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Wickboldt v. Massachusetts Mutual Life Insurance Co.

United States District Court, M.D. Florida, Orlando Division

September 5, 2019

LLOYD WICKBOLDT, Plaintiff,
v.
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY, Defendant.

          ORDER

          JOHN ANTOON II UNITED STATES DISTRICT JUDGE.

         In this dispute over interpretation of a disability insurance policy, [1] Dr. 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.

         I. Background

         A. Factual History

         In 1985, Dr. Wickboldt-then a 33-year-old practicing dermatologist-applied for and obtained a policy of disability insurance[2] from MassMutual's predecessor.[3] 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.[4] 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 1.

         In 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.

         B. Pertinent Policy Provisions

         The Basic Policy provides for payment of benefits for "total disability"[5] 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"[6]-$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.

         The COLA Rider provides for the payment of monthly "benefit increases"-the amount of which adjusts each year based on the Consumer Price Index[7]-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.

         How 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 ends;
• 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 so[8] per month in "benefit increases" under the COLA Rider.

         Finally, the Lifetime Rider provides:

This rider provides monthly total disability benefits to be paid beyond the Anniversary on or after your 65th birthday. ...

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