Chu, DDS v. The Paul Revere Life Insurance Company
OPINION AND ORDER GRANTING PLAINTIFF'S MOTION TO DETERMINE DAMAGES [DOC. 37]. Signed by District Judge Avern Cohn. (MVer)
UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF MICHIGAN
JACQUELYN K CHU, DDS,
Case No. 15-14357
THE PAUL REVERE
LIFE INSURANCE COMPANY,
HON. AVERN COHN
OPINION AND ORDER GRANTING PLAINTIFF’S TO MOTION TO DETERMINE
DAMAGES (Doc. 37)
This is a disability insurance case. Plaintiff Chu (Chu) is a dentist who could no
longer work after developing carpal tunnel syndrome. At the time she stopped working,
Chu was insured under a disability policy from Defendant Paul Revere Life Insurance
Company (Paul Revere). Chu sued Paul Revere because it withheld disability benefits
on the grounds that by refusing to undergo surgery, Chu was refusing to receive
“appropriate” care to treat her condition. On February 7, 2017, the Court granted Chu’s
motion for summary judgment (Doc. 11) and denied Paul Revere’s motion for summary
judgment (Doc. 13), holding that “appropriate” care did not mandate surgery. In their
respective motions for summary judgment, the parties did not address damages.
Paul Revere filed a motion for reconsideration (Doc. 26), which was denied. Chu
then filed a motion to enforce judgment (Doc. 32), which was denied without prejudice
because the Court determined that its disposition on the summary judgment motions
was not final absent an award of damages. At the same time, the Court reopened the
case to entertain a motion to determine damages.
Now before the Court is Chu’s motion to determine damages (Doc. 37), to which
Paul Revere has responded (Doc. 38) and Chu has replied (Doc. 39). Two oral
arguments were held, and the parties have filed supplemental briefs (Docs. 46, 47, 48)
to support their claims.
In its motion for summary judgment, Paul Revere raised and briefed the issue of
whether Chu should be entitled to benefits after December 2014, which is when she
stopped receiving any kind of medical treatment for her condition. However, the Court in
its disposition of the motion for summary judgment made no determination regarding the
medical treatment issue, but only determined whether Chu was required to undergo
surgery. The medical treatment issue was also not addressed by the Court or the
parties at the summary judgment oral argument, or in the motion for reconsideration.
Now, Chu says Paul Revere should not be allowed to raise a substantive issue again in
order to determine the correct amount of damages owed. Paul Revere says because
the Court made no specific determination about the doctor’s care issue, Paul Revere
should be allowed to raise it again.
Relevant language from the disability insurance policy reads as follows:
1.10 “Total Disability” means that because of Injury or Sickness:
a. You are unable to perform the important duties of Your Occupation; and
b. You are receiving Physician’s Care. We will waive this requirement if
We receive written proof acceptable to Us that further Physician’s Care
would be of no benefit to You.
“Physician’s Care” means the regular and personal care of a Physician
which, under prevailing medical standards, is appropriate for the condition
causing the disability.
Paul Revere has already admitted in its correspondence with Chu that it believes
medical treatment short of surgery would be of no benefit to her:
“It is the opinion of our physician that hand therapy would not be expected to
resolve the trigger finger condition.” (Oct. 31, 2014 letter, Doc. 11, Ex. 9)
“You treated with a hand specialist who decreased your pain with a steroid
injection. However, you indicated you continued to have locking and clicking
of the left middle finger.” (Dec. 31, 2014 letter, Doc. 11, Ex. 11)
“Therapy would not harm your trigger finger conditions; however, it would not
resolve it. Resolution would only occur from surgical intervention.” (Id.)
“You have tried all alternative measures for your condition; i.e., medication,
steroid injections and most recently, physical therapy. To no avail, your
conditions have not improved.” (Id.)
(emphasis added). Therefore, because the Court has already determined that Chu is
not required to undergo surgery, she is entitled to disability benefits starting from March
24, 2014, the date of Paul Revere’s last benefit payment.
Because Paul Revere has not disputed Chu’s damages calculation method,
including the prejudgment interest rate and cost of living adjustment, Chu shall lodge
with the Court an updated calculation of damages through March 2018. At that time, the
Court will enter an order specifying the amount of damages owed.
UNITED STATES DISTRICT JUDGE
Dated: March 6, 2018
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?