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Bonin v. Provident Life and Accident Insurance Co.

United States District Court, N.D. California

May 1, 2015

JOHN E. BONIN, Plaintiff,
v.
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY, Defendant.

ORDER GRANTING MOTION FOR PARTIAL SUMMARY JUDGMENT Re: Dkt. No. 47

SUSAN ILLSTON, District Judge.

On May 1, 2015, the Court heard argument on the motion by defendant Provident Life and Accident Insurance Co. for partial summary judgment. For the reasons stated below, the Court GRANTS defendant's motion for partial summary judgment.

BACKGROUND

Plaintiff John Bonin purchased two disability insurance policies from Provident in 1985 and 1990, respectively. Docket No. 47, Bishop Decl. Exhs. 1, 2. On June 9, 2005, Bonin submitted a claim under the polices stating that as of September 2004 he could no longer work as a mortgage loan officer, noting symptoms of stress, depression, and anxiety. Id. Exh. 3. In response, Provident initiated a review of plaintiff's claim which included reviewing medical records submitted by plaintiff, reviewing his tax records, conducting interviews with plaintiff, his former employer and his treating physician, and commissioning two independent medical evaluations by a psychiatrist and a physiologist not employed by Provident. Id. ¶¶ 8-13. Both the Provident and independent physicians agreed that any ailment Bonin might have had would not preclude him from continuing his work as a loan officer, and at least one doctor found that Bonin was likely malingering. Id. ¶¶ 14-17, Exhs. 7-9.

On May 31, 2006, Provident sent Bonin a letter indicating the findings of its investigation, and advising him that he was ineligible for benefits under the policy. Id. Exh. 10. Provident had provided Bonin with benefits throughout the duration of the investigation, and opted to continue paying benefits until August 26, 2006, as one of the independent physicians noted that "a brief period of cognitive therapy would facilitate a return to work." Id. The letter also advised Bonin that he could appeal its determination within 180 days, and that in any event, under the policy, he had three years to bring legal action "from the date proof of claim is required." Id. Exh. 10 at 6. Bonin timely appealed the determination with the assistance of counsel. Id. ¶ 21. However, after a second extensive review process, on January 22, 2007, Provident affirmed its earlier finding of ineligibility. Id. ¶ 29, Exh. 20.

In April of 2008, Bonin's then-attorney sent Provident a letter stating that he had retained a rehabilitation consultant and a disability claims consultant to review plaintiff's claims file, and contending that he "believe[s] [he] can prove [Provident] acted in bad faith by unreasonably withholding benefits from Mr. Bonin." Bishop Decl., Exh. 21 at 3. The letter went on to make an exploding offer for settlement, after which point a lawsuit would be filed. Id. at 4. Provident responded approximately four weeks later, reiterating its position that Bonin was ineligible for benefits under the policy. Bishop Decl., Exh. 22. As defendant concedes, had Bonin followed through on his threat to sue, it would have been within the contractual limitations period. Def. Mot. at 18. However Bonin made no effort to prosecute his claims and did not contact Provident again until October of 2012.

On October 3, 2012, Bonin wrote Provident, asking them to once again "revisit a determination of benefits [it] made on May 31, 2006." Id. Exh. 23 at 1. Bonin explained that since 2008 he had been working as a school teacher, although at a salary below his earnings as a loan officer. Id. He also noted that beginning in 2011, he worked as a marketing director at a mortgage company, but was forced to quit because he was unable to cope with the stressful nature of the job. Id. Bonin clarified that he did "not want [Provident to] start a new claim [.]" Rather, he wanted Provident "to take [his] original claim, which [it] denied [in 2006], and re-evaluate it now that [it had] a longer history of [his] condition[.]" Id. Exh. 24 at 2.

Provident responded that it would not revisit its May 2006 determination, but invited Bonin to submit a claim for disability arising after that time. Id. Exh. 26. On March 8, 2013, Bonin responded in turn by submitting new claim forms. Id. Exhs. 27, 28. Provident replied with a letter summarizing its correspondence with Bonin since his October 2012 letter, and informing him of his policy benefits. Id. Exh. 29. Therein, it stated that the earliest date it could consider his claim for was August 27, 2006-as Bonin had previously received benefits through August 26 during the review process that ultimately resulted in finding that he was not disabled under the policies. Id. at 2. Provident's initial review of the records tended to show that Bonin would not be eligible for benefits in light of the fact that (1) he had only visited a mental health professional three times in the calendar years 2007 and 2008, and had sought no such visits since then; (2) a 2007 doctor's note indicated that Bonin had improved and was ready to resume "analytical financial work;" and (3) Bonin had been operating his own consulting firm since 2008, earning a salary in excess of a hundred thousand dollars in 2012. Id. ¶ 40, Exh. 32. Provident began scheduling an independent medical examination, however it was unable to reach Bonin. Id. ¶ 43. Bonin filed the present action before any examination could take place, and never received a final determination from Provident arising from his 2012 letter.

On February 20, 2014, plaintiff filed a complaint against Provident alleging causes of action for (1) bath faith, (2) intentional infliction of emotional distress, and (3) breach of contract. Compl. ¶¶ 6-18. On June 6, 2014, the Court granted defendant's motion to dismiss with leave to amend.[1] Docket No. 30. On July 23, 2014, plaintiff filed a first amended complaint alleging the same three causes of action. Docket No. 36, FAC ¶¶ 12-24. Now before the Court is defendant's motion for partial summary judgment, which seeks to limit the time period that may serve as a basis for Bonin's claims. Docket No. 47. Specifically, Provident argues that any claims arising out of its 2006 denial of benefits are now time barred. Id.

LEGAL STANDARD

Summary judgment is proper if the "pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any, show that there is no genuine issue as to any material fact and that the moving party is entitled to a judgment as a matter of law." Rosenbaum v. Washoe Cnty., 663 F.3d 1071, 1075 (9th Cir. 2011); Fed.R.Civ.P. 56(a). The moving party bears the initial burden of demonstrating the absence of a genuine issue of material fact. Celotex Corp. v. Catrett, 477 U.S. 317, 323 (1986). The moving party, however, has no burden to disprove matters on which the non-moving party will have the burden of proof at trial. The moving party need only demonstrate to the Court that there is an absence of evidence to support the non-moving party's case. Id. at 325.

Once the moving party has met its burden, the burden shifts to the non-moving party to "set out specific facts showing a genuine issue for trial.'" Id. at 324 (quoting then-Fed. R. Civ. P. 56(e)). To carry this burden, the non-moving party must "do more than simply show that there is some metaphysical doubt as to the material facts." Matsushita Elec. Indus. Co., Ltd. v. Zenith Radio Corp., 475 U.S. 574, 586 (1986). "The mere existence of a scintilla of evidence... will be insufficient; there must be evidence on which the jury could reasonably find for the [non-moving party]." Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 252 (1986).

In deciding a summary judgment motion, the court must view the evidence in the light most favorable to the non-moving party and draw all justifiable inferences in its favor. Id. at 255. "Credibility determinations, the weighing of the evidence, and the drawing of legitimate inferences from the facts are jury functions, not those of a judge... ruling on a motion for summary judgment." Id. However, conclusory, speculative testimony in affidavits and moving papers is insufficient to raise genuine issues of fact and defeat summary judgment. Thornhill ...


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