Reynolds v. Great-W. Life & Annuity Ins. Co.
| Decision Date | 05 February 2020 |
| Docket Number | Case No. 8:19-cv-604-T-24JSS |
| Citation | 437 F.Supp.3d 1134 |
| Parties | Ryan REYNOLDS, Plaintiff, v. GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY, Defendant. |
| Court | U.S. District Court — Middle District of Florida |
Gerasimos (Jerry) Theophilopoulos, Theophilopoulos Law, P.A., Tarpon Springs, FL, James J. Dowling, Berger & Dowling, Insurance Lawyers, Palm Harbor, FL, for Plaintiff.
William Jeremiah Tolton, III, Kilmer, Voorhees & Laurick, P.C., Portland, OR, for Defendant.
SUSAN C. BUCKLEW, United States District Judge THIS CAUSE comes before the Court on Defendant Great-West Life & Annuity Insurance Company's Motion for Summary Judgment with supporting exhibits (Doc. 30) and supporting Declaration (Doc. 31). Plaintiff Ryan Reynolds filed a Response in Opposition with exhibits (Doc. 34). The Court, having carefully considered the parties' submissions, finds that Defendant's Motion is due to be granted for the reasons that follow.
Plaintiff, Ryan Reynolds, a former beneficiary under a group term life insurance plan ("the Plan") sponsored by the American Dental Association ("ADA") and insured by Defendant, Great-West Life & Annuity Insurance Company, brings this one-count action for declaratory relief to restore terminated coverage and to recover insurance proceeds.1 Plaintiff's father, Dr. Steve Reynolds ("Dr. Reynolds"), a former dentist, originally obtained life insurance under the Plan in 1986. (Goodreau Decl., ¶¶ 2, 8).2 Dr. Reynolds opted to make his premium payments for the Plan semi-annually, making them due every January 1 and July 1. (Goodreau Decl., ¶ 11). Until 2006, Dr. Reynolds had in place an optional waiver of premium benefit, which would allow premiums due for the Plan to be waived if he became totally disabled and unable to work in any occupation based on his education and experience. (Goodreau Decl., ¶¶ 9, 12). Dr. Reynolds' coverage under the Plan terminated on August 1, 2018, due to non-payment of the semi-annual premium due July 1, 2018. (Goodreau Decl., ¶ 20). Until that time, his coverage included a basic life benefit of $1,000,000 and an accidental death benefit of $1,000,000. (Doc. 30, Ex. 5). Dr. Reynolds died on October 18, 2018. (Doc. 30, Ex. 11).
Regarding premiums, the Plan's insurance certificate states, in relevant part:
(Doc. 30, Ex. 5, p. 6). Under the heading "TERMINATION," the certificate states, in relevant part:
The insurance of an insured Member will end on the earliest of the following:
(Id. at 13).
The relevant facts concerning the non-payment of premium and termination of the certificate begin with the Premium Notice generated by Defendant's computerized administration system in June 2018 for the semi-annual premium due July 1. (Doc. 30, Ex. 1). The notice sent to Dr. Reynolds was one of many created at that time in separate, carefully monitored batches generated, printed and mailed within a few business days. (Doc. 30, Ex. 1; Goodreau Decl., ¶ 16). All automatically generated notices are printed, folded, and stuffed into pre-metered, window envelopes by a printing mechanism that is part of this integrated administration and document management system. (Goodreau Decl., ¶ 16). The batch of exactly 500 Premium Notices that Dr. Reynolds' notice was among commenced production on June 1, 2018, and mailed on June 11, 2018. (Id. ). His notice was addressed to his address of record in place since February 5, 2007, when he submitted his most recent change: 10365 Gifford Dr., Spring Hill, FL, 34608. (Id. ). The notice set forth the separately itemized basic member life and accidental death benefit premiums, showed the subtractions for a premium credit and a high volume discount, indicated that the net premium due for the second half of 2018 was $2,013.02, and identified the July 1, 2018 due date. (Id. ). This notice was printed and mailed consistent with Defendant's usual business practices for automated mailings and a copy automatically placed and maintained as a record within Dr. Reynolds' account records. (Id. ). The original was not returned by the United States Postal Service ("USPS") as undeliverable. (Id. ).
Since January 2011, it has been Defendant's usual business practice to have its computerized account administration system automatically capture the accounts of any insureds that do not reflect a credited premium payment a few business days after the semi-annual due date has expired and those accounts are automatically programmed to receive follow-up reminder notices. (Goodreau Decl., ¶ 17). Reminder notices encourage insureds to maintain their insurance and reduce the chance of unintended terminations. (Id. ). Reminder notices for the July 1, 2018 premium payment were mailed July 17, 2018. (Id. ). Dr. Reynolds' account was in this unpaid status, and a reminder notice was printed and mailed to him at the same address to which the earlier premium notice was mailed. (Doc. 30, Ex. 1; Goodreau Decl., ¶ 17). The Reminder Notice repeated the premium amount owed and the expired due date, and informed him that the insurance was in a grace period expiring on July 31, 2018. (Id. ). Like the Premium Notice, this one also mentioned online and toll-free telephone payment options. (Id. ). This Reminder Notice was generated, printed and mailed consistent with Defendant's usual business practices for automated mailings and a copy was automatically placed and maintained as a record within Dr. Reynolds' account records. (Goodreau Decl., ¶ 17).
In late July 2018, the USPS returned the Reminder Notice to Defendant. (Doc. 30, Ex. 3; Goodreau Decl., ¶ 18). A stamp on the envelope stated that it was being "returned to sender" because the time for forwarding the recipient's mail had expired. (Id. ) It also contained the address that Dr. Reynolds' mail was being forwarded to: 12241 Lexington Park Dr. Apt 307, Tampa, FL 33626-2725. (Id. ). An employee of Defendant opened the envelope, copied onto the reminder notice the information stamped on the envelope by the USPS, and enclosed the copy with a manually created cover letter dated July 31, 2018, addressed to Dr. Reynolds at this new address. (Id. ) Dr. Reynolds' address of record was also updated. (Goodreau Decl., ¶ 18). This cover letter indicated that the enclosed notice had been returned by the USPS and was designed as a form for Dr. Reynolds to sign and return to formally update his address of record. (Id. ). This letter and the enclosed reminder notice were mailed on July 31, 2018, and copies of each were retained together by Defendant as a record, placed and maintained within Dr. Reynolds' account records, consistent with Defendant's usual business practices for generating and maintaining manual mailings. (Id. ).The original letter that was manually sent to the updated address was not returned by the USPS. (Goodreau Decl., ¶ 18).
After the contractual grace period has expired without a premium payment, Defendant's computerized account administration system again captures the accounts of insureds that do not reflect a credited premium payment and those accounts are automatically programmed to receive a final notice titled "Lapse Notice." (Goodreau Decl., ¶ 19). This additional notification process has been Defendant's customary business practice since January 2011. (Goodreau Decl., ¶¶ 17, 19). The Lapse Notice is a final attempt by Defendant to encourage recipients to resurrect terminated insurance. (Doc. 30, Ex. 4; Goodreau Decl., ¶ 19). For the July 1, 2018 semi-annual premium due date, these notices were generated and mailed on August 9, 2018. (Id. ). Defendant generated a Lapse Notice for Dr. Reynolds at the new address to which the July 31 letter had been mailed a week earlier. (Id. ). It contained the same items of information and looked similar to the original Premium Notice. (Id. ). However, unlike prior notices, this one stated that the insurance was terminated. (Id. ). As a condition of this offer, it could only be exercised if the insured is alive at the time their payment is received, which cannot be after August 31. (Id. ). The Lapse Notice stated, in pertinent part:
This Lapse Notice was generated, printed, and mailed...
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