Harris v. Provident Life & Accident Insurance Co.

Summary

The Second Circuit reviewed summary judgment rulings involving a disability insurance claim by an anesthesiologist alleging latex-induced asthma and related conditions. The court held that conflicting medical evidence created genuine issues of material fact regarding total disability, vacated summary judgment for the insured on the breach-of-contract claim, and remanded that claim. It affirmed dismissal of the implied-covenant claim and the insurer’s rescission counterclaim.

Holdings

1. Summary judgment for Harris was improper because conflicting medical evidence created genuine issues of material fact concerning what disability, if any, affected Harris and whether it totally disabled her from working as an anesthesiologist.
2. The district court properly dismissed Harris's implied-covenant claim because it was duplicative of the breach-of-contract claim under New York law, and the claim also failed under California law because Provident's denial was supported by a genuine dispute concerning coverage and was not shown to be unreasonable.
3. Provident was not entitled to rescission because Harris's nondisclosure of the Johns Hopkins and Mayo Clinic reports was immaterial to Provident's decision to deny benefits.

Questions Presented

1. Whether conflicting medical evidence created genuine issues of material fact concerning whether Harris was totally disabled under the disability insurance policy.
2. Whether Harris's claim for breach of the implied covenant of good faith and fair dealing was duplicative of her breach-of-contract claim under New York law or otherwise viable under California law.
3. Whether Provident was entitled to rescission of the insurance contract because Harris failed to disclose the results of her Johns Hopkins and Mayo Clinic evaluations.
4. Whether Provident's supplemental expert report was admissible for purposes of summary judgment.

Disposition

vacated