Opinion

James Fortune v. Unum Life Insurance Company of America

  • 360 S.W.3d 390
  • 2010 Tenn. App. LEXIS 643
  • 2010 WL 3984705
Court
Court of Appeals of Tennessee
Filed
Oct 12, 2010
Status
Published
Author
Farmer
On the bench
Judge David R. Farmer
Cited by
18 cases
Authority
More cited than 66.4%

The opinion

IN THE COURT OF APPEALS OF TENNESSEE

AT JACKSON

July 28, 2010 Session

JAMES FORTUNE v. UNUM LIFE INSURANCE COMPANY OF

AMERICA, ET AL.

Direct Appeal from the Circuit Court for Shelby County

No. CT-005641-06 Donna Fields, Judge

No. W2009-01395-COA-R3-CV - Filed October 12, 2010

This appeal arises out of an alleged wrongful denial of long term disability benefits. The

plaintiff/appellant filed suit asserting multiple causes of action against an insurance company

that contracted to provide long term disability insurance to employees of the City of

Germantown. The defendants/appellees, the insurance company and its parent corporation,

moved for summary judgment arguing, inter alia, that the applicable statutory and

contractual limitations periods barred each of the plaintiff’s causes of action. The trial court

agreed and granted summary judgment in favor of the defendants. We affirm.

Tenn. R. App. P. 3 Appeal as of Right; Judgment of the Circuit Court Affirmed and

Remanded

D AVID R. F ARMER, J., delivered the opinion of the Court, in which A LAN E. H IGHERS, P.J.,

W.S., and H OLLY M. K IRBY, J., joined.

Daniel A. Seward, Memphis, Tennessee, for the appellant, James Fortune, as substituted by

Bettye Bedwell, Bankruptcy Trustee.

S. Russell Headrick and Leigh M. Chiles, Knoxville, Tennessee, for the appellees, Unum

Life Insurance Company of America and The Unum Group, f/k/a Unum Provident

Corporation.

OPINION

I. Background and Procedural History

The following facts are undisputed. Unum Life Insurance Company of America

(“Unum Life”) issued a group long term disability policy to the City of Germantown,

Tennessee on June 1, 1994. James Fortune (“Fortune”) was insured under this policy when

he became disabled on or about June 15, 1999. Unum Life paid long term disability benefits

to Fortune for a period but terminated his claim after concluding he was ineligible to receive

continued benefits. Unum Life informed Fortune’s then counsel of the termination by letter

dated October 19, 2001, explaining that Fortune’s benefits would cease on October 31, 2001.

More than three years later, Unum Life entered into a “Regulatory Settlement

Agreement” (“RSA”) with state insurance regulators, including the Commissioner of the

Tennessee Department of Commerce and Insurance, and the United States Department of

Labor. The RSA, among other things, created a “plan of corrective action” to address a

number of regulatory and statutory concerns raised regarding prior claim assessments. It also

instituted improved claim handling procedures for future claim assessments. Pertinent to this

appeal, the RSA established a claim reassessment process through which an identified class

of claimants could receive de novo review of prior assessments. Importantly, however, the

RSA specifically stated that neither it “nor any of the relief to be offered under this

Agreement shall be interpreted to alter in any way the contractual terms of any policy, or to

constitute a novation of any policy.”

On January 13, 2005, the Claim Reassessment Unit of Unum Life’s parent

corporation, UnumProvident Corporation (now known as “Unum Group”), mailed Fortune

notice that his claim for long term disability benefits was eligible for reassessment under the

terms of the RSA. Fortune soon thereafter executed a “Request to Participate” form

indicating his desire to participate in the claim reassessment process. After receiving further

correspondence regarding his claim, Fortune executed a waiver and release containing the

following language:

[A]ny applicable statute of limitations is tolled during the pendency of the

reassessment of my claim; however, I understand that my participation in this

Claim Reassessment Process will not revive or reinitiate the statute of

limitations with respect to the previous claim decision.

The Claim Reassessment Unit thereafter initiated a review of Fortune’s claim, eventually

informing Fortune’s present counsel by letter dated April 11, 2006, that it concurred in the

original decision to deny Fortune continued disability benefits because he did not meet the

definition of disability contained in the policy after October 31, 2001.

Fortune commenced this action against Unum Life in October 2006.1 Fortune alleged

1

The parties’ briefs indicate that Fortune filed his initial complaint solely against Unum Life, Unum

(continued...)

-2-

in his complaint and amended complaint that: (1) Unum engaged in unfair and deceptive acts

or practices in violation of the Tennessee Consumer Protection Act (“TCPA”) when it denied

and continued to deny Fortune’s claim; (2) Unum knowingly, intentionally, and in bad faith

denied and continued to deny Fortune’s claim; (3) Unum engaged in fraud and

misrepresentation when it denied and continued to deny Fortune’s claim; (4) Unum

knowingly concealed and continued to conceal relevant information from Fortune regarding

his claim; and (5) Unum committed breach of contract when it denied Fortune’s claim in

October 2001 and again intentionally violated the terms of the policy in April 2006. Fortune

alleged that he incurred losses and injuries as a result of Unum’s actions including but not

limited to loss of past due benefits plus interest, loss of his life insurance policy, loss of

retirement benefits due to his forced early retirement, pain and suffering, and emotional

distress. He requested compensatory damages and punitive damages, as well as treble

damages and attorney’s fees for the alleged violation of the TCPA.

Unum subsequently filed a motion for summary judgment arguing, inter alia, that

each cause of action asserted in Fortune’s complaint was time-barred. Unum argued that the

lengthiest statutory or contractual limitations period applicable to the alleged causes of action

was three years and that Fortune had filed his complaint nearly five years after his claims

accrued. The trial court conducted a hearing on the motion and granted summary judgment

in favor of Unum, finding “no genuine issue as to any material fact, and that Defendants are

entitled to judgment as a matter of law because all claims contained in Plaintiff’s complaint

are barred by the applicable contractual and statutory periods of limitations.” Fortune, as

substituted by bankruptcy trustee Bettye Bedwell (“the Trustee”), later filed a motion to alter,

amend, or vacate the court’s judgment, which the trial court denied.2 Following denial of the

motion, the Trustee timely appealed.

1

(...continued)

Life removed the case to the United States District Court for the Western District of Tennessee, and the

federal court remanded the case back to Shelby County Circuit Court after Fortune filed an amended

complaint adding Unum Group as a defendant. The record, however, contains only the original complaint

filed in state court against Unum Life. Although the record does not contain an amended complaint adding

Unum Group as a defendant, the defendants’ answer nonetheless purports to respond to Fortune’s “Amended

Complaint” and lists Unum Life and Unum Group as defendants. It appears, therefore, that Unum Group was

made a party to this lawsuit. For convenience, we will collectively refer to Unum Life and Unum Group as

“Unum” throughout the remainder of this opinion. We will also assume in light of the arguments before the

trial court and this Court that Fortune’s amended complaint reproduced the allegations of his original

complaint. To the extent Fortune’s amended complaint may have alleged additional causes of action, they

were neither addressed before the trial court nor presented on appeal.

2

The record shows that United States Bankruptcy Judge Paulette J. Delk authorized Fortune’s

attorney, Daniel Seward, to represent the Trustee in this case following Fortune’s filing for Chapter 7

bankruptcy.

-3-

II. Issues Presented

The issues before this Court, as we perceive them, are:

(1) Whether Unum alleged undisputed facts to establish that an agreed

three-year limitations period bars Fortune’s claim for breach of contract

where Unum did not allege undisputed facts establishing that it

apprised Fortune of the policy’s limitations provision;

(2) Whether the reassessment of Fortune’s claim revived his claim,

renewed his policy, or otherwise constituted a new policy of insurance

such that his breach of contract action did not accrue until the Claim

Reassessment Unit concluded its review in April 2006; and

(3) Whether Unum presented undisputed facts to establish that the

applicable statutes of limitations barred Fortune’s statutory and tort

causes of action where Fortune filed a sworn affidavit stating that he

learned of these causes of action within one year of the filing of his

complaint.

III. Standard of Review

This Court reviews a trial court’s decision on a motion for summary judgment de novo

with no presumption of correctness. Martin v. Norfolk S. Ry. Co., 271 S.W.3d 76, 84 (Tenn.

2008) (citing Blair v. W. Town Mall, 130 S.W.3d 761, 763 (Tenn. 2004)). We review the

evidence in the light most favorable to the nonmoving party and draw all reasonable

inferences in favor of the nonmoving party. Id. (citing Staples v. CBL & Assocs., 15 S.W.3d

83, 89 (Tenn. 2000)).

IV. Analysis

Rule 56 of the Tennessee Rules of Civil Procedure provides that a party is entitled to

summary judgment if the “pleadings, depositions, answers to interrogatories, and admissions

on file, together with the affidavits . . . show that there is no genuine issue as to any material

fact and that the moving party is entitled to a judgment as a matter of law.” Tenn. R. Civ.

P. 56.04. The moving party has the ultimate burden of demonstrating that summary

judgment is appropriate, Martin, 271 S.W.3d at 83 (citing Byrd v. Hall, 847 S.W.2d 208, 215

(Tenn. 1993)), and consequently bears the initial burden of providing a properly supported

motion showing there is no genuine issue of material fact and the moving party is entitled to

judgment as a matter of law, id. (citing Staples, 15 S.W.3d at 88; McCarley v. W. Quality

-4-

Food Serv., 960 S.W.2d 585, 588 (Tenn. 1998)). “The moving party may make the required

showing and therefore shift the burden of production to the nonmoving party by either: (1)

affirmatively negating an essential element of the nonmoving party’s claim; or (2) showing

that the nonmoving party cannot prove an essential element of the claim at trial.” Id. (citing

Hannan v. Alltel Publ'g Co., 270 S.W.3d 1, 5 (Tenn. 2008); McCarley, 960 S.W.2d at 588;

Byrd, 847 S.W.2d at 215 n.5). The burden-shifting analysis differs if the moving party bears

the burden of proof at trial. Hannan, 270 S.W.3d at 9 n.6. “For example, a plaintiff who

files a motion for partial summary judgment on an element of his or her claim shifts the

burden by alleging undisputed facts that show the existence of that element and entitle the

plaintiff to summary judgment as a matter of law.” Id. n.6. “Similarly, a defendant asserting

an affirmative defense . . . shifts the burden of production by alleging undisputed facts that

show the existence of the affirmative defense.” Id. n.6.

A party will not succeed on a motion for summary judgment merely by asserting that

the nonmoving party is without evidence to support its claim. Martin, 271 S.W.3d at 83-84

(citing Byrd, 847 S.W.2d at 215). “The moving party must either produce evidence or refer

to evidence previously submitted by the nonmoving party that negates an essential element

of the nonmoving party’s claim or shows that the nonmoving party cannot prove an essential

element of the claim at trial.” Id. at 84 (citing Hannan, 270 S.W.3d at 5). Production of

evidence raising doubts about the merits of the nonmoving party’s claim will not suffice. Id.

(citing McCarley, 960 S.W.2d at 588). “[T]he moving party must point to evidence that

tends to disprove an essential factual claim made by the nonmoving party.” Id. (citing Blair,

130 S.W.3d at 768). If the moving party does not carry its initial burden, the nonmoving

party has no obligation to produce evidentiary materials in support of its position. Id. (citing

McCarley, 960 S.W.2d at 588; Staples, 15 S.W.3d at 88).

Once a moving party carries its initial burden, the focus of the inquiry shifts to the

nonmoving party who must “affirmatively show facts either (a) supporting the elements of

its claim or defense if it has the burden of persuasion, or (b) negating the movant’s claim or

defense if the movant has the burden of persuasion.” Lawrence A. Pivnick, Tennessee

Circuit Court Practice § 27:5, at 382-83 & n.48 (2010) (collecting cases). The Tennessee

Supreme Court has articulated four methods by which the nonmoving party can satisfy its

burden of production and defeat a motion for summary judgment:

(1) pointing to evidence establishing material factual disputes that were

over-looked or ignored by the moving party; (2) rehabilitating the evidence

attacked by the moving party; (3) producing additional evidence establishing

the existence of a genuine issue for trial; or (4) submitting an affidavit

explaining the necessity for further discovery pursuant to Tenn. R. Civ. P.,

Rule 56.06.

-5-

McCarley, 960 S.W.2d at 588 (citing Byrd, 847 S.W.2d at 215 n.6). Courts must accept the

evidence proffered by the nonmoving party as true and resolve any doubts concerning the

existence of a genuine issue of material fact in favor of the nonmoving party. Martin, 271

S.W.3d at 84 (citation omitted). “‘A disputed fact is material if it must be decided in order

to resolve the substantive claim or defense at which the motion is directed.’” Id. (quoting

Byrd, 847 S.W.2d at 215). “A disputed fact presents a genuine issue if ‘a reasonable jury

could legitimately resolve that fact in favor of one side or the other.’” Id. (quoting Byrd, 847

S.W.2d at 215).

This appeal requires us to consider whether Unum has borne its burden to establish

the applicable contractual or statutory limitations periods as affirmative defenses to Fortune’s

causes of action. The Trustee argues that summary judgment is inappropriate for various

reasons. The Trustee first contends that Unum is not entitled to summary judgment on the

breach of contract action because Unum failed to allege undisputed facts demonstrating that

the agreed three-year limitations period has not been tolled. The Trustee argues in the

alternative that Unum is not entitled to summary judgment because the reassessment of

Fortune’s claim either revived his claim, renewed the policy, or constituted a new policy of

insurance such that the breach of contract action did not accrue until the Claim Reassessment

Unit concluded its review in April 2006. Finally, the Trustee submits that Unum is not

entitled to summary judgment on Fortune’s statutory and tort claims because there is a

disputed issue of fact concerning when he discovered Unum’s alleged fraudulent, deceptive,

or unlawful conduct. We will address these issues in turn.

The Trustee submits that Unum is not entitled to summary judgment on the breach of

contract action because there is an issue of fact as to whether the applicable limitations

period has been tolled. The group long term disability policy at issue indisputably precluded

Fortune or his authorized representative from commencing any legal action “until 60 days

after proof of claim has been given” or “more than 3 years after the time proof of claim is

required.” The Trustee does not challenge whether the parties contracted to establish an

enforceable agreed limitations period of three years. See Brick Church Trans., Inc. v. S. Pilot

Ins. Co., 140 S.W.3d 324, 329 (Tenn. Ct. App. 2003) (citations omitted) (“Tennessee has

long held that an insurance policy provision establishing an agreed limitations period within

which suit may be filed against the company is valid and enforceable.”); see also Certain

Underwriters at Lloyd's of London v. Transcarriers, Inc., 107 S.W.3d 496, 499 (Tenn. Ct.

App. 2002) (citations omitted). Nor does the Trustee challenge whether Fortune failed to

filed his complaint within three years of the October 2001 denial of continued benefits.

Rather, the Trustee argues that Unum is not entitled to summary judgment because it has not

alleged undisputed facts showing it provided Fortune or his attorney a copy of the policy or

other notice at least three years prior to the filing of his complaint. The Trustee submits that

an agreed limitations period is tolled in Tennessee until an insured is apprised of a policy’s

-6-

provisions and, thus, Unum’s failure to allege facts affirmatively showing that it provided

Fortune with a copy of the policy or other notice precludes summary judgment.

The Trustee cites the lone unreported decision of Jackson v. Potomac Insurance Co.,

Hamilton Law (Tenn. Ct. App. Sept. 8, 1982), in support of the proposition that an agreed

limitations period is tolled in Tennessee until the insured is specifically apprised of a policy’s

provisions.3 In Jackson, an insured filed suit to recover for a loss under the terms of a

homeowner’s policy that Potomac Insurance Company (“Potomac”) had issued him.

Jackson, at *1. The loss occurred on March 24, 1979, when thieves broke into the insured’s

van and stole several items of personal property. Id. at *2. After an insurance adjustor told

the insured’s wife that Potomac would not cover the loss absent proof of forcible entry, the

insured sought legal assistance. Id. The insured, however, was initially unable to provide

counsel with a copy of the controlling policy because Potomac had never provided him the

original. Id. The insured requested a copy from his insurance agent, but none was

forthcoming. Id. Eventually, the insured drove to the insurance agency, picked up a copy

of the insurance policy, and delivered it to his attorney on August 27th or 28th of 1979. Id.

On August 26, 1980, the insured filed suit. Id. at *3.

The pertinent question before this Court was whether the policy’s one-year contractual

limitations period barred the insured’s claim. The trial court had held on de novo review

from the general sessions court that the insured’s claim was not barred because a

misrepresentation of Potomac’s insurance adjustor had tolled the policy’s one-year

limitations period. Id. This Court disagreed with the trial court’s conclusion that the

insurance adjustor had committed fraud or misrepresentation but affirmed the trial court’s

decision on other grounds. Id. While recognizing that the insured had not established the

elements of estoppel, this Court determined that “where the general limitation provided by

statute has been shortened by contract it is appropriate to accord the insured the full contract

period after he has been apprised of the provisions of the policy.” Id. at *5; but see

3

The Trustee’s attorney has neglected to provide this Court a copy of the decision in Jackson

pursuant to Rule 12 of the Rules of the Court of Appeals of Tennessee, which states:

(a) No opinion of any court that has not been published shall be cited in papers filed in this

Court unless a copy thereof has been furnished to this Court and to adversary counsel. Such

unpublished opinions shall be included as appendices to any brief or other paper filed with

this Court.

Tenn. Ct. App. R. 12(a). Our review of the record reveals that the Trustee’s attorney apparently was unable,

or perhaps unwilling, to locate a copy of this decision even though it is the sole authority cited in support of

the Trustee’s position. Fortunately for the Trustee, opposing counsel experienced less difficulty procuring

a copy of the opinion and adhering to the rules of this Court.

-7-

Transcarriers, 107 S.W.3d at 499 (“The courts of this state generally have held that a

contractual limitations period begins to run upon accrual of the cause of action.”). Because

the insured in Jackson had filed suit within one year of receiving a copy of the policy, we

held that the suit was timely filed and affirmed the trial court’s decision. Jackson, at *5. The

Trustee asks this Court to follow Jackson and hold that summary judgment is inappropriate

on his breach of contract claim because Unum did not allege undisputed facts to show that

Fortune filed suit more than three years after obtaining a copy of his policy or receiving

notice of its provisions.

Unum argues to the contrary that this Court should adopt the position of the Sixth

Circuit in the unreported decision of Jones v. Allstate Ins. Co., 42 F.3d 1388, 1994 WL

677676 (6th Cir. 1994) (per curiam) (unpublished table decision), which expressly repudiated

Jackson. In Jones, a married couple (“the Joneses”) suffered a fire loss to a residence insured

under a homeowner’s policy with Allstate Insurance Company (“Allstate”). Jones, 1994 WL

677676, at *1. Allstate denied the Joneses’ claim on November 15, 1988, because they had

provided false information on their insurance application. Id. The couple’s attorney received

a copy of the insurance policy on September 29, 1989, and filed a complaint in state court

on December 28, 1989. Id. The United States District Court for the Western District of

Tennessee granted the insurance company’s motion for judgment as a matter of law after

Allstate removed the action to federal court because the Joneses had failed to file suit within

the policy’s agreed limitations period of one year.4 Id. The Joneses appealed.

The United States Court of Appeals for the Sixth Circuit affirmed the decision of the

district court, explaining:

Tennessee Code Annotated § 28-3-109(a)(3) provides that “[a]ctions on

contracts not otherwise expressly provided for . . . shall be commenced within

six (6) years after the cause of action accrued.” Tenn. Code Ann. §

28-3-109(a)(3) (1980). Tennessee courts, however, have consistently upheld

contractual periods of limitations that reduce the statutory period for filing suit.

See, e.g., Gutherie v. Connecticut Indemnity Ass'n, 49 S.W. 829, 830 (Tenn.

1899) (holding that insurance policy’s limitation for bringing suit was valid);

Tullahoma Concrete Pipe Co. v. Gillespie Constr. Co. & U.S. Fidelity & Guar.

Co., 405 S.W.2d 657, 664 (Tenn. 1966) (holding that provision in contract that

suit must be brought within one year after sub-contractor ceased work on

project was valid); Das v. State Farm Fire & Cas. Co., 713 S.W.2d 318, 324

4

The insurance policy in Jones contained a provision stating that “[a]ny suit or action [against

Allstate] must be brought within one year after the date of loss.” Jones, 1994 WL 677676, at *1 (citation

omitted).

-8-

(Tenn. Ct. App. 1986) (holding that dismissal of plaintiffs’ suit was justified

by their failure to sue within one year after insurance company’s first denial

of liability); Hill v. Home Ins. Co., 125 S.W.2d 189, 192 (Tenn. Ct. App. 1938)

(holding that contractual limitation requiring suit on fire policy to be

commenced within one year after date of loss was valid and enforceable).

Furthermore, in Hill, the Tennessee Court of Appeals held that the words

“after the date of loss” in an insurance policy provision limiting suit on the

policy means “after the cause of action accrues,” and that the cause of action

accrues at the time that the insurance company denies liability for the insured’s

claim. 125 S.W.2d at 192. Under Hill, the Joneses should have filed suit

within a year after they were notified by Allstate that their claim was being

denied, i.e., by November 15, 1989.

The Joneses argue, however, that the policy’s one-year time period to bring

suit should have been tolled until the time when they or their attorney received

a copy of the insurance policy, and thus had actual notice of the one-year

limitation. Under this scenario, the Joneses would have filed suit in a timely

manner, as the suit was filed within three months of their attorney’s receipt of

the policy. There are no reported Tennessee cases directly on point.

Even so, the Joneses do cite an unreported Tennessee decision, Jackson v.

Potomac Ins. Co., 7 TAM 41-21 (Tenn. Ct. App. Sept. 8, 1982), as support for

their position. The reasoning of the case is not persuasive, and we are not

bound by that decision. See Southern Ry. Co. v. Foote Mineral Co., 384 F.2d

224, 228 (6th Cir. 1967) (stating that unpublished opinion of Tennessee

Supreme Court is not binding on that court and accordingly federal court is not

bound by decision that would not be binding on highest state court); Patton v.

McHone, 822 S.W.2d 608, 615, n. 10 (Tenn. Ct. App. 1991) (noting that where

Tennessee Supreme Court had in fact reviewed case, but had only concurred

in result, unpublished opinion of Tennessee Court of Appeals had no

precedential value except to parties in case).

We believe that the Tennessee Supreme Court would hold that the instant suit

is absolutely barred by the one-year limitation in the insurance policy. Other

jurisdictions have espoused this view. See, e.g., Schoonover v. American

Family Ins. Co., 572 N.E.2d 1258, 1264 (Ill. Ct. App. 1991) (holding that

although claimant had not received a copy of insurance policy, one-year

limitation of policy applied because where insured had notice that policy

existed, it was his responsibility, and not insurance company’s, to insure his

knowledge of contents of policy); Young v. Seven Bar Flying Service, Inc., 685

-9-

P.2d 953, 956 (N.M. 1984) (holding that where insured was on notice that

insurance coverage had been obtained, insurance company’s failure to provide

insured with a copy of the insurance policy did not preclude application of

policy’s one-year time period for bringing suit to bar insured’s belated claim);

Alfieri v. Monoghan Real Estate, Inc., 283 A.2d 685, 686 (Del. Sup. Ct. 1971)

(holding that where insureds procured copies of their policies before

contractual time limitation was to expire, but then failed to file suit until

almost one year later and after contractual deadline for filing suit had passed,

in the absence of showing of misconduct by insurance company, contractual

time limit applied, and suit was barred).

In reviewing the district court’s judgment as a matter of law, we accept as true

the Joneses’ claim that they never received a copy of the insurance policy.

Even so, the Joneses acknowledge that they had received documents from

Allstate regarding the issuance of insurance coverage, the amounts of

coverage, renewal notices, and premium notices. These documents constituted

notice to the Joneses that an insurance policy was in effect, and the November

15, 1988 denial of claim letter was further notice to the Joneses that they

should obtain a copy of the policy. Moreover, the Joneses’ attorney did in fact

receive a copy of the policy with adequate time to file the action within the

one-year period, but he failed to meet the deadline. Finally, the Joneses have

made no claim that Allstate intentionally prevented their knowledge of the

policy provision placing a one-year time period for commencing suit on the

policy, or that Allstate engaged in other misconduct that might estop

application of the contractual provision. We hold that the Joneses’ failure to

comply with the policy provision now bars their claim.

Jones, 1994 WL 677676, at *2-3.

We find the reasoning of the Sixth Circuit’s decision in Jones more persuasive on the

question at hand, especially where the plaintiff has already accepted payments of benefits as

a third party beneficiary of the policy. See Benton v. Vanderbilt Univ., 137 S.W.3d 614, 618

(Tenn. 2004) (quoting United States Fid. & Guar. Co. v. Elam, 278 S.W.2d 693, 702 (Tenn.

1955) (“‘Before the beneficiary may accept the benefits of the contract, he must accept all

of its implied, as well as express, obligations. . . . [I]f the beneficiary accepts, he adopts the

bad as well as the good, the burden as well as the benefit.’”). Here, it is undisputed that

Fortune knew the policy governing his claim existed, that he accepted benefits under the

terms of the policy for two years prior to denial, and that he received inquiry notice through

the denial of claim letter that he should obtain a copy of his policy if he or his attorney did

not already have one. These undisputed facts are sufficient in our opinion to warrant

-10-

summary judgment where the plaintiff has not alleged that the insurance company withheld

a copy of the policy or obstructed his ability to learn of its contents.5 Unlike Jackson, there

has been no suggestion that the insurance company failed to provide the plaintiff with a copy

of the policy, failed to respond timely to a request for a copy of the policy, or otherwise

impeded the plaintiff’s ability to learn of the policy’s provisions. Unum is therefore entitled

to summary judgment on the breach of contract issue if we accept its contention that

Fortune’s cause of action accrued in October 2001.

The Trustee submits that the reassessment process revived Fortune’s claim, renewed

his insurance policy, or otherwise constituted a new policy of insurance such that the breach

of contract action did not accrue until the Claim Reassessment Unit concluded its review in

April 2006.6 The RSA, the conditional waiver and release, and the parties’ correspondence,

however, collectively indicate that the RSA was an optional process that did not create any

new rights in the claimant beyond the right to seek reassessment. The RSA, for example,

expressly states that the “purpose of the Claim Reassessment Process provided for under this

Agreement is to offer an entirely optional method for claimants who wish to have their

claims reassessed under these procedures,” that “[n]either this Agreement nor any of the

relief to be offered under this Agreement shall be interpreted to alter in any way the

contractual terms of any policy, or to constitute a novation of any policy,” and that “to the

extent that following the reassessment there remains a complete or partial denial of benefits,

a claimant’s right to initiate or continue litigation regarding that portion of the prior denial

. . . shall not be waived.” Similarly, the conditional waiver and release expressly provided

that the reassessment process would “not revive or reinitiate the statute of limitations with

respect to the previous claim decision.” As Unum persuasively explains in its brief,

[T]he RSA did not create a claim process that would result in “new” claims.

If a participant’s claim remained viable - i.e., the limitations period remained

open - then the limitations period was expressly tolled to allow time for Unum

Life to complete its reassessment before a claimant need file suit related to the

claim denial. If, however, the limitations period had run on a claim, no

“revival” of the claim could occur. In this case, all periods of limitations had

expired by October 2004 - before the RSA was even finalized and

5

We express no opinion on whether a different rule should apply if a plaintiff alleges that an

insurance company impeded his or her ability to obtain a copy of the relevant policy or learn of its contents.

6

The Trustee has not argued that Unum breached the RSA or that Fortune is entitled to enforce its

terms. See MacLennan v. Provident Life & Acc. Ins. Co., 676 F. Supp. 2d 57, 68 (D. Conn. 2009) (applying

Tennessee law and finding disputed issues of material fact concerning whether an insurance company had

violated the terms of the RSA).

-11-

implemented, before Fortune opted into the process, and long before his claim

was reassessed. By the time the reassessment process had begun, there was no

then-pending limitations period to toll. The RSA cannot be read to revive

expired statutes of limitations or to create new claims for plaintiffs who had

already failed to timely assert their rights.

We agree and find that Unum has alleged undisputed facts demonstrating that the

reassessment did not revive Fortune’s claim, renew his policy, or constitute a new policy of

insurance.

The decision of the United States District Court for the Western District of Tennessee

in Lindsey v. Allstate Insurance Co., 34 F. Supp. 2d. 636 (W.D. Tenn. 1999), is inapposite.

In Lindsey, the district court declined to dismiss a claim for breach of contract as time-barred

where (1) it was possible that the policy at issue was renewed within six years of the filing

of suit, and (2) the contractual allegations also extended to a policy that remained in effect

at the time of the decision. Lindsey, 34 F. Supp. 2d. at 650. The district court explained that

“[a]lthough a renewal of an insurance contract may be routine and require very little

negotiation, a renewal does contain the essential elements of a contract: offer, acceptance and

consideration.” Id. The undisputed facts, however, show that neither the RSA nor the

correspondence between the parties contained the essential elements of a contract required

to renew the policy. And the Trustee’s brief contains absolutely no explanation of how this

Court could reach a contrary conclusion. Accordingly, we find that Fortune’s cause of action

for breach of contract accrued at the very latest in October 2001 when Unum terminated his

benefits by letter.7 See Transcarriers, 107 S.W.3d at 499-500 (finding that a “contractual

statute of limitations begins to run upon denial of liability or upon expiration of the immunity

period, whichever comes first”). Because Fortune filed suit well beyond the policy’s agreed

limitations period of three years, the trial court’s grant of summary judgment on the breach

of contract issue is affirmed.

The next question before this Court is whether Unum is also entitled to summary

judgment on Fortune’s statutory and tort claims.8 The TCPA provides that a private action

for damages resulting from unlawful or deceptive acts or practices “shall be brought within

one (1) year from a person’s discovery of the unlawful act or practice.” Tenn. Code Ann. §

7

We are not asked to determine whether Fortune’s claim actually accrued prior to this date under the

terms of the contract.

8

Although the Trustee’s brief once mentions Fortune’s “bad faith” claim, it does not contain an

argument supported by citations to authority or citations to the record to demonstrate that the trial court erred

when it granted summary judgment on this issue. The issue is therefore waived. See Sneed v. Board of

Professional Responsibility of Supreme Court, 301 S.W.3d 603, 615 (Tenn. 2010).

-12-

47-18-110 (Supp. 2009). Tennessee Code Annotated section 28-3-105, which the parties

agree governs Fortune’s allegations of fraud and misrepresentation, provides that an action

for injuries to real or personal property must be commenced within three years of accrual.

Tenn. Code Ann. § 28-3-105(1) (2000). Here, it is undisputed that Fortune filed his

complaint more than three years after the initial termination of his claim for continued

benefits. The Trustee nevertheless contends that a question of fact exists about when Fortune

discovered his causes of action, citing a sworn affidavit that states Fortune “became aware

that the Defendants had improperly denied [his] claim for long term disability benefits within

one year of suit being filed.” The Trustee accordingly argues that the applicable limitations

periods were tolled under the discovery rule and, thus, his statutory and tort actions did not

accrue in October 2001. We disagree. Although Fortune’s affidavit creates a factual dispute

concerning his actual, subjective discovery of Unum’s alleged wrongful conduct, the

resolution of this dispute is immaterial because Fortune was aware of sufficient facts to put

a reasonable person on notice that he had suffered injury or damages when Unum denied his

claim.

This Court considered and rejected a nearly identical argument under the TCPA in

Schmank v. Sonic Automotive, Inc., No. E2007-01857-COA-R3-CV, 2008 WL 2078076

(Tenn. Ct. App. May 16, 2008). The consumer in Schmank filed suit against an automobile

dealer, its owner, and the Automobile Protection Corporation alleging that the defendants

violated the TCPA by “stuffing” a worthless product, an anti-theft system and warranty, into

two separate vehicle sales agreements. Schmank, 2008 WL 2078076, at *1. The defendants

responded in part that the TCPA’s one-year statute of limitations barred the consumer’s

claim. Id. at *1. The trial court agreed and granted the defendants’ motion to dismiss

“‘primarily, on the statute of limitations issue as to each purchase and, secondarily, on the

issue of failure to state a claim under the Tennessee Consumer Protection Act.’” Id. at *2.

The consumer appealed.

This Court described the determinative issue on appeal as follows:

Whether the trial court erred in granting the Defendants’ motion to dismiss on

grounds that Plaintiff’s claims were barred by the statute of limitations when

the complaint was filed within a year of the time that Plaintiff asserted that she

discovered her injury.

Id. In answering this question in the negative, we first acknowledged that “the Tennessee

legislature has determined that a plaintiff’s TCPA claim accrues at time of the ‘discovery of

the unlawful act or practice,’ thereby making applicable the ‘discovery rule’ first applied over

thirty years ago in Teeters v. Currey, 518 S.W.2d 512 (Tenn. 1974).” Schmank, 2008 WL

2078076, at *2 (citations omitted). We then quoted Pero's Steak and Spaghetti House v. Lee,

-13-

90 S.W.3d 614 (Tenn. 2002), which restated the discovery rule thus:

“It is now well-established that, where applicable, the discovery rule is an

equitable exception that tolls the running of the statute of limitations until the

plaintiff knows, or in the exercise of reasonable care and diligence, should

know that an injury has been sustained. Quality Auto Parts Co. Inc., 876

S.W.2d [818,] at 820 [Tenn. 1994]. The discovery rule does not, however, toll

the statute of limitations until the plaintiff actually knows that he or she has a

cause of action. The plaintiff is deemed to have discovered the right of action

when the plaintiff becomes aware of facts sufficient to put a reasonable person

on notice that he or she has suffered an injury as a result of the defendant's

wrongful conduct. Shadrick v. Coker, 963 S.W.2d 726, 733 (Tenn. 1998); Roe

v. Jefferson, 875 S.W.2d 653, 657 (Tenn. 1994).”

Schmank, 2008 WL 2078076, at *2-3 (quoting Lee, 90 S.W.3d at 621). This Court

acknowledged that the question of “[w]hether the plaintiff exercised reasonable care and

diligence in discovering the injury or wrong is usually a fact question for the jury to

determine.” Id. (quoting Wyatt v. A-Best Co., 910 S.W.2d 851, 854 (Tenn. 1995) (citing

McIntosh v. Blanton, 164 S.W.3d 584, 586 (Tenn. Ct. App. 2004)). We went on to state,

however, that

where the undisputed facts demonstrate that no reasonable trier of fact could

conclude that a plaintiff did not know, or in the exercise of reasonable care and

diligence should not have known, that he or she was injured as a result of the

defendant's wrongful conduct, Tennessee case law has established that

judgment on the pleadings or dismissal of the complaint is appropriate.

Id. (citing Stanbury v. Bacardi, 953 S.W.2d 671, 677-78 (Tenn. 1997); Roe v. Jefferson, 875

S.W.2d 653, 658 (Tenn. 1994); Brandt v. McCord, No. M2007-00312-COA-R3-CV, 2008

WL 820533, at *4 (Tenn. Ct. App. Mar. 26, 2008)). After reviewing the allegations of the

complaint, we held that the consumer in Schmank had failed to timely bring her action for

violation of the TCPA because “all of the facts sufficient to put a reasonable person on notice

that she had suffered injury resulting from the Defendants’ allegedly wrongful conduct were

known or readily available to [the consumer] at the time she entered into the agreement to

purchase her vehicles.” Id. at *3. After rejecting the consumer’s claim for fraudulent

concealment, we affirmed the dismissal of the action. Id. at *5.

Unum argues that we should reach a similar conclusion here, submitting that Fortune’s

cause of action for violation of the TCPA accrued when Unum denied his claim for

continued long term disability benefits in October 2001. Unum argues that Fortune was

-14-

indisputably aware of sufficient facts in October 2001 to place a reasonable person on notice

that his injury or damages resulted from Unum’s alleged unlawful conduct. Unum maintains

that it matters not whether Fortune knew the specific type of legal claim he had or that the

injury resulted from an unfair or deceptive act or practice under the TCPA. See John Kohl

& Co. P.C. v. Dearborn & Ewing, 977 S.W.2d 528, 533 (Tenn. 1998) (citing Shadrick v.

Coker, 963 S.W.2d 726, 733 (Tenn. 1998) (“[T]here is no requirement that the plaintiff

actually know the specific type of legal claim he or she has, or that the injury constituted a

breach of the appropriate legal standard.”). According to Unum, “[t]he only relevant fact for

purposes of applying the statute of limitations is when Fortune became aware that his claim

had been denied, and that fact is indisputable: Fortune became aware of the claim denial in

October 2001, five years before he filed his belated lawsuit.” We agree and hold that the

undisputed facts demonstrate that Fortune, with the exercise of reasonable care and diligence,

should have discovered that he suffered injuries or incurred damages as a result of Unum’s

alleged wrongful denial of disability benefits in October 2001. Further, we hold that the

same reasoning supports the grant of summary judgment on Fortune’s remaining tort claims.

See Potts v. Celotex Corp., 796 S.W.2d 678, 680 (Tenn. 1990) (citations omitted) (“Under

the “discovery rule” applicable in tort actions . . . the cause of action accrues and the statute

of limitations begins to run when the injury occurs or is discovered, or when in the exercise

of reasonable care and diligence, it should have been discovered.”). The trial court’s grant

of summary judgment on Fortune’s statutory and tort claims is affirmed.

The remaining issues discussed in the appellant’s brief are without merit. The Trustee

submits that summary judgment is inappropriate because a genuine issue of material fact

exists concerning whether Fortune was of unsound mind when Unum terminated his

disability claim. Tennessee Code Annotated section 28-1-106 states:

If the person entitled to commence an action is, at the time the cause of action

accrued, either within the age of eighteen (18) years, or of unsound mind, such

person, or such person’s representatives and privies, as the case may be, may

commence the action, after the removal of such disability, within the time of

limitation for the particular cause of action, unless it exceeds three (3) years,

and in that case within three (3) years from the removal of such disability.

Tenn. Code Ann. § 28-1-106 (2000). The Trustee, however, did not allege unsoundness of

mind as a basis for tolling the limitations periods and or raise this argument before the trial

court. It is therefore not properly before this Court on appeal. See Fayne v. Vincent, 301

S.W.3d 162, 171 (Tenn. 2009) (citations omitted) (acknowledging the “continuing vitality

and validity of the principle that parties will not be permitted to raise issues on appeal that

they did not first raise in the trial court” and further holding that “the party invoking this

principle has the burden of demonstrating that the issue sought to be precluded was, in fact,

-15-

not raised in the trial court”).

The Trustee’s brief also contains bare assertions that Unum should be equitably

estopped from alleging the applicable limitations periods as affirmative defenses and that this

Court should not consider information contained in or attached to the sworn affidavit of

Sharon Haas. These “arguments,” however, are wholly unsupported by citation to authority

in support of the appellant’s positions. Equally absent from these abbreviated “arguments”

is any attempt to explain how the elements of equitable estoppel are satisfied or why the

affidavit of Sharon Haas is inadmissible. These perfunctory “arguments” are insufficient to

warrant this Court’s attention on appeal and are therefore waived. See Bean v. Bean, 40

S.W.3d 52, 55-56 (Tenn. Ct. App. 2000) (citations omitted). The same is true for the

Trustee’s brief “argument” on the question of fraudulent concealment, which cites authority

but nonetheless contains no explanation of how the doctrine is applicable under the

undisputed facts, and its “argument” on the admissibility of Mona Bombassi’s affidavit,

which simply asserts that she was not an employee and/or keeper of the records of Unum Life

Insurance Company. Further, even if the Trustee’s conclusory statements regarding the

inadmissibility of Mona Bombassi’s affidavit constituted an argument, no issue was raised

on this basis before the trial court.

In conclusion, we find that Unum is entitled to summary judgment on each of

Fortune’s causes of action. It is undisputed that Unum notified Fortune’s prior attorney in

October 2001—notice that is imputed to Fortune as a result of the attorney-client

relationship, see Winstead v. First Tennessee Bank N.A., Memphis, 709 S.W.2d 627, 632-33

(Tenn. Ct. App. 1986) (citations omitted)—that Fortune’s claim for continued benefits was

terminated. To the extent Fortune stated he did not actually learn of the alleged unlawful,

unfair, or deceptive practices of Unum in 2001, the undisputed facts show that he should

have known in the exercise of reasonable care and diligence that he had sustained injuries

or damages when Unum denied his claim. Fortune nevertheless did not file suit until October

2006, well beyond the expiration of the controlling limitations periods. We therefore hold

that the trial court properly granted summary judgment in favor of Unum.

V. Conclusion

For the foregoing reasons, we affirm the decision of the trial court. Costs of this

appeal are taxed to the appellant, Bettye Bedwell as bankruptcy trustee, and her surety for

which execution may issue if necessary.

_________________________________

DAVID R. FARMER, JUDGE

-16-

This is a copy of a public record, reproduced as it was published. It is not legal advice, and it may not be the version a court would rely on. Check the official source before you cite it.

A word about cookies

We need a few to keep you signed in and the library working. The rest help us see which pages people use and where they get stuck. They stay off unless you say yes.