Butler v. Sentry Ins. A Mut. Co.
| Decision Date | 31 July 1986 |
| Docket Number | No. 85 C 10466.,85 C 10466. |
| Citation | 640 F. Supp. 806 |
| Parties | William P. BUTLER, Plaintiff, v. SENTRY INSURANCE A MUTUAL COMPANY, Defendant. |
| Court | U.S. District Court — Northern District of Illinois |
Cornelius P. Callahan, Thomas L. Hogan, Chicago, Ill., for plaintiff.
John W. Lally, Chicago, Ill., for defendant.
William Butler ("Butler") brings this diversity-of-citizenship action against Sentry Insurance A Mutual Company ("Sentry"),1 claiming entitlement to health benefits under Sentry's Group Policy No. 90-13493-43 (the "Policy"). Now Sentry has moved for summary judgment under Fed.R.Civ.P. ("Rule") 56. For the reasons stated in this memorandum opinion and order, the motion is granted.
Sentry is a Wisconsin-incorporated and Wisconsin-based insurance company (¶ 2). In 1977 Sentry issued the Policy to First National Bank of Minneapolis, Trustee of the Phi Delta Phi Insurance Trust ("Trust") (Policy Application at 1). Agents of Sentry and Trust signed the Policy Application in Minnesota (id.). Butler (an Illinois citizen and resident) is an insured person under the Policy (¶¶ 1, 5).
Between December 1982 and May 1983 Butler received treatment for alcoholism at Little Hill-Alina Lodge ("Little Hill") (¶ 6; Butler A. ¶ 4). Little Hill is a licensed "alcoholism rehabilitation facility" (Butler A. ¶¶ 2, 3).
After his discharge from Little Hill Butler submitted a loss claim to Sentry. That claim was refused (¶ 6) because treatment at alcoholism rehabilitation facilities is excluded from Policy coverage (Policy at 3):
"Hospital" wherever used in the policy means an establishment which ... is not primarily a clinic, nursing, rest or convalescent home or similar establishment and is not other than incidentally, a place for alcoholics or drug addicts.
Butler does not (and cannot) contend the Policy on its face covers his Little Hill treatment. Instead he seeks to link one policy provision to a network of statutes in a manner requiring Sentry to provide him with such coverage despite the Policy exclusion:
Thus Butler would have it the confluence of the Policy, Subdivision 7 and Section 632.89(2) mandates coverage for his Little Hill treatment. Neither side has turned up any case law supporting or negating that analysis, nor has this Court's independent research disclosed any. Nevertheless a commonsense reading of the statutes shows Butler's Tinker-to-Evers-to-Chance combination fails to make the play.
While no statement of purpose accompanies Subdivision 7, its intent is clear enough. For the protection of its residents and the affirmative advancement of certain social policies, each state imposes various requirements on insurers desiring to sell insurance to the state's residents. One such frequently-dealt-with social policy is the treatment of alcoholism. Thus, for example, Wisconsin has seen fit to require insurers to include alcoholism-treatment coverage when they write health-insurance policies on Wisconsin residents (see Wis. Stat. § 631.01(1)).
Insurers are of course not limited to single-state operations. Not surprisingly, then, states that have made such policy judgments often extend them to foreign insurers that issue policies covering the states' residents as well as to domestic insurers under their direct control. That is what Subdivision 7 does for Minnesota: It says foreign insurers' policy terms cannot be less favorable to Minnesota residents5 than Minn.Stat. §§ 62A.01 to 62A.09 would require of Minnesota insurers.6
That of course is the correct reading of Subdivision 7. It imposes no requirement that a foreign insurer must offer Minnesota residents all terms mandatory under the foreign state's laws. Subdivision 7 is written in conjunctive and permissive ("may," not "shall") terms. It says policies issued by foreign insurers and delivered in Minnesota:
In other words, the statutory structure is that if Wisconsin law required Wisconsin insurers to include a provision less favorable to an insured than the comparable Minnesota provision (say a shorter period for furnishing proof of loss), a Wisconsin insurer could not include that provision when delivering policies to Minnesota persons. Instead the insurer must use the more favorable Minnesota version as a floor.
Butler's argument stands that on its head. He says Minnesota requires Sentry to offer a policy more favorable than Minnesota law would require. After all, nothing in Minn.Stat. §§ 62A.01 to 62A.09 () requires coverage for alcoholism treatment.7
In any case Wisconsin's own law does not require Wisconsin insurers to provide alcoholism coverage to everyone. That coverage is required only when the policy is delivered or issued for delivery in Wisconsin (not true here) or when the insured is a Wisconsin resident (also not true here) — see Wis.Stat. § 631.01(1), which imposes those limits on the applicability of all of Wis.Stat. ch. 632. Thus even if Minnesota law did require Sentry to include all forms of coverage Wisconsin law requires (as it does not), Wisconsin law itself does not require alcoholism treatment coverage in policies not written for Wisconsin residents. Sentry need not provide such coverage to Butler.8
There are no issues of material fact, and Sentry is entitled to a judgment as a matter of law. This action is dismissed.
APPENDIX
Butler has attempted to take an impermissible stance on the present motion. His Requests for Admission include a request that Sentry admit:
3. That said policy of insurance states the policy was issued by the Defendant with headquarters located in Stevens Point, Wisconsin.
Sentry A. ¶ 3 responds:
3. It admits that defendant has its home office at Stevens Point, Wisconsin; to the extent that this admission implies that the policy was issued in Wisconsin, rather than Minnesota, it denies the allegations of paragraph 3.
Sentry has, in short, said Minnesota was the state of issuance.
In that context, Butler Mem. 1 seeks to precede its legal analysis with an attempted hedge:
Plaintiff, without waiving its right to contend that the law other than that of the State of Minnesota may apply and assuming arguendo that Defendant's assertion that the law of Minnesota does apply, states as follows:
But that flouts the entire concept of a summary judgment motion. Summary judgment is a substitute for trial — more accurately, a determination that no trial (in the sense of an evidentiary hearing) is needed because the absence of genuine issues of material fact permits a final disposition on principles of law alone. Anderson, ___ U.S. at ___, 106 S.Ct. at 2511-12.
Just as a party who has gone through a full-blown trial and has lost that trial cannot advance evidence that should have been, but was not, offered at the trial, so a party cannot hold back legal arguments on the opponent's summary judgment motion until (having lost the motion) the party must make a motion to reconsider. American Floral Services, Inc. v. Florists' Transworld Delivery Association, 633 F.Supp. 201, 224-25 (N.D.Ill.1986) and cases there cited. This Court must reject Butler's effort at a mere arguendo assumption, with its implication that Butler can shift gears if Sentry wins its motion (as it now has).
It is therefore irrelevant that the question of where an insurance policy is deemed to have been issued may sometimes be a difficult one. Sentry A. ¶ 3 is of course consistent with the fact that agents of both Sentry and Trust signed the documents in Minnesota, and Butler is at this point bound to the proposition the Policy was "issued" there.
ON MOTION FOR RECONSIDERATION
This Court's July 11, 1986 memorandum opinion and order (the "Opinion")1 granted Sentry's summary-judgment motion, dismissing this action in its entirety.2 Now Butler has moved under Fed.R.Civ.P. ("Rule") 59(e) for reconsideration of that dismissal. For the reasons stated in this memorandum opinion and order, the motion (in the sense it asks a different result) is denied.
Sentry is based in, and incorporated under the laws of, Wisconsin. Sentry issued the Policy to Trust in Minnesota. Butler (an Illinois citizen and resident) is a Policy-covered person. There is no dispute that Butler claims Policy coverage for treatment at an "alcoholism treatment center," nor is there any dispute that the Policy's literal terms exclude coverage for alcoholism-treatment-center care....
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