United States District Court, M.D. Florida, Orlando Division
ANTOON II UNITED STATES DISTRICT JUDGE.
dispute over interpretation of a disability insurance policy,
Lloyd Wickboldt moves for summary judgment on his claims for
a declaratory judgment and for damages for breach of contract
against Massachusetts Mutual Life Insurance Company
(MassMutual). (Mot. Summ. J., Doc. 34). And although Mass.
Mutual did not file a motion of its own, the parties agree
that there are no disputed material facts and that denial of
Dr. Wickboldt's motion "should result in the entry
of judgment in favor of MassMutual." (Doc. 44 at 2 &
n.1). After review of the record and the parties'
submissions on Dr. Wickboldt's motion, the Court
concludes that Dr. Wickboldt's motion must be denied and
that judgment must be entered for MassMutual.
1985, Dr. Wickboldt-then a 33-year-old practicing
dermatologist-applied for and obtained a policy of disability
insurance from MassMutual's
predecessor. In addition to the Basic Policy (Doc. 34-1
at 3 through 7), Dr. Wickboldt also purchased a Cost of
Living Rider (COLA Rider) (Doc. 34-1 at 8 & 9) at the
same time. A year later, he purchased another
rider-the Lifetime Total Disability Benefits Rider (Lifetime
Rider). (Doc. 34-1 at 10). The Basic Policy and COLA Rider
had an effective date of September 1, 1985; the Lifetime
Rider, September 1, 1986. (Coverage Page, Doc. 34-1 at 17).
And under the policy's terms, "[a]n Anniversary
falls each year on the same month and day as the effective
date," (Doc. 34-1 at 4)-in other words, every September
2000, at the age of forty-eight, Dr. Wickboldt became totally
disabled-defined in the policy as unable, "because of
sickness or injury," to "do the main duties of
[his] occupation," (Doc. 34-1 at 4)-and he has remained
totally disabled since then. MassMutual began paying monthly
benefits shortly after Dr. Wickboldt became totally disabled
and continues to pay benefits to him. But the parties dispute
the amount of benefits to which Dr. Wickboldt is and has been
entitled since September 1, 2017-the policy Anniversary
following his sixty-fifth birthday.
Pertinent Policy Provisions
Basic Policy provides for payment of benefits for "total
disability" beginning one month after an elimination
period. (Doc. 34-1 at 4). The amount of the monthly benefit
is described as the "basic monthly benefit shown on the
Coverage Page"-$8, 000- "multiplied by the ratio of
[Dr. Wickboldt's] loss of income to [his] predisability
income." (Doc. 34-1 at 4). Dr. Wickboldt began receiving
disability benefits of $8, 000 per month in mid-2000.
COLA Rider provides for the payment of monthly "benefit
increases"-the amount of which adjusts each year based
on the Consumer Price Index-starting after one year of
disability. The COLA Rider states in part:
This rider provides monthly benefit increases while
you're totally or residually disabled. . . .
When We'll Pay Monthly Benefit
Increases. We'll pay monthly benefit increases
while you're receiving total or residual disability
benefits. The benefit increases will start after you've
been totally and/or partially disabled for 12 months, or the
full elimination period, if longer. We'll make the first
payment one month later.
Long We'll Pay Benefit Increases. While
you're totally or residually disabled, we'll pay
benefit increases until the earliest of:
• the date your total or residual disability ends;
• the date the maximum benefit period under this rider
• the anniversary on or after your 65th birthday.
(Doc. 34-1 at 8 (emphasis in original)). Pursuant to this
rider, after twelve months of receiving $8, 000 in monthly
benefits under the Basic Policy, in 2001 Dr. Wickboldt
continued to receive those benefits each month and also began
to receive monthly benefit increases. By June 2015, Dr.
Wickboldt was apparently receiving a total of approximately
$16, 000 per month in combined benefits-that is, $8, 000 per
month under the Basic Policy plus an additional $8, 000 or
per month in "benefit increases" under the COLA
the Lifetime Rider provides:
This rider provides monthly total disability benefits to be
paid beyond the Anniversary on or after your 65th birthday.