Everett v. American General Life Insurance Company

Filing 56

ORDER. IT IS ORDERED: Plaintiff's Motion to Clarify 52 is GRANTED. Defendant's Motion for Reconsideration/Renewed Motion for Summary Judgment 51 is DENIED. Signed by Judge B. Lynn Winmill. (caused to be mailed to non Registered Participants at the addresses listed on the Notice of Electronic Filing (NEF) by (st)

UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF IDAHO
DEANNA EVERETT aka Deanna
Everett Whitley,

Case No. 1:14-cv-00121-BLW
ORDER

Plaintiff,
v.
AMERICAN GENERAL LIFE
INSURANCE COMPANY, formerly
known as American General Assurance
Company, an insurance company
licensed to do business in the State of
Idaho pursuant to Idaho Code, Title 41,
Defendant.

The Court’s staff and counsel had an informal conference regarding the pending
motions. All agreed the parties would fully brief the motion to clarify, and the Court
would address that motion before determining whether additional briefing on the motion
to reconsider was necessary. The motion to clarify is now fully briefed.
This Court originally granted summary judgment in favor of American General
based on two separate grounds: (1) that Everett’s expert, Dr. Seale, was not disclosed as

ORDER - 1

an expert, and therefore could not rebut Defendant’s expert testimony about the
decedent’s cause of death; and (2) Everett did not submit sufficient proof of loss. The
Ninth Circuit reversed and remanded the case on both grounds.
Regarding Dr. Seale, the Ninth Circuit remanded the matter back to this Court,
finding that there is a genuine issue of material fact regarding when Dr. Seale formed his
opinion on the cause of death, and therefore the matter should not have been decided on
summary judgment.
On the proof of loss issue, the Ninth Circuit determined that the record does not
reveal that American General asked for a new proof of loss. The Ninth Circuit stated that
American General requested additional information, Everett submitted some but not all of
the information, and American General then merely asked for more information “to
complete processing the claims.” The Ninth Circuit concluded that Everett gave
American General authorization to do obtain three pieces of information: (1) Whitley’s
medical records; (2) contact information for Whitley’s cardiologist, primary care
physician, and surgeon; and (3) notification that her claim was that Whitley’s death was
caused by a car accident. The Ninth Circuit then concluded that this was sufficient to give
American General “a reasonable opportunity to investigate and determine its liability,”
which is a sufficient proof of loss under Idaho law. Estate of Holland v. Metro. Prop. &
Cas. Ins. Co., 279 P.3d 80, 90 (Idaho 2012).
In its original motion for summary judgment, American General also asked the
Court to grant summary judgment on the grounds that the exclusions in Whitley’s policy

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bar coverage, regardless of whether Dr. Seale’s testimony is admitted. This Court did not
address that issue in detail because it granted summary judgment on the other two
grounds. However, the Ninth Circuit nevertheless determined on appeal that American
General does not explain why the rule stated in Jones v. Mountain States Telephone and
Telegraph Co., 670 P.2d 1305 (Idaho Ct. App. 1983) would not apply to the policy
exclusions. The Ninth Circuit stated that Jones held that “where an insurance policy
requires that an accident be the sole cause of death or injury, a loss is still covered, even
though a pre-existing disease may have contributed to the loss, if the accident is the
dominant cause.” Jones, 670 P.2d at 1312. Id. Thus, the Ninth Circuit declined to affirm
summary judgment on that ground as well.
Under these circumstances, American General’s Motion for
Reconsideration/Renewed Motion for Summary Judgment is without merit. Based upon
the Ninth Circuit’s decision, this case must now proceed to trial. Accordingly, the Court
will grant Everett’s Motion to Clarify, deny American General’s Motion for
Reconsideration/Renewed Motion for Summary Judgment, and set a status conference for
the purpose of setting a trial date.
ORDER
IT IS ORDERED:
1.

Plaintiff’s Motion to Clarify (Dkt. 52) is GRANTED.

2.

Defendant’s Motion for Reconsideration/Renewed Motion for Summary
Judgment (Dkt. 51) is DENIED.

ORDER - 3

3.

The Court will enter a separate notice of hearing setting this case for a trial
setting conference.

DATED: March 28, 2018
_________________________
B. Lynn Winmill
Chief U.S. District Court Judge

ORDER - 4