Jeffrey L Wissot v. Great-West Life and Annuity Insurance Company et al

Filing 34

Statement of Uncontroverted Facts and Conclusions of Law Re: Defendant's Motion for Summary Judgment 18 signed by Judge Ronald S.W. Lew. After consideration of the papers and arguments in support of and in opposition to Defendant Great-West Life and Annuity Insurance Company's ("Defendant") Motion for Summary Judgment Regarding Choice of Law Issue 18 , the Court makes the following findings of fact and conclusions of law. SEE DOCUMENT FOR FULL AND COMPLETE DETAILS. (jre)

Download PDF
1 2 3 4 5 6 7 8 UNITED STATES DISTRICT COURT 9 CENTRAL DISTRICT OF CALIFORNIA 10 11 Jeffrey L. Wissot, DDS, 12 13 14 15 16 17 18 ) ) Plaintiff, ) ) v. ) ) ) Great-West Life and Annuity ) Insurance Co. and American ) Dental Association, ) ) Defendants. ) ) CV 11-10040 RSWL (JCGx) Statement of Uncontroverted Facts and Conclusions of Law Re: Defendant’s Motion for Summary Judgment [18] After consideration of the papers and arguments in 19 support of and in opposition to Defendant Great-West 20 Life and Annuity Insurance Company’s (“Defendant”) 21 Motion for Summary Judgment Regarding Choice of Law 22 Issue [18], the Court makes the following findings of 23 fact and conclusions of law. 24 25 UNCONTROVERTED FACTS 1. The American Dental Association (“ADA”) sponsors 26 group insurance plans for the benefit of its members. 27 Goodreau Decl. ¶ 1. 28 2. In 1992, the ADA contracted with Defendant to 1 1 administer and insure a group disability income 2 protection plan in order to insure qualifying ADA 3 members. 4 Id. at ¶¶ 5-6. 3. In relevant part, the 1992 version of the group 5 policy stated that the policy was “subject to the laws 6 of the State of Illinois” (Id. at Ex. 2, p. 28) and, 7 under the heading “Conformity With Statutes,” that it 8 was “amended to comply at all times with the minimum 9 requirements of the State of Illinois which apply to 10 Group Long Term Disability Insurance” (Id. at Ex. 2, p. 11 51). 12 3. An essentially identical version of the 13 “Conformity With Statutes” provision was included in 14 corresponding individual certificates issued to insured 15 members. 16 Id. at Ex. 3, p. 69. 4. On July 27, 1996, Plaintiff, a member of the 17 ADA, became insured with Defendant under the group 18 policy. 19 Wissot Decl. ¶ 1. 5. The ADA and Defendant subsequently changed some 20 of the features of the group policy, effective May 1, 21 1997. Goodreau Decl. ¶ 7. A replacement policy 22 document and replacement individual certificates were 23 issued to all covered members. Id. at ¶¶ 7-8, Exhs. 4, 24 5. 25 6. In relevant part, the 1997 version of the group 26 policy stated that the group policy was “subject to the 27 laws of the State of Illinois.” Id. at Ex. 4, p. 89. 28 Furthermore, the 1997 version of the policy provided 2 1 that “[t]his [group] policy and any dispute between a 2 Member and the Company arising in connection therewith 3 are subject to and governed by and shall be construed 4 in accordance with Illinois law.” Id. at Ex. 4, p. 116 5 (emphasis in original). 6 7. An essentially identical version of the latter 7 provision was included under the heading “Conformity 8 With Statutes” in the individual replacement 9 certificates issued to covered members, including 10 Plaintiff. 11 Id. at ¶ 7, Ex. 5, p. 140. 8. In 2003, Plaintiff filed a claim with Defendant 12 for total disability benefits, which was approved. 13 However, in August 2012, upon Plaintiff reaching age 14 sixty-five, Defendant ceased paying him certain 15 benefits. Id. at ¶ 2. 16 CONCLUSIONS OF LAW 17 1. In adjudicating state law claims, a federal 18 court applies the choice of law principles of the state 19 in which it sits. Abat v. Chase Bank USA, N.A., 738 F. 20 Supp. 2d 1093, 1095 (C.D. Cal. 2010). 21 2. California law provides that in determining 22 whether a choice-of-law provision is enforceable, the 23 Court must apply Restatement (Second) of Conflict of 24 Laws (“Restatement”) § 187(2). Nedlloyd Lines B.V. v. 25 Superior Court, 3 Cal. 4th 459 (1992). 26 3. Pursuant to Restatement § 187(2), the Court’s 27 first step is to determine whether the chosen state, in 28 this case Illinois, has a substantial relationship to 3 1 the Parties or to their transaction, or whether there 2 is any other reasonable basis for applying the law of 3 the chosen state. Nedlloyd, 3 Cal. 4th at 466. If 4 this initial test is satisfied, California law dictates 5 that the Illinois choice-of-law provisions be enforced, 6 unless Plaintiff establishes that Illinois law is 7 contrary to a fundamental public policy of California 8 and California has a materially greater interest in the 9 determination of the particular issues at hand. Wash. 10 Mut. Bank, FA v. Superior Court, 24 Cal. 4th 906, 917 11 (2001). 12 4. The initial test is satisfied in this case, as 13 reflected by Defendant’s assertion that Illinois has a 14 substantial relationship with the Parties (Def.’s Mot. 15 7:13-22) and Plaintiff’s acknowledgment that, for 16 purposes of the Nedlloyd test, Illinois has a 17 “sufficient” relationship to the Parties’ transactions 18 (Pl.’s Opp’n 8:22-24). 19 5. Accordingly, the Illinois choice-of-law 20 provisions are enforceable, for even if their 21 enforcement contravenes a fundamental public policy of 22 California, Plaintiff has not shown that California has 23 a “materially greater interest” than Illinois in having 24 its law applied in this Action. See Abat, 738 F. Supp. 25 2d at 1096. 26 6. With regard to whether Plaintiff’s claims are 27 covered by the Illinois choice-of-law provisions, the 28 California Supreme Court has noted that “the scope of a 4 1 choice-of-law clause in a contract is a matter that 2 ordinarily should be determined under the law 3 designated therein.” 4 n.3. Wash. Mutual, 24 Cal. 4th at 916 See also Nedlloyd, 3 Cal. 4th at 469 n.7. Thus, 5 the Court looks to Illinois law in determining whether 6 Plaintiff’s claims are subject to the Illinois choice7 of-law provisions. 8 7. Claims two through seven are subject to the 9 Illinois choice-of-law provisions because they each 10 “depend upon” the group policy contract in various 11 ways, including the fact that they could not exist were 12 it not for the existence of the group policy contract. 13 See Amakua Dev. LLC v. Warner, 411 F. Supp. 2d 941, 955 14 (N.D. Ill. 2006). 15 8. Given Plaintiff’s concession that if his claims 16 are subject to the Illinois choice-of-law provisions, 17 claims three and four should be dismissed pursuant to 18 215 Illinois Compiled Statute 5/155 (Pl.’s Opp’n 21:519 7, 22:13-14), Plaintiff’s third and fourth claims are 20 accordingly dismissed. 21 9. Based on the foregoing, Defendant is entitled to 22 summary judgment on the issues of (1) whether the 23 Illinois choice-of-law provisions are enforceable, (2) 24 whether the Illinois choice-of-law provisions cover 25 /// 26 /// 27 /// 28 /// 5 1 Plaintiff’s claims two through seven, and (3) dismissal 2 of claims three and four. 3 4 IT IS SO ORDERED. 5 DATED: December 12 , 2012. 6 7 8 RONALD S.W. LEW HONORABLE RONALD S.W. LEW Senior, U.S. District Court Judge 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 6

Disclaimer: Justia Dockets & Filings provides public litigation records from the federal appellate and district courts. These filings and docket sheets should not be considered findings of fact or liability, nor do they necessarily reflect the view of Justia.


Why Is My Information Online?