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Gueorguiev v. The United States Life Insurance Company in City of New York

United States District Court, E.D. Michigan, Southern Division

October 19, 2016



          MARK A. GOLDSMITH, United States District Judge.

         This matter is before the Court on Defendant The United States Life Insurance Company in the City of New York's motion for summary judgment (Dkt. 63), and Plaintiff's motion in limine to exclude toxicology report, or alternately, to compel discovery (Dkt. 77). The issues have been fully briefed, and a hearing was held on September 22, 2016. Defendant seeks a ruling that an insurance contract was formed between Plaintiff and Defendant, which included exclusions for losses that were incurred as the result of committing a crime or being intoxicated. Defendant also seeks a ruling that a toxicology report proves that the exclusions apply and relieves Defendant of its obligation to pay benefits to Plaintiff. Plaintiff seeks to exclude the toxicology report on the ground that Defendant has failed to lay an adequate foundation for the report. In the alternative, Plaintiff seeks an order from this Court compelling Defendant to provide further information regarding how the results contained within the report were reached. For the reasons explained below, the Court grants in part and denies in part Defendant's motion, and denies Plaintiff's motion.

         I. BACKGROUND

         Plaintiff and the decedent, her husband Peter Gueorguiev, received a mortgage loan from CitiMortgage, a former defendant in this case. Enrollment Form, Ex. E to Pl. Resp., at 1 (Dkt. 70-6). As part of the mortgage, Plaintiff and the decedent were offered the opportunity to purchase coverage under a policy of group accidental death and dismemberment insurance that was underwritten by Defendant. Id.

         Defendant claims that the decedent purchased the policy and named Plaintiff as the beneficiary, but a review of the enrollment form for the policy demonstrates that it is unclear whether both parties were the insureds and whether both parties are beneficiaries. Id. Under the section entitled “Enrollment Options, ” the form has the names of both Plaintiff and the decedent printed. Id. However, a line was drawn through Plaintiff's name, which indicates that she would not be insured by the policy. Id. Yet, under the section entitled “Insured's Birth Date, ” there are two dates listed, and under the section entitled “Beneficiary, ” both Plaintiff's and the decedent's names are listed. Id. The decedent is the only person to have signed the enrollment form dated December 27, 2006. Id.

         On February 1, 2007, a cover letter and Certificate of Insurance were sent to the decedent. Cover Letter, Ex. D to Pl. Resp. (Dkt. 70-5). The letter stated that the Certificate of Insurance for the policy that Plaintiff and the decedent applied for was enclosed. Id. Plaintiff argues that the enclosed document was a one-page document that lists the certificate number, group policy number, effective date, the participating association, and the schedule of benefits. See Plaintiff's Purported Certificate of Insurance, Ex. F. to Pl. Resp., at 1 (Dkt. 70-7). Defendant contends that the enclosed document was a four-page document that, among other things, sets forth the exclusions in the policy. See Defendant's Purported Certificate of Insurance, Ex. A. to Def. Reply, at 1 (Dkt. 73-2).

         The purported insurance policy provided by Defendant states that benefits will be provided in the event of the accidental loss of life. Insurance Policy, Ex. A to Def. Mot., at 13 (cm/ecf page) (Dkt 63-2). The purported insurance policy includes a section that states that “[i]f benefits are payable under the Accidental Death section of this policy, United States Life will pay the amount indicated in the Schedule of Benefits for loss which results from a covered accident which occurs while the insured person is driving . . . in a private passenger car.” Id. The policy also contains various exclusions, of which two are relevant here: commission of a crime and intoxication. Specifically, the policy provides that “no benefits will be paid for any loss that results from or is caused directly, indirectly, wholly or partly by . . . 5. Committing a crime, or an attempt to do so . . . 6. Being intoxicated or under the influence of any drug, unless taken as prescribed by a physician.” Id.

         Sometime between 11:30 p.m. on August 8, 2013 and 1:00 a.m. on August 9, 2013, the decedent was driving north on M-30 in Edenville Township. Traffic Crash Report, Ex. C to Def. Mot., at 3 (cm/ecf page) (Dkt. 63-4). As the road began to curve to the right, the decedent drove off the road. Id. The decedent proceeded to drive through a fence and into an unoccupied building. Id. The decedent was pronounced dead at the scene by Dr. Dennis Wagner, the Midland County medical examiner. Incident Report, Ex. D. to Def. Mot., at 5 (Dkt. 63-5). Among the items recovered from the decedent's vehicle was an open bottle of Jack Daniels whiskey. Property Receipts, Ex. G to Def. Mot., at 3 (cm/ecf page) (Dkt. 63-8). At 3:08 a.m., Wagner took a blood sample from the decedent. Blood Sample Collection Form, Ex. E to Def. Mot., at 1 (cm/ecf page) (Dkt. 63-6). On August 16, 2013, Greta Gill, a forensic scientist with the Michigan Department of State Police, conducted an analysis of the blood taken by Wagner. Laboratory Report, Ex. F to Def. Mot., at 2 (cm/ecf page) (Dkt. 63-7). The analysis revealed that the decedent had a blood alcohol level of 0.15. Id.

         Plaintiff filed a claim with Defendant for the proceeds of the insurance policy, see Claim Form, Ex. J to Def. Mot., at 1 (Dkt. 63-11), which was denied. Letter from AIG Benefits Solutions to Plaintiff's Counsel, Ex. K to Def. Mot., at 3 (cm/ecf page) (Dkt. 63-12). Defendant noted that Plaintiff's blood alcohol level was 0.15 at the time of his death. Id. Defendant stated that, as a result, policy exclusions five and six relieved Defendant of paying benefits to Plaintiff because the decedent died as the result of committing a crime and being intoxicated. Id. Plaintiff appealed the denial of her claim. Letter from Plaintiff's Counsel to AIG Benefits Solutions, Ex. L to Def. Mot., at 2 (cm/ecf page) (Dkt. 63-13). In her letter of appeal, Plaintiff theorized that the crash could have been due to previous chest pain or that the analysis of the decedent's blood was simply mistaken. Id. at 5. Defendant subsequently denied Plaintiff's appeal. Plaintiff then filed the instant action, alleging three counts: breach of contract, negligence, and tortious interference with a contract.[1] Third Am. Compl. (Dkt. 24).


         A court must grant summary judgment “if the movant shows that there is no genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law.” Fed.R.Civ.P. 56(a). “In making this determination, the court must view the evidence in the light most favorable to the non-moving party and draw all reasonable inferences in its favor.” U.S. S.E.C. v. Sierra Brokerage Servs., Inc., 712 F.3d 321, 327 (6th Cir. 2013). The court must determine “whether the evidence presents a sufficient disagreement to require submission to a jury or whether it is so one-sided that one party must prevail as a matter of law.” Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 251-252 (1986). In considering the material facts in the record, a court must recognize that “[t]he mere existence of a scintilla of evidence in support of the plaintiff's position will be insufficient; there must be evidence on which the jury could reasonably find for the plaintiff.” Id. at 422. In this case, Defendant bears the burden of proving that any coverage under the policy is negated by an exclusion. Monteleone v. The Auto Club Grp., 113 F.Supp.3d 950, 959 (E.D. Mich. 2015). “Where the moving party has the burden . . . his showing must be sufficient for the court to hold that no reasonable trier of fact could find other than for the moving party.” Calderone v. United States, 799 F.2d 254, 259 (6th Cir. 1986) (citation and internal quotation marks omitted).

         III. ANALYSIS

         The issues concerning Defendant's motion for summary judgment and Plaintiff's motion in limine, especially as they concern the admissibility of the toxicology report, are intertwined. As a result, the motions will be analyzed together.

         A. ...

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