Summary
concluding that Morgan and Trainor controlled claim seeking an order that the ensured was entitled to future disability benefits, even with the caveat, "as long as the insured met the terms and conditions for coverage under the insurance policy."
Summary of this case from Carpenter v. Paul Revere Life Ins. Co.Opinion
Case No. 01 C 7366
September 20, 2002
REVERSE SIDE OF MINUTE ORDER
Plaintiff Ira Shyman has filed suit against defendant Unum Life Insurance Company of America ("Unum) regarding his entitlement to benefits under a long-term disability insurance policy underwritten by Unum. In count I of his complaint, Shyman seeks a judgment (1) ordering Unum to pay monthly disability payments to Shyman retroactive to May 1999 and (2) declaring that "Shyman is entitled to ongoing payment of benefits after the entry of judgment subject to the policy terms and conditions[.]" Defendant Unum has filed a motion to dismiss count I pursuant to Fed.R.Civ.P. 12(b)(6) solely to the extent that Shyman seeks a declaratory judgment regarding his entitlement to benefits under the disability insurance policy in the future.
Although labeled by defendant as a motion to strike, defendant's motion is a motion to dismiss pursuant to Fed.R.Civ.P. 12(b)(6).
The court finds that the Seventh Circuit's decisions in Morgan v. Aetna Life Insurance Co., 157 F.2d 527 (7th Cir. 1946), and Trainor v. Mutual Life Insurance Co., 131 F.2d 895 (7th Cir. 1942) are controlling. Where, as here, the validity and existence of a disability insurance policy are not disputed, and the issue is whether the insured has satisfied the terms and conditions for coverage under the disability insurance policy, the damages available to the insured if he prevails are the amount of insurance benefits in default at the commencement of the suit. Morgan, 157 F.2d at 530; Trainor, 131 F.2d at 897. Plaintiff Shyman has cited no caselaw supporting his request for a declaratory judgment regarding future benefits, and his efforts to distinguish Morgan and Trainor are to no avail. In both Morgan and Trainor, the district courts granted the exact relief that Shyman seeks here, ordering that the insured was entitled to future disability benefits as long as the insured met the terms and conditions for coverage under the insurance policy. Morgan, 157 F.2d at 529; Trainor, 131 F.2d at 896. In both cases, the Seventh Circuit modified or reversed the district courts' decisions as they related to future benefits. Morgan, 157 F.2d at 530; Trainor, 131 F.2d at 897-98. Whether Shyman will be entitled to disability benefits in the future depends upon certain conditions precedent — i.e., whether he meets the terms and conditions for coverage in the future, And as the Seventh Circuit held in Morgan, such conditional payments cannot be enforced until due. Morgan, 157 F.2d at 530.
Accordingly, defendant Unum Life Insurance Company of America's motion to dismiss count I solely to the extent it seeks a declaratory judgment regarding plaintiff Shyman's entitlement to disability benefits in the future is granted. This dismissal is without prejudice. The court expresses no opinion as to whether Shyman will be entitled to benefits under the disability insurance policy in the future.