6; Pl.'s Proposed Stmt. of Uncontroverted Facts and Conclusions of Law ¶ 15.

7. In 2003 Plaintiff ended his dentistry practice at the age of fifty-five. SUF ¶ 9. Plaintiff subsequently submitted a claim for disability benefits to Defendant, which Defendant paid to Plaintiff. Id . ¶¶ 6-7.

8. Plaintiff did not suffer a total disability before ...


Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.