Groff v. Paul Revere Life Ins. Co., 91-1601-CIV.

CourtUnited States District Courts. 11th Circuit. United States District Courts. 11th Circuit. Southern District of Florida
Citation887 F. Supp. 1515
Decision Date04 August 1993
Docket NumberNo. 91-1601-CIV.,91-1601-CIV.
PartiesJulian H. GROFF, Plaintiff, v. The PAUL REVERE LIFE INSURANCE COMPANY, Defendant.

887 F. Supp. 1515

Julian H. GROFF, Plaintiff,

No. 91-1601-CIV.

United States District Court, S.D. Florida.

August 4, 1993.

887 F. Supp. 1516

Jonathan H. Groff, Miami, FL, for plaintiff.

Mark D. Greenberg, Stinson, Lyons, Gerlin & Bustamante, P.A., Miami, FL, for defendant.


K. MICHAEL MOORE, District Judge.

THIS CAUSE came before the Court upon Defendant's, The Paul Revere Life Insurance Company, ("Revere"), Motion for Summary Judgment pursuant to Rule 56 of the Federal Rules of Civil Procedure. After consideration of the Motion, Plaintiff's response in opposition thereto, the affidavits and records submitted on behalf of both parties, and the pertinent portions of the record, the Court enters the following Memorandum Order.


I. Background

Plaintiff, Dr. Julian Groff, ("Dr. Groff"), brought this action for breach of contract against Revere, seeking benefits under the terms of three disability policies purchased from Revere. See Exhibits "A", "B", and "C" to complaint. Dr. Groff is an ear, nose, and throat surgeon who, at least prior to January, 1991, also had a subspeciality in head and neck cancer surgery. Dr. Groff was one of the few surgeons in the South Florida area who performed major head and neck cancer surgery, and accepted referrals of such cases from numerous local physicians. Dr. Groff's practice was divided by 60% surgery to 40% clinical.

On January 23, 1991, while skiing in Vail, Colorado, Dr. Groff suffered significant injuries to his shoulder and adjoining areas of his body. Specifically, Dr. Groff dislocated his shoulder, fractured a piece of bone, and tore the cartilage in the shoulder joint. A subsequent Magnetic Resonance Imaging ("MRI") examination revealed that a piece of bone remained out of place, resulting in the necessity of additional physical therapy by Dr. Groff.

Dr. Groff returned to his practice within weeks of the injury. Because of his injuries, however, the scope of Dr. Groff's practice allegedly became limited. He became unable to perform "major" neck and head cancer surgeries without assistance, and even procedures which could previously be performed in his office had to be performed at a hospital facility. Dr. Groff hired an associate surgeon in 1991 who assists him in performing the more complex and physically demanding procedures.1

Based upon his alleged inability to perform the tasks of his occupation, Dr. Groff seeks to enforce the provisions of the "Total Disability" clause of each policy. The clause at issue in this action, which is identical in each policy, defines "Total Disability" to mean "that, as a result of such injury or sickness, the insured is unable to perform the duties of his regular occupation;.... See "Total Disability" Clause of Policies attached to Complaint as Exhibits "A", "B" and "C". Revere filed the instant Motion, seeking entry of summary judgment and judicial determination that Dr. Groff is not totally disabled within the meaning of that clause of the policies.

II. Standard of Review on Summary Judgment

The standard to be applied in reviewing a summary judgment motion is stated unambiguously in Rule 56(c) of the Federal Rules of Civil Procedure:

The judgment sought shall be rendered forthwith 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.

It may be entered only where there is no genuine issue of material fact. Moreover, the moving party has the burden of meeting

887 F. Supp. 1517
this exacting standard. Adickes v. S.H. Kress & Co., 398 U.S. 144, 157, 90 S.Ct. 1598, 1608, 26 L.Ed.2d 142 (1970)

In applying this standard, the Eleventh Circuit has explained:

In assessing whether the movant has met this burden, the courts should view the evidence and all factual inferences therefrom in the light most favorable to the party opposing the motion. Adickes v. S.H. Kress & Co., 398 U.S. 144 at 157, 90 S.Ct. 1598 at 1608 26 L.Ed.2d 142; (1970) Environmental Defense Fund v. Marsh, 651 F.2d 983 at 991 1981. All reasonable doubts about the facts should be resolved in favor of the non-movant. Casey Enterprises v. Am. Hardware Mutual Ins. Co., 655 F.2d 598, 602 (5th Cir.1981). If the record presents factual issues, the court must not decide them; it must deny the motion and proceed to trial. Marsh, 651 F.2d at 991; Lighting Fixture & Elec. Supply Co. v. Continental Ins. Co., 420 F.2d 1211, 1213 (5th Cir.1969). Summary judgment may be inappropriate even where the parties agree on the basic facts, but disagree about the inferences that should be drawn from these facts. Lighting Fixture & Elec. Supply Co., 420 F.2d at 1213. If reasonable minds might differ on the inferences arising from undisputed facts, then the court should deny summary judgment. Impossible Electronic Techniques Inc. v. Wackenhut Protective Systems, Inc., 669 F.2d 1026 at 1031 (5th Cir.1982) ; Croley v. Matson

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