Provident Life v. Goel
| Decision Date | 04 December 2001 |
| Docket Number | No. 99-60443,99-60443 |
| Citation | 274 F.3d 984 |
| Parties | (5th Cir. 2001) PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY, Plaintiff-Counter Defendant-Appellee, v. DINESH K. GOEL, Defendant-Counter Claimant-Appellant |
| Court | U.S. Court of Appeals — Fifth Circuit |
[Copyrighted Material Omitted]
[Copyrighted Material Omitted] Appeals from the United States District Court for the Southern District of Mississippi
Before HIGGINBOTHAM, WIENER, and DENNIS, Circuit Judges.
After suffering an injury to his hand that prevented him from performing surgery, Dr. Dinesh K. Goel sought disability benefits under a policy issued by Provident Life and Accident Insurance Company ("Provident"). Although it paid on the claim, Provident reserved its rights and ultimately brought this declaratory judgment action to rescind the policy, contending that Dr. Goel did not satisfy a condition precedent to coverage by failing to cancel a disability policy he held with another insurer. The district court granted summary judgment to Provident and denied Dr. Goel's subsequent motion for relief from judgment. Our consideration of the record, the briefs, and the arguments presented by both parties convinces us that summary judgment was appropriate. We further find that the district court did not abuse its discretion in denying Dr. Goel's Rule 60(b) motion for relief from judgment. Accordingly, we affirm.
This action concerns the validity of a disability insurance policy issued by Provident to Dr. Dinesh K. Goel. The circumstances surrounding the issuance of the policy date back to 1992. At that time, Dr. Goel practiced as a surgical specialist in Jackson, Mississippi, where he continues to reside. Although Dr. Goel maintained $11,000 a month in disability coverage with The Paul Revere Life Insurance Company, his financial obligations and rapidly rising income caused him to seek additional coverage. To that end, Dr. Goel contacted Anil Sharma, a personal friend and Provident agent, to discuss increasing his coverage to approximately $25,000 a month. Through Mr. Sharma, Dr. Goel submitted three applications for disability coverage with Provident.
On his first application, dated November 11, 1992, Dr. Goel stated that he did not have disability coverage. Provident later issued a policy that provided the $15,000 monthly benefit requested in the application. But after realizing that he did not disclose his Paul Revere coverage on the Provident application, Dr. Goel allowed this policy to lapse through non-payment of the first premium.
On June 21, 1993, Dr. Goel submitted his second application to Provident. In a letter dated September 27, 1993, a Provident Field Underwriter informed Mr. Sharma that "[i]n order for Mr. Goel to qualify for the $25,000 of benefit you requested, his income level would need to be upwards of $1,000,000.00 annually, to be considered as an exception to the Maximum Issue Rule."1 Based on his $400,000 income in 1992, Provident advised Dr. Goel that it would issue him $15,000 a month in coverage if he agreed to cancel his Paul Revere policy.2 Because Dr. Goel was unwilling to cancel his Paul Revere coverage, he allowed the second application to expire.
In 1993, Dr. Goel's income increased to over $719,000. This significant increase brought about Dr. Goel's third and final application to Provident on February 28, 1994. On his application, Dr. Goel disclosed his $11,000 policy with Paul Revere but answered "N/A" to the following question:
4.(f) If any coverage is to be replaced by the coverage applied for, the following coverage(s) will be permanently cancelled within 30 days of the issue date or effective date, whichever is later, of the insurance coverage issued pursuant to this application.
Co. Name___________________ Amount $________________
In a "Personal History Interview" conducted in connection with his application, Dr. Goel again disclosed his Paul Revere policy and further indicated that he would not terminate his existing coverage. But Provident also maintained its position concerning the Paul Revere coverage: it would provide $15,000 a month in coverage only if Dr. Goel agreed to cancel his Paul Revere policy. Provident therefore prepared an Amendment to Dr. Goel's application that changed his answer to Question 4(f) from "N/A" to "Paul Revere."
On June 28, 1994, Provident approved and printed, along with the Amendment, a disability policy for Dr. Goel that provided a monthly benefit of $15,000. Instructions accompanying the Amendment and the policy directed the agent to obtain Dr. Goel's signature on the Amendment before releasing the policy to him.3 The Amendment, relating to cancellation of the Paul Revere coverage, stated:
In consideration of the issuance of the policy to which this amendment is attached, it is understood and agreed that my signed application dated February 28, 1994 is amended as follows:
THE ANSWER TO QUESTION 4F IS CHANGED TO READ: "PAUL REVERE"
Neither Dr. Goel nor the agent, Mr. Sharma, recalls the Amendment or when it was signed.4 But Provident did receive the signed Amendment, and a copy remains in its underwriting file.5 Moreover, Dr. Goel retained the policy as issued and paid the monthly premiums.
On October 26, 1996, Dr. Goel suffered a disabling injury to his hand that prevented him from performing surgery. He later sought benefits under the Provident policy. During its investigation of his claim, Provident discovered that Dr. Goel had not cancelled his Paul Revere coverage. Provident therefore elected to pay benefits under a reservation of rights.
On April 16, 1997, Provident filed a Complaint for Declaratory Judgment and Other Relief seeking to rescind and cancel the disability policy and recover all benefits paid to Dr. Goel. In its Complaint, Provident alleged that it issued the policy to Dr. Goel "on the condition or promise of Goel that he would cancel his Paul Revere coverage." According to Provident, Dr. Goel's failure to cancel the Paul Revere policy rendered the Provident policy "voidable." Dr. Goel answered the Complaint and filed a Counterclaim demanding damages from Provident for bad faith breach of contract. Dr. Goel also invoked the incontestability provision of the Provident policy6 and raised affirmative defenses of waiver, estoppel, and fraud. Provident denied Dr. Goel's allegations in its Answer to the Counterclaim.
On February 20, 1998, Dr. Goel filed a Motion for Partial Summary Judgment on his contract claim; Provident responded three days later with a Motion for Summary Judgment on its complaint. On September 28, 1998, after hearing oral argument on the parties' motions, the district court granted Provident's motion and denied Dr. Goel's motion. In reaching its decision, the court relied on the Amendment to Question 4(f) of Dr. Goel's application and found that Dr. Goel breached a condition precedent to coverage by failing to cancel his Paul Revere policy. The district court reasoned that the policy--presented along with the Amendment to the application--constituted a counter-offer by Provident that Dr. Goel accepted by signing the Amendment, retaining the policy, and paying the required premiums.
Following the entry of judgment, Provident filed a Motion to Amend Final Judgement asking the district court to "specify the amount of the Plaintiff's recovery and the amount of interest it is entitled to receive until the judgment is paid." Dr. Goel later filed a Rule 60(b)7 Motion for Relief from Judgment, in which he claimed to have "new evidence indicating that [he] never signed the application amendment, but that his signature was forged." This "new evidence" consisted of a report prepared by Mr. Frank Hicks, a handwriting expert who concluded that Dr. Goel's signature on the Amendment was probably forged. On May 24, 1999, the court entered an Amended Final Judgment ordering Dr. Goel to pay Provident $274,413.38, plus post-judgment interest on this amount from September 28, 1998, until paid, less an offset of $36,401.40 for premiums paid. Dr. Goel filed a Notice of Appeal on June 22, 1999.
Although he had filed a Notice of Appeal from the Amended Final Judgment, Dr. Goel's Rule 60(b) motion was still pending in the district court. In August 1999, the district court "terminated" the motion, reasoning that Dr. Goel's appeal rendered the motion moot. Dr. Goel submitted a motion for reconsideration of that ruling, contending that a Rule 60(b) motion should be addressed on the merits rather than terminated as moot. The district court agreed with this contention. Therefore, on March 29, 2000, after full review and consideration of the motion, the district court denied it on the merits. In addition to his appeal from the Amended Final Judgment of June 22, 1999, Dr. Goel also appeals from the denial of his Rule 60(b) motion.
"We review a district court's award of summary judgment under the same standards that the district court applied to determine whether summary judgment was appropriate."8 "Summary judgment is appropriate if the record discloses '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.'"9 In making such a determination, the district court must look to "the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any. . . ."10 It therefore follows that "our review is confined to an examination of materials before the [district] court at the time the ruling was made; subsequent materials are irrelevant."11
The party moving for summary judgment must establish that there are no genuine issues of material fact. "Once the moving party makes that showing, however, the burden shifts to the nonmoving party to show that summary judgment is not appropriate."12 Thus, to defeat a motion for summary judgment, the nonmoving party...
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