Searching over 5,500,000 cases.


searching
Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.

Rao Suryadevara v. Unum Group

April 19, 2013

RAO SURYADEVARA, PLAINTIFF,
v.
UNUM GROUP, DEFENDANTS.



The opinion of the court was delivered by: Glasser, Senior United States District Judge:

MEMORANDUM AND ORDER

Plaintiff Rao Suryadevara ("Suryadevara" or "plaintiff") brings this action against Unum Group ("Unum" or "defendant") for breach of contract and unjust enrichment of a disability insurance policy, seeking money damages and a declaratory judgment. Suryadevara claims that he suffered from two separate disabilities and, therefore, is entitled to greater benefits than he is currently receiving under the policy. Unum raises affirmative defenses of equitable estoppel and fraud, arguing that Suryadevara is bound by his prior representations that he suffered from one, continuous disability.

Currently before the Court is Unum's motion to dismiss pursuant to Rule 12(b)(6) of the Federal Rules of Civil Procedure. For the reasons set forth below, defendant's motion is hereby DENIED.

BACKGROUND

The following facts are taken from plaintiff's Complaint and documents attached to the Complaint or incorporated by reference; they are accepted as true for purposes of this motion.

Plaintiff is a native of India who trained and worked as a physician outside the United States. Declaration of Patrick W. Begos in Support of Defendant's Motion to Dismiss dated Dec. 10, 2012 ("Begos Decl."), Ex. C at 49-50 (Dkt. No. 8-1).*fn1 He came to the United States in the 1980s where he first received training in internal medicine and then in cardiology. Id. In 1992, while a resident in internal medicine at Detroit Medical Center, plaintiff applied for and received disability insurance from Provident Life and Accident Insurance Company, which is now owned by Unum.*fn2 Verified Complaint ("Compl.") ¶ 7, Ex. A at 1, 17 (Dkt. No. 1).

I.Disability Insurance Policy

The insurance policy provides that in return for quarterly premiums that increase annually for five years, plaintiff will receive monthly benefits if he becomes either totally or residually disabled. Compl., Ex. A at 3-4. Plaintiff fully paid the required premiums under the policy. Compl. ¶ 11.

A.Total and Residual Disability

Under the policy, "totally disabled means that due to Injuries or Sickness:

1. you are not able to perform the substantial and material duties of your occupation; and

2. you are receiving care by a Physician which is appropriate for the condition causing the disability."

Compl., Ex. A at 4. "Sickness means sickness or disease which is first manifested while your policy is in force." Id.

If plaintiff becomes totally disabled before his 65th birthday, then he will receive a fixed monthly benefit for the rest of his life and will no longer have to pay premiums. Id. at 3, 6. The amount of the benefit depends on when the disability begins, and does not increase over time. The benefit starts at $4,500 per month and increases as follows:

Update Increase Date New Monthly Benefit for Total Disability 7/01/93 $4,820.00 7/01/94 $5,160.00 7/01/95 $5,530.00 7/01/96 $5,920.00 7/01/97 $6,340.00

Id. at 3.

The policy defines "residually disabled" to mean that "due to Injuries or Sickness:

1. you are not able to do one or more of your substantial and material daily business duties or you are not able to do your usually daily business duties for as much ...


Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.