Nugent v. Unum Life Insurance Co. of America
752 F. Supp. 2d 46
| D.D.C. | 2010Background
- Nugent is a neuroradiologist who suffers post-concussive syndrome from a 1999 auto accident.
- She remained unable to perform neuroradiology and attempted part-time work in 2002, then resigned in 2004.
- Unum initially paid benefits and later engaged in a Claim Reassessment Process under a Regulatory Settlement Agreement.
- Nugent signed Conditional Waivers in 2005 and 2007 agreeing not to pursue certain claims if reassessment changed denial.
- Reassessment determined total disability from 11/12/1999 to 6/1/2002 but found no ongoing cognitive deficits; Nugent seeks ongoing and extra-contractual relief.
- The Complaint seeks declaration of continuing disability, past and future benefits, premium repayment, bad-faith damages, IIED, and attorney fees; Unum moves to dismiss Counts II, IV, V, VI and to strike numerous paragraphs.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Scope of the waiver during reassessment | Waiver not broad enough to bar all initial-claims extras | Waiver covers any aspect of prior denial reversed or changed | Waiver does not bar all extra-contractual claims; limited scope retained |
| Intentional infliction of emotional distress independent of contract | Tort claim rests on independent outrageous conduct | Claims are contractual, not independent torts | Count IV dismissed for lack of independent tort separate from contract |
| Implied covenant of good faith and fair dealing | Breach of implied covenant can recover extra-contractual damages | Bad faith claim is largely contractual; may not recover tort-like damages | Count II survives to extent pleaded; dismissal without prejudice as to some claims |
| Punitive damages | Bad faith conduct warrants punitive damages | No independent tort; no basis for punitive damages | Count V dismissed |
| Attorney fees | Fees may be awarded for vexatious conduct | Absent contract/statute, American Rule applies | Count VI denied without prejudice; discovery may illuminate. |
Key Cases Cited
- Choharis v. State Farm Fire & Cas. Co., 961 A.2d 1080 (D.C.2008) (independent torts must exist apart from contract; insurance dispute may support torts only if independent duty)
- Sere v. Group Hospitalization, Inc., 443 A.2d 33 (D.C.1982) (merger of tort with contract requires independent duty and damages beyond contract)
- Washington v. Government Employees Ins. Co., 769 F. Supp. 383 (D.D.C.1991) (insurer conduct may be considered in contract context; limited tort claims)
- Messina v. Nationwide Mut. Ins. Co., 998 F.2d 2 (D.C.Cir.1993) (bad faith tort not generally available; contract-based damages favored)
- Allworth v. Howard Univ., 890 A.2d 194 (D.C.2006) (implied covenant arises in contract; damages tied to contract performance)
- Howard Univ. v. Baten, 632 A.2d 389 (D.C.1993) (mental anguish damages generally not recoverable in contract)