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Cote v. United of Omaha Life Insurance Co.

United States District Court, D. Connecticut

March 15, 2017

LAUREL M. COTE Plaintiff
v.
UNITED OF OMAHA LIFE INSURANCE COMPANY Defendant.

          RULING ON PLAINTIFF'S AND DEFENDANT'S MOTIONS FOR SUMMARY JUDGMENT

          VICTOR A. BOLDEN UNITED STATES DISTRICT JUDGE.

         Plaintiff Laurel M. Cote has sued Defendant United of Omaha Life Insurance Company (“Omaha”) for breach of contract, alleging that Omaha wrongly canceled the life insurance policy (“the Policy”) that it issued to her husband, Caroll Cote, in 2011.

         Defendant advised the Plaintiff that it was rescinding Mr. Cote's policy in August 2013, after Omaha determined that Mr. Cote had misrepresented his medical history in his application for life insurance. Ms. Cote then filed an action for breach of contract in Connecticut State Court on October 9, 2014 and Defendant removed the case to this Court on November 4, 2014. See Notice, ECF No. 1. On July 15, 2016, both parties moved for summary judgment. For the reasons that follow, both motions are DENIED.

         I. Factual Background[1]

         On September 19, 2011, Mr. Cote applied for a $150, 000 life insurance policy from United of Omaha for mortgage protection. Def.'s L.R. 56(a) Stmt., ECF No. 59, ¶ 1. He completed a supplemental application regarding his health on September 27, 2011. Id. at ¶ 2. Question 3(h) of this application asked if he had “ever (a) received treatment for, or (b) been advised by a member of the medical profession to seek treatment regarding: cancer, tumor, […or a] blood/bleeding disorder.” Id. at ¶ 3. The application also required Mr. Cote to “immediately notify” United of Omaha any time he experienced a “change in health or habits” that would change his answers to any of the questions on the Application. Id. at ¶ 4.

         After processing Mr. Cote's application, Omaha issued the Policy on October 6, 2011. Id. at ¶ 5. Mr. Cote was diagnosed with Leukemia in January, 2012. Id. at ¶ 6. He passed away on December 29, 2012. Id. at ¶ 7. Because he died within two years of obtaining the Policy, Omaha did a standard review of his application. Id. at ¶ 8. During this review, Omaha discovered that doctors had reported two issues with Mr. Cote's blood-thrombocytopenia (low platelet count in his blood) and anemia (low red blood cell count)-at appointments between May and September of 2011. Id. at ¶ 10. Omaha rescinded the Policy in a letter to Plaintiff Laurel Cote on August 6, 2013. Id. Omaha claimed that Mr. Cote had made a material misrepresentation, which warranted rescission, by answering “no” to Question 3(h) of the Policy questionnaire. Id. In October 2014, Ms. Cote sued Omaha for breach of contract. See Not. of Removal, ECF No. 1., ¶ 2.

         A. Mr. Cote's Medical History

         The record reveals that Mr. Cote met with two of his doctors, Dr. Kevin D. Dieckhaus and Dr. Stanley Babu, to discuss abnormal blood test results in the spring of 2011. See Pl.'s L. R. 56(a) Stmt., ECF No. 55, ¶¶ 1-3; Def.'s L. R. 56(a) Stmt., ¶¶ 24-25. In early 2011, Mr. Cote had an operation on his leg after falling from a tree in early 2011. Pl.'s L.R. 56(a) Stmt., ¶ 3. After this operation he developed an infection that required intensive treatment. Id. at ¶ 4. At this point, he started to see an infectious disease specialist, Dr. Dieckhaus, to monitor the infection. Id. at ¶ 3.

         1. Treatment by Dr. Dieckhaus in 2011

         Dr. Dieckhaus did “bloodwork” for Mr. Cote on July 13, August 12, and September 9, 2011 and discovered that Mr. Cote had anemia and thrombocytopenia. Pl.'s L.R. 56(a) Stmt. ¶ 9-12. Dr. Dieckhaus believed that the blood conditions might have been caused by Mr. Cote's consumption of Bactrin, a strong antibiotic that he had been taking to treat the infection on his leg. Id. at ¶ 7.

         Dr. Dieckhaus' medical records confirm that he disclosed the results of Mr. Cote's blood tests to Mr. Cote and his wife at an August 22, 2011 appointment. Pl.'s L.R. 56(a) Stmt. ¶ 12. The records state that “Mr. Cote and his wife appeared to be well aware of the potential risks and benefits of continued antibiotics versus stopping them and he is willing to attempt a trial of lower dose antibiotic with supplementation of his folate.” Id. at 14 (citing Dieckhaus Medical Report, Ex. B to Dickman Aff., ECF No. 58-2) (“Dieckhaus Medical Report”). Dr. Dieckhaus prescribed folate to Mr. Cote and scheduled another blood test on September 6, 2011. Id. at 19-20. His notes from the meeting state “I am concerned regarding [Mr. Cote's] blood work, which is now showing a decrease in his platelet count…. After extensive discussion, we have opted to reduce [Mr. Cote's] Bactrin.” Dieckhaus Medical Report, 1.

         At an appointment with the Cotes on September 28, 2011, Dr. Dieckhaus explained the results of the September 6 blood test. He explained that Mr. Cote's platelet count had dropped to a dangerous level. Pl.'s L.R. 56(a) Stmt. ¶ 19. He mentioned to the couple that it was a “critical problem” and a “big issue that needed to be addressed.” Id. at ¶ 36; see also Def.'s L.R. 56(a) Stmt. ¶¶ 20-21. A summary of the meeting in Dr. Dieckhaus's records confirms that Dieckhaus “suspected” that Mr. Cote's thrombocytopenia was due to his dosage of antibiotics. Dieckhaus Medical Report II, Ex. F to Dickman Aff., ECF No. 58-7. Dr. Dieckhaus recommended discontinuing the antibiotics and arranged for Mr. Cote to take weekly blood tests to assess his platelet levels. Id.

         The record does not make clear whether Dr. Dieckhaus used the word “disorder” when describing Mr. Cote's blood problems. Dr. Dieckhaus did state that he had “no reason to believe” that anyone had told Mr. Cote that he had a “blood disorder.” Dieckhaus Dep. 93: 1-5 (“Q. As you sit here today, do you have any reason to believe that Mr. Cote had been told by anybody that blood disorder was a possible problem for him in September or October of 2011? A. No.”). He also stated that he “probably would not have” used the word “disorder” to describe Mr. Cote's test results. Id. at 121: 16-19 (responding to a question asking “Do you know if you would have used the word “disorder” in connection with describing those low blood values?).

         2. Treatment by Dr. Babu in 2011

         Mr. Cote met with a primary care physician, Dr. Babu, for a pre-operation physical on May 10, 2011. Def.'s L.R. 56(a) Stmt., ¶ 11. Dr. Babu reviewed Mr. Cote's blood tests at this appointment and diagnosed him with anemia. Pl.'s L.R. 56(a) Stmt., ¶ 34, He also reviewed Mr. Cote's blood work again on September 30, 2011, at a “health maintenance evaluation” of Mr. Cote. Pl.'s L.R. 56(a) Stmt., ¶ 26; Def.'s L.R. 56(a) Stmt., ¶ 25. Dr. Babu's notes from this meeting describe a diagnosis of anemia and thrombocytopenia. Def.'s L.R. 56(a) Stmt., ¶ 25 (citing Babu Medical Report, Ex. G, Dickman Aff., ECF No. 58-7) (“Babu Medical Report”). Dr. Babu's notes further state that Mr. Cote's anemia was “asymptomatic” and that he was taking iron supplements and “doing well.” Babu Medical Report, 1. Under the “thrombocytopenia” diagnosis, Dr. Babu noted that the “etiology [was] unclear at this time” and wrote “recheck again.” Id. at 3. At the appointment, Dr. Babu told the couple that Mr. Cote's throbocytopenia might have been caused by his antibiotics or by a different condition called idiopathic thrombocytopenic pupura (ITP). Def.'s L.R. 56(a) Stmt., ¶ 28. He asked Mr. Cote to get more blood tests. He also did not use the word “disorder” at the appointment. Pl.'s L.R. 56(a) Stmt., ¶ 39; Babu Dep. 69: 7-13 (“Q. Okay. Do you have any recollection of ever telling Carroll Cote that he had a blood disorder? A. Never. Q. If you had told him he had a blood disorder, would you have made note of that in any of your charts or records? A. I would have.”).

         B. Evidence of Mr. Cote's “Blood Disorder”

         The record contains statements from both doctors clarifying their understanding of the term “blood disorder.” In response to a question about thrombocytopenia, Dr. Babu stated that he considered the condition to be a “lab result” rather than a “blood disorder. Babu Dep., 69: 4-13 (“Q. Do you consider that a blood disorder or simply a symptom, a lab result? A. A lab result”). Dr. Babu stated that anemia was a “low ...


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