United States District Court, M.D. Florida, Fort Myers Division
OPINION AND ORDER 
POLSTER CHAPPELL UNITED STATES DISTRICT JUDGE
matter comes before the Court on Defendant's Motion to
Dismiss Amended Complaint (Doc. 19) filed on July 15, 2019.
Plaintiff filed a Response in Opposition (Doc. 27) on August
12, 2019. For the reasons set forth below, the Motion is
case involves a single claim for breach of contract in which
Plaintiff Christine P. Madden, a retired chiropractor, alleges
that her disability insurance company, National Life
Insurance Company (National Life), improperly denied her
total disability benefits due under a disability insurance
policy. The Court recounts the factual background as pled in
Plaintiff's Amended Complaint, which it must take as true
to decide whether the Amended Complaint states a plausible
claim. See Chandler v. Sec'y Fla. Dep't
of Transp., 695 F.3d 1194, 1198-99 (11th Cir. 2012).
while living in Georgia, purchased an individual disability
income insurance policy from National Life, Policy No.
D2163414, effective January 14, 1991 (the Policy). (Doc. 8 at
¶ 8; Doc. 8-1). The Policy provides a monthly benefit if
Madden becomes totally disabled from her occupation. (Doc. 8
at ¶ 9).
to her disability, Madden was a dermatologist operating her
practice near Atlanta, Georgia. (Doc. 8 at ¶ 13). She
suffers from cervical disc disease and torticollis, which
causes her head to tilt and turn to the left, as well as
muscle spasms and pain in her neck. (Doc. 8 at ¶ 14).
Madden had surgery for her condition in 2013 and as of March
19, 2013, she was unable to return to her dermatology
practice. (Doc. 8 at ¶ 17). It is on this date that
Plaintiff alleges she became totally disabled under the terms
of the Policy.
reported her disability to National Life on April 15, 2013,
when she spoke to a National Life representative. As a result
of that conversation, Madden understood that she would not be
eligible for benefits under the Policy. (Doc. 8 at ¶
19). That same day, National Life sent Plaintiff a letter
enclosing forms to be completed for her disability claim.
(Doc. 8 at ¶ 20). Madden did not receive the claim
forms, nor would she have completed them, since she had been
advised by National Life that her claim would not be viable.
(Doc. 8 at ¶ 21).
about June 26, 2013, Madden wrote to National Life requesting
cancellation of the Policy, as she did not want to continue
paying premiums for ineffective coverage. The Policy states
that the termination became effective on July 14, 2013. (Doc.
8-1). Madden had no reason to abandon her claim at that time
if she believed it was viable, since she was still disabled
and expected that her condition was permanent. (Doc. 8 at
early 2015, Madden contacted National Life to request a copy
of her Policy so she could determine whether to renew her
disability claim, but National Life did not provide it. (Doc.
8 at ¶ 23). In November 2015, after several exchanges,
National Life agreed to reopen Madden's claim but still
failed to produce a copy of the Policy. (Doc. 8 at ¶
24). On or about February 29, 2016, National Life produced a
copy of the Policy to Madden's counsel. (Doc. 8 at ¶
resubmitted her claim to National Union on or about February
7, 2017 which National Union denied on or about July 24,
2017. (Doc. 8 at ¶¶ 26-27). Madden submitted an
appeal to National Life on October 30, 2018 after gathering
and preparing information to respond to the concerns raised
in National Life's denial letter. (Doc. 8 at ¶ 28).
National Life has upheld its decision. (Doc. 8 at
Life moves to dismiss for failure to state a claim, arguing
that because Plaintiff breached the contract herself, she
cannot recover, and that Plaintiff's claims are
considering a motion to dismiss under Federal Rule of Civil
Procedure 12(b)(6), the court must accept all factual
allegations as true and view them in a light most favorable
to the plaintiff. See Ashcroft v. Iqbal, 556 U.S.
662, 678 (2009). This consideration is limited “to the
pleadings and exhibits attached thereto[.]”
Grossman v. Nationsbank, N.A., 225 F.3d 1228, 1231
(11th Cir. 2000). However, a complaint listing mere
“labels and conclusions, and a formulaic recitation of
the elements of a cause of action will not do.”
Bell Atl. Corp. v. Twombly, 550 U.S. 554, 555
(2008). Likewise, “[f]actual allegations that are
merely consistent with a defendant's liability” are
insufficient. Chaparro v. Carnival Corp, 693 F.3d
1333, 1337 (11th Cir. 2012) (internal citations omitted). And
the allegations must not force the court to speculate or
operate on mere suspicion. Twombly, 550 U.S. at 555.
In contrast, the Court will not dismiss a complaint where the
Plaintiff pleads facts that make the claim facially
plausible. SeeTwombly, 550 U.S. at 570. A
claim is facially plausible when the court can draw a
reasonable inference, based on the facts pleaded, that the
opposing party is liable for the alleged misconduct. See
Iqbal, 556 U.S. at 678. This plausibility standard