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Cich v National Life Insurance Company

Case No. 12-3223 (C.A. 8, Apr. 8, 2014)

Curtis Cich sued National Life Insurance Company (“National Life”) and Penn Mutual Life Insurance Company (“Penn Mutual”) after both companies denied his claims for disability benefits under insurance policies they had issued to him. The district court granted summary judgment for the insurance companies, and we affirm.

I.



Cich obtained his license as a doctor of chiropractic in Minnesota in January 1987 and established a practice in Maple Grove, Minnesota, shortly thereafter. During the course of his practice, Cich purchased two disability income policies and three business overhead expense policies from National Life. He also purchased a disability income policy from Penn Mutual. The policies provide monthly payments of various amounts and for various periods of time in the event that the insured suffers a “total disability.”

The National Life disability income policies and one of the National Life business overhead expense policies define “total disability” as follows, with minor, immaterial deviations: “The Insured shall be deemed totally disabled only if the Insured . . . is unable to perform the material and substantial duties of the Insured’s occupation due to . . . accidental injury . . . or . . . sickness.” The other National Life business overhead expense policies similarly define “total disability” and “totally disabled” to mean “injury or sickness restricts your ability to perform the material and substantial duties of your regular occupation to an extent that prevents you from engaging in your regular occupation.” The Penn Mutual policy states that the insured will be considered totally disabled only if certain conditions are met, including (1) “You are unable to do the substantial and material duties of your regular occupation” and (2) “Your total disability results from sickness or injury.” The policies also require that to qualify as totally disabled, the insured must be receiving appropriate medical care for the condition, with variations not material here regarding what qualifies as appropriate.

Between 1988 and 2006, the Minnesota Board of Chiropractic Examiners received numerous complaints that Cich misled patients about treatment costs and insurance coverage. On March 27, 2008, the Board suspended Cich’s chiropractic license for two years and ordered him to pay a $50,000 fine. The Minnesota courts upheld the two-year license suspension and reduced the fine to $30,000.
 

 

Judge(s): Steven Colloton
Jurisdiction: U.S. Court of Appeals, Eighth Circuit
Related Categories: Contracts , Insurance
 
Circuit Court Judge(s)
Steven Colloton
Jane Kelly
William Riley

 
Trial Court Judge(s)
Donovan Frank

 

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sickness as required by the policies. -5- fact for trial and the movant is entitled to judgment as a matter of law. fed. r. civ. independent medical examinations to dispute his medical condition. cich asserts that corp. of s.d. v. am. foods grp., inc., 281 f.3d 733, 738 (8th cir. 2002). time disability begins. see webster’s third new international dictionary 1560 submitted: october 24, 2013 medical care for the condition, with variations not material here regarding what ___________________________ appeal from united states district court de novo. myers v. lutsen mountains corp., 587 f.3d 891, 892 (8th cir. 2009). in this disabilitybenefits,theywereobligatedtopaybenefitsimmediatelywhenhesubmitted mutual rejected his claims. cich sued the insurers in minnesota state court, and the of the illness. therefore, he contends, the district court erred by granting summary cich’s submissions also reported that he first received treatment for his lllllllllllllllllllll defendants - appellees. excerpts from the disability income policies appear in cich’s appendix. v. in march 2008. the policies require that an insured must be receiving appropriate life for disability benefits pursuant to his policies. cich asserted that he was totally usual work, because his minnesota license was suspended, and the potential for independent examinations while his claims were pending or while benefits were being business overhead expense policies define “total disability” as follows, with minor, district court’s grant of summary judgment and denial of partial summary judgment national life and penn mutual and denied cich’s motion for partial summary companies, cich argues that even if his chiropractic license had not been suspended, proof of loss forms to national life and penn mutual until the insurers obtained 1 34, at 4-8; r. doc. 51, at 13. appellant’s app. 132-41, 146-52. excerpts from the business overhead expense upheld the two-year license suspension and reduced the fine to $30,000. as to whether he was disabled by the adjustment disorder before his license was him from operating his chiropractic practice. cich reported that he last worked on ___________________________ in the record define “occupation” as “the specialized occupation of the insured at the time . . . disability begins” or “the occupation of the insured at the time . . . disability per month, until she concluded in october 2009 that cich could continue treatment on disabled” to mean “injury or sickness restricts your ability to perform the material and practice in other jurisdictions was speculative. the sickness for which he was treated no. 12-3223 date when cich alleges that his disability began, cich was not engaged in the practice immaterial deviations: “the insured shall be deemed totally disabled only if the business overhead expense policies similarly define “total disability” and “totally reestablishing a practice of chiropractic in march 2010 does not qualify him for mutual life insurance company (“penn mutual”) after both companies denied his an as-needed basis. ____________ thehonorabledonovanw.frank,unitedstatesdistrictjudgeforthedistrict examination was performed. whatever the merit of this timing argument in a case 1997). due to injury or sickness. as of march 2008, cich was unable to practice chiropractic of chiropractic. that a sickness or illness might have prevented cich from court determined that cich was not disabled by an adjustment disorder as of march life and penn mutual moved for summary judgment, arguing that cich did not suffer 2 for these reasons, the district court correctly granted summary judgment for received numerous complaints that cich misled patients about treatment costs and and its use in the context of the onset of a disability lead us to conclude—absent life disability income policies and one business overhead expense policy excerpted granted summary judgment for the insurance companies, and we affirm. ______________________________ after collecting information about cich’s condition, national life and penn businessoverheadexpensepoliciesfromnationallife. healsopurchasedadisability 1987andestablishedapracticeinmaplegrove,minnesota,shortlythereafter. during -7- cich’s motion on the ground that the policies required more than mere submission of lllllllllllllllllllll plaintiff - appellant, from a total disability under the policies. the district court agreed and granted of minnesota. -3- for the district of minnesota - minneapolis contrary evidence from cich—that it likewise means the insured’s usual work at the adjustment disorder until february 2009, nearly a year after his license was suspended “you are unable to do the substantial and material duties of your regular occupation” summary judgment is appropriate when there is no genuine issue of material insured . . . is unable to perform the material and substantial duties of the insured’s sought treatment for an adjustment disorder, the practice of chiropractic was not his for the eighth circuit chiropractic no longer was an occupation from which he could become disabled by p. 56(a); celotex corp. v. catrett, 477 u.s. 317, 322-23 (1986). we review the ____________ before riley, chief judge, colloton and kelly, circuit judges. in 2009 thus did not disable him from his occupation as a chiropractor. see, e.g., -6- cich moved for partial summary judgment, arguing that he submitted proof of occupation due to . . . accidental injury . . . or . . . sickness.” the other national life ii. expense policies does not define “occupation,” but the ordinary meaning of the term disability on february 5, 2009. his treatment provider was karen kramer, a licensed cich obtained his license as a doctor of chiropractic in minnesota in january his policies with national life and penn mutual entitled the insurers to obtain according to the policies issued by national life and penn mutual, an insured curtis cich sued national life insurance company (“national life”) and penn opined that cich would be able to work, but not at his chiropractic practice because disability.” -2- curtis l. cich, “occupation” under the terms of the policies. national life insurance company, a vermont corporation; penn mutual life district court1 the course of his practice, cich purchased two disability income policies and three emotional features” and symptoms including “extreme anxiety and stress” prevented his adjustment disorder prevented himfrom performing his occupation since the onset loss forms in april 2009, and that the policies required national life and penn mutual challenging the district court’s grant of summary judgment for the insurance in april and may 2009, cich submitted claims to penn mutual and national “regular occupation” as his “usual work when total disability starts.” the national amounts and for various periods of time in the event that the insured suffers a “total to pay him benefits thereafter. cich argued that because national life and penn 2010, the date on which he was eligible to have his license reinstated, because the virtue of sickness in february 2009. the penn mutual policy defines the insured’s profession, or other means of earning a living”). as of february 2009, when cich diversity case, we construe the policies according to minnesota law. see orion fin. substantial duties of your regular occupation to an extent that prevents you from disabled as of february 5, 2009, because an “adjustment disorder with mixed mutual had not received independent medical examinations to dispute cich’s once cich lost his chiropractic license in march 2008, the practice of insurance policies, however, provide for benefits when an insured is totally disabled. of its association with his anxiety. kramer continued to treat cich approximately once medical treatment to qualify as totally disabled. insurance company, a pennsylvania corporation, i. disability benefits, because the sickness did not render him unable to perform an 2008 or thereafter, because he was not receiving appropriate medical care for a summary judgment for national life and penn mutual on alternative grounds. the is totally disabled if he is unable to perform his “occupation” or “regular occupation” license for two years and ordered him to pay a $50,000 fine. the minnesota courts paid, but did not expressly state that the insurers could withhold payment until an ____________ march 27, 2008, and did not expect to return to practice. judgment. the judgment of the district court is affirmed. an insured is totally disabled when injury or sickness renders him unable to perform insurers removed the case to federal court based on diversity of citizenship. national require that to qualify as totally disabled, the insured must be receiving appropriate “sickness.” that argument fails because cich did not seek treatment for his (1993) (defining “occupation” as “the principal business of one’s life . . . a craft, trade, proof of loss forms to entitle him to benefits. months regardless of the results of those examinations. the district court denied judgment for the insurers on the ground that the license suspension, rather than the suspended, so that he would qualify for benefits based on a disability caused by benefits to an insured who is not totally disabled. colloton, circuit judge. social worker. on six occasions between february and june 2009, kramer and cich filed: april 8, 2014 disability until late 2011, he was entitled to disability payments for the intervening claims for disability benefits under insurance policies they had issued to him. the income policy from penn mutual. the policies provide monthly payments of various cich contends in the alternative that he is entitled to benefits as of march 27, will be considered totally disabled only if certain conditions are met, including (1) regular work or occupation at the time the disability begins. in february 2009, the ____________ insurance coverage. on march 27, 2008, the board suspended cich’s chiropractic court first concluded that cich failed to present sufficient evidence that his inability because his license was suspended. an incapacity arising from license suspension is engaging in your regular occupation.” the penn mutual policy states that the insured begins.” an excerpt in the record from the other two national life business overhead cich appears to contend, however, that there is a genuine issue of material fact where the insured is totally disabled and thus entitled to benefits at one time or policies appear in the district court record. r. doc. 35-1, at 21-22, 24-25; see r. doc. not a “sickness” or an “injury” that qualifies as a total disability under the policies. another, we see no basis under the policies to require the insurance companies to pay united states court of appeals policies, because his license suspension caused the inability to work. second, the adjustment disorder prevented him from returning to the practice of chiropractic. the -4- the national life disability income policies and one of the national life the duties of his occupation. an occupation, under the policies, is the insured’s allmerica fin. life ins. & annuity co. v. llewellyn, 139 f.3d 664, 666 (9th cir. between 1988 and 2006, the minnesota board of chiropractic examiners adjustment disorder, caused his inability to work. engaged in talk therapy sessions and other treatment for cich’s condition. kramer and (2) “your total disability results from sickness or injury.” the policies also to work in his occupation was caused by a sickness or injury, as required by the qualifies as appropriate.2 cich also argues that even if the insurers properly denied his claims for


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