Solomon v. Royal Maccabees Life Ins. Co.

• Decision Date: 25 January 2001
• Docket Number: Docket No. 213969.
• Citation: 243 Mich. App. 375,622 N.W.2d 101
• Parties: Neil SOLOMON, M.D., Ph.D., Plaintiff-Appellant, v. ROYAL MACCABEES LIFE INSURANCE COMPANY, Defendant-Appellee.
• Court: Court of Appeal of Michigan — District of US

622 N.W.2d 101

243 Mich. App. 375

Neil SOLOMON, M.D., Ph.D., Plaintiff-Appellant, v. ROYAL MACCABEES LIFE INSURANCE COMPANY, Defendant-Appellee.

Docket No. 213969.

Court of Appeals of Michigan.

Submitted October 18, 2000, at Detroit.

Decided November 28, 2000, at 9:00 a.m.

Released for Publication January 25, 2001.

Sullivan, Ward, Bone, Tyler & Asher, P.C. (by Ronald S. Lederman), Southfield, for the plaintiff.

Denison Maxwell P.L.C. (by Elaine A. Parson), Bloomfield Hills, for the defendant.

Before JANSEN, P.J., and DOCTOROFF and O'CONNELL, JJ.

O'CONNELL, J.

Plaintiff appeals as of right from an order granting defendant's motion for summary disposition, MCR 2.116(C)(10). On appeal, plaintiff argues that summary disposition was improper because he presented sufficient evidence to establish a question of fact that precluded summary disposition. Plaintiff also argues that the trial court erred in failing to address his argument that defendant's experts' opinions lacked sufficient foundation to be considered as substantive evidence. We affirm.

On March 19, 1997, plaintiff filed a complaint against defendant to recover disability insurance benefits pursuant to a disability insurance policy and a policy covering overhead expenses. Plaintiff's disability insurance policy provided benefits in the event that, because of "accident or illness," plaintiff was prevented from performing the "substantial and material duties of his regular occupation." In his complaint, plaintiff alleged that he was a medical doctor who maintained a full-time practice in Baltimore, Maryland, until June 1993, when his severe bipolar affective disorder caused him to become totally and permanently disabled. According to plaintiff, his bipolar disorder caused him to have improper sexual relationships with his female patients. In October 1993, plaintiff voluntarily surrendered his license to practice medicine in Maryland. Plaintiff admitted that defendant paid him disability benefits and overhead expenses from November 22, 1993, to January 22, 1994, but alleged that defendant ceased paying benefits when it incorrectly determined that plaintiff was not totally and permanently disabled. Plaintiff sought to recover the amount of unpaid benefits.

On May 11, 1998, plaintiff filed a motion for partial summary disposition with regard to the issue of defendant's liability. Plaintiff asserted that, throughout his adult life, he had been afflicted with bipolar disorder, otherwise known as manic depression, and that his disorder forced him to voluntarily cease practicing medicine during the summer of 1993 and ultimately to surrender his medical license in October 1993. On that same date, defendant filed its motion for summary disposition, arguing that plaintiff was fully able to practice medicine and that only his voluntary surrender of his medical license prevented him from doing so. Defendant argued that plaintiff did not become depressed until June 1993, when one of his lovers began to blackmail him, a number of his former patients commenced legal proceedings against him, and the Maryland Board of Physician Quality Assurance (board) began to investigate him. Defendant further argued that plaintiff's inability to practice medicine was not the result of his bipolar disorder because plaintiff had practiced successfully for thirty years notwithstanding the disorder. Defendant also contended that, while plaintiff claimed to have been disabled in June 1993, he did not seek psychiatric help or discontinue treating patients until August of that year. Therefore, defendant argued, plaintiff was not disabled in June 1993 because he was able to continue treating patients.

At the hearing on the parties' respective motions for summary disposition, the trial court recognized that the sole issue in this case was which of two possible causes, plaintiff's medical illness or the surrender of his license, prevented him from performing the substantial and material duties of his regular occupation. The trial court determined that plaintiff established the existence of a factual disability, but that his legal disability was the actual cause of his inability to practice medicine. Therefore, the trial court granted defendant's motion for summary disposition and denied plaintiff's motion for partial summary disposition.

Plaintiff argues that trial court erred in granting defendant's motion for summary disposition. According to plaintiff, a factual question existed regarding whether he sustained a factual, versus a legal, disability, and this factual question prevented the trial court from granting defendant's motion for summary disposition. Plaintiff's position is that the uncontradicted evidence established that he had suffered from bipolar disorder since his late teens and that his condition worsened after he suffered a severe head injury in an automobile accident in 1982. After that time, plaintiff began having inappropriate sexual relationships with his patients, and because of his impaired condition, he was unable to control and prevent this inappropriate behavior.

A generally recognized principle of insurance law is that the burden of proof lies with the insured to show that the policy covered the damage suffered. 10 Couch, Insurance, 3d, § 147:29, p. 147-46; Williams v. Detroit Fire & Marine Ins. Co., 280 Mich. 215, 218, 273 N.W. 452 (1937). We review de novo a trial court's grant or denial of a motion for summary disposition. Spiek v. Dep't of Transportation, 456 Mich. 331, 337, 572 N.W.2d 201 (1998). When reviewing a motion for summary disposition granted pursuant to MCR 2.116(C)(10), we consider the affidavits, pleadings, depositions, admissions, and documentary evidence in the light most favorable to the nonmoving party. Morales v. Auto-Owners Ins. Co., 458 Mich. 288, 294, 582 N.W.2d 776 (1998). A motion for summary disposition under MCR 2.116(C)(10) is proper if no genuine issue of material fact exists, thereby entitling the moving party to judgment as a matter of law. Id.

Plaintiff testified during his deposition that he became very depressed in June 1993 and decided to decrease the amount of time that he spent treating patients. The record below contained evidence that plaintiff also stopped paying blackmail money to a woman with whom he had had a sexual relationship for seven or eight years. When plaintiff refused to continue paying, the woman reported to the board that plaintiff had had inappropriate sexual relationships with his patients. Several patients, along with the woman who allegedly blackmailed plaintiff, then filed a lawsuit against him in June or July 1993, and plaintiff became severely depressed and contemplated suicide. He then visited Dr. Neil Pauker, who referred him to Dr. Chester W. Schmidt, Jr.

Dr. Schmidt, a psychiatrist, diagnosed plaintiff with bipolar disorder toward the end of 1993 or the beginning of 1994. He first treated plaintiff on August 24, 1993, and determined, at that time, that plaintiff suffered from depression. Dr. Schmidt then completed a claim form indicating that plaintiff was unable to practice medicine, and plaintiff submitted the form to defendant. The form indicated that plaintiff was partially disabled from June 19, 1993, until August 14, 1993, and that, thereafter, he was totally disabled.

Plaintiff admitted during his deposition that he had had numerous inappropriate sexual relationships with many different women, some of whom were patients, and that the board was investigating him as a result. He testified that he feared that he would again initiate sexual relationships with patients if he were to resume practicing medicine. He further testified that he signed a letter permanently surrendering his medical license only because he was horribly depressed and unable to defend himself and that signing the letter was the only way to prevent the board from releasing the information to the media. The letter read, in pertinent part:

I understand that this letter of surrender shall be considered a PUBLIC document immediately upon its acceptance by the Board of Physician Quality Assurance (the "Board"). I also understand that this surrender of my medical license is and shall be considered IRREVOCABLE.

My decision to surrender my license to practice medicine has been prompted by an investigation of my practice by the Board. The Board initiated this investigation after it received several complaints, and after it became aware of several civil actions filed against me by former patients, all of which alleged that I instigated improper sexual contact with patients during the physician/patient relationship.

I admit that for at least the past 20 years, I have used my position as a physician to instigate a wide range of sexual relations with at least eight women patients. This conduct included acts of sexual intercourse, as well as other explicit sex acts. These activities took place in my medical office during patient visits, as well as in other locations. I admit that I engaged in sexual misconduct with my patients during the physician/patient relationship. I admit that I engaged in this conduct with multiple patients over the same time period. I recognize that these patients developed a sense of trust, confidence and dependence through the physician/patient relationship, and that I misused my influence as a physician and the trust my patients placed in me for my own sexual gratification. I admit that it was improper to engage in any sexual relationship with any patient.

The Board's investigation resulted in charges under the Maryland Medical Practice Act (the "Act").

Dr. Schmidt testified that plaintiff had not had any inappropriate sexual relationships since his treatment began. He determined that plaintiff had suffered bipolar disorder his entire life, along with long periods of hypomania, and that a severe head injury that he suffered in an automobile accident in 1982 may have made him more susceptible to...