SAR

AH L. T HOR P E,

P la in t if f,
v. BANNER LIF E INSURANCE CO.,

Defendan t. UNITED STAT ES DIS TRICT COURT F OR THE D ISTRIC T OF CO LU M BIA

Ci vi l A cti on 08 -00 17 0 (H HK)

M EM OR

AN DU M OP IN ION AN D O RD ER Sara h L . T ho rp e (“ Th or

pe ” ), a lif e ins ur anc e po lic y

be ne fi c iary , b ri ng s th is a c tio n a g a ins t Ba nner L ife Insuranc e Company (“B anner ”) a lleg ing that Ba nner br eac hed its contrac t with Peter Boy le (“ Boy le”) , the holder of

life insuranc e policy

number 17B 758759 (the “ Policy ”) by ref using to pa

y benef its under the Policy

to Thorpe. Thor

pe also a lleg es a tort c ause of action based on B anner ’s re fusal to pay . Thorpe se eks a de clar atory judgme nt that the life insuranc e policy issued to Boyle is valid, and also see ks to recove r compe nsatory and punitive damag es for Ba nner’ s alleg ed bre ach of

contra ct and tortious re fusal to pay under the Policy
. Be fore the Court is Banne r’s motion for summary judgme nt [ #25]. Upon consideration of the motion, the opposition thereto, and the r ecor d of this case , the Court conclude s that the mot ion mus t be GR

AN TE D i n p art

and DENI ED in p art . I. BACKG ROUND I n M ay 20 04 , B oyle a

pp lie d f or a lif e ins ur anc e po lic y

wi th B ann e r. B oyle fi lle d o ut a
numbe r o f f

or ms, (c oll e c tiv e ly , th e “ Ap pli c a tio n” ), that r e qu e ste d in fo rm a tio n a bo ut B oyle ’s state of hea lth. Boyle’s re prese ntations on the Medical Examiner’s Repor t, Part I Iof the Application2

(“Par t I I ”) a re of particula r importance to this case. Part I Iasked B oyle to answe r a numbe r of questions reg ardinghis medical history and cur rent state of

health. Part I Iconsists of the front and bac k of a sing le pag e. At the top of the front pag e, Part I Istates, “All YES answe rs re quire fu ll d e ta ils .” (D e f. ’s Mo t. S umm . J., Ex. 1 to E x. A. ) T he ba c k p a g e of Part I Ire qu e ste d d e ta ils in c onne c tio n w iththe ins ur e d’ s ans we rs on the fr on t pa g e , a sk ingthe ins ur e d to “ [g ]ive fu ll details for e ach que stion answere d YES, including date, nature of illness or injury , number of
a tta c ks , d ur a tio n, se ve ri ty , tr e a tme nt, re su lts , n a me , a dd re ss a nd te le ph on e numbe r o f d oc tor s, hospitals or clinics involved.” ( Id. ) F inally , Part I Irequire d Boy le to attest that “to the be st of [hi s] knowledge and belief , the answe rs re corde d here in are true a nd complete” by

signingthe back pa g e of Par

t I I . ( Id. ) I n September 2004, B anner issued Boy

le the Policy

insuring B oyle’s life f

or $1 million. Boy le named T horpe a s his benefic iary upon his death. B oyle died on January 3, 2006. The autopsy indicated that he died of c ardiova scular dise ase. Thor pe notified B anner

of B oyle’s death a nd submitt ed a c laim to Banne r for pay ment acc ording to the Policy . Upon lear ning of Boy le’s death, Ba

nner initiated a

n investigation into Boy le’s medica l history pursuant to the terms of the Policy , which per mitted Banne r to contest the Policy if the insured die d within two y ear s of the issuance of the Policy
. Ba nner’ s investigation revea led that B oyle filled pre scriptions for a varie ty of medications in the five-year

period prior

to applying f

or the Policy

and the time betwe en apply ing f or and beingissued the Policy . Boy le filled pre scriptions for pa in killers, including Vic odin, Percoc et and Oxy contin, as we ll as muscle re laxants, antidepressants, and slee p aids. Boy le did not reve al the se pr e sc ri pti on s o n h is A pp lic a tio n. At

le a st e ig ht d if

fe re nt d oc tor s p re sc ri be d th e seUnder Fe dera l Rule of Civil Procedur e 56, summary judgme nt shall be g rante d if the 1 pleading s, depositions, answers to interr og atories, a dmissions on file and a ffidavits show that the re is n o g e nu ine iss ue of mate ri a l f

a c t in dis pute and

tha t th e mov ingpa

rt y is e nti tle d to judgme nt as a matter

of law. F ed. R. Civ. P. 56(c). Mater ial fac ts are those “that mig ht affe ct the outcome of the suit under the g overninglaw.” Anderson v. Liberty Lobby, I nc. , 477 U.S. 242, 24 8 ( 19 86 ). I n c on sid e ri nga mot ion fo r s umm ary

jud g me nt, the “ e vid e nc e of the no n- mov ant i s to be believe d, and all justifiable infe renc es ar e to be dr awn in his favor .” Id . at 255. The nonmoving pa

rty ’s opposition must consist of more than me re unsuppor ted alleg ations or denials a nd must be supported by

aff idavits or other c ompetent evidenc e setting forth spec ific fa cts showing that there is a g enuine issue f or trial. F e d. R. C iv. P. 5 6( e ); Ce lote xCor p. v . Ca tre tt , 4 77 U. S. 31 7, 32 3- 24 (1 98 6) . T he no n- mov ingpa rt y is “ re qu ir e d to pr ov ide e vid e nc e tha t w ou ld p e rm it a rea sonable jury

to find” in its favor. Laningham v. U.S. Navy , 813 F.2d 1236, 1242 ( D.C. Cir. 1987). I f the e vidence is “mere ly colora ble” or “not sig nificantly

probative,” summary

judgme nt may be g rante d. Anderson , 477 U.S. at 249-50. 3 medications for

Boy le; the doctors state d they wer e unaw are that Boy

le was r ece iving presc riptions for other me dications from other doctors. In a letter

dated F ebrua

ry 2, 2007, Ba nner de nied issuance of bene fits under the Policy and re scinded the Policy on the g rounds that Ba nner w ould not have issued the Policy had B oyle re prese nted his true medica l history in the Application. II. AN AL YSI S Ba nner move s for summary

judgme nt on all of Thorpe ’s claims. First, B anner alleg es 1 that Boy le’s misrepr esentations on the Application were false a nd materia l to Banne r. Second, Ba nner a rgues that the Policy

never took effe ct bec ause B oyle fa iled to meet a c ondition prec edent; ther efor e, B anner could neve r have brea ched its contra ct with Boy le by failing to pay benef its under the Policy . Finally , Ba nner a sserts that its alleg ed fa ilure to pay under the Policy does not assume the c hara cter of a tort, a

nd there fore Thorpe c annot re cover on her a sserted tort
cause of ac tion. Thorpe re joins that Banne r wa ived its right to conduc t an investig ation fo llo wi ngB oyle ’s de a th a nd that th e c ourt

c ann ot r e sc ind

the Pol ic y

or de c lare it i nv a lid

a s aOther c ases state that under D istrict of Columbia choice of law rule s, the jurisdiction 2 with the most significa

nt interest in insurance case s is “either the place of the oc curr ence that require s cover ag e or the insured’s he adquar ters.” Nat ion wid

e Mu t. I ns . Co . v . Na t’ l REO

Mg mt
. Inc. , 205 F.R.D. 1, 9 (D .D.C. 2000). Her e, the insure d’s “he adquar ters” is the D istrict of Columbi a bec ause that is where B oyle re sided. Ther efor e, District of Columbia law still applies un de r t his te st. 4 matter of la

w. Thorpe further

argues that she may

maintain her tort c laim. The Court addre sses
eac h argument in turn. A. Choice of Law The pa rties disag ree as to which lawshould apply to this case. B anner

argues that Maryland law a

pplies beca

use the Policy

was issued pursua

nt to an application for

m approve d for
us e in M ary

land and be c a us e Part Iof the Ap pli c a tio n w a s si g ne d in Ma ry land . B ann e r c on te nd s, ho we ve r, tha

t Ma ry land and Di str ic t of

Col umb ia

law a re su bs tanti a lly

sim ila r a nd that B ann e r i s entitled to summary

judgme nt under e ither jurisdiction’s law. Thor pe re joins that District of Columbi a law should a

pply beca use the Policy

was de livered in the D istrict of Columbia. The Court ag ree s with Thorpe. W h e nd e c i d i n g s t a t e l aw c l a i m s i nf e d e r a l c o u rtw h e r e j u r i s d i c t i o ni s b a s e d o nd i v e r s i t y, the cour t “‘a ppl[ ies] the choice- of-law rules of the jurisdiction in which’” it sits. Nnadili v. Chevron USA, I

nc. , 4 3 5 F. S u

p p . 2 d 9 3 , 9 7 (D
. D. C
. 2 0 0 6 ) ( qu o t i n g Ideal Elec . Sec. Co. v . Int’l Fid. Ins. Co. , 129 F.3d 143, 148 ( D.C. Cir. 1997)). Unde r the c hoice of law rule s in the District of Columbia, insurance contra cts are g overne d by the substantive law of

the state in which the policy is delivered. Liberty Mut. Ins. Co. v. Travelers I ndem. Co. , 78 F.3d 639, 642 ( D.C. Cir. 1996). He re, the policy

was de livered to B oyle in the District of Columbia on September 14, 2004. (Compl. ¶ 15.) Ther efor e, District of Columbia substantive law a pplies to this case. 25

B. Thor pe ’s Br e ac h of C ont r ac t C lai m Ba nner a rgues that Thorpe ’s bre ach of contra ct claim must fail bec ause B anner was entitled to rescind the Policy and, in the alter

native, the Policy

was ne ver va lid. Thorpe disag ree s and fur ther a rgues that B anner

waived is rig ht to conduct an investig ation following Boy le’s death in the f

irst place. 1. Bann e r D id N

ot W aiv eits Rig

ht to Cond

uc t an Inv esti

ga tio n. As an initial matter, the c ourt conc ludes that Ba nner did not wa ive its right to conduc t the inv e sti g a tio n. Th or

pe argue s th a t B ann e r w a ive d it s r ig ht t o v oid the Pol ic y

be c a us e it f a ile d to conduct more than a c ursory investigation at the time Boyle applied f or the Policy . Thorpe fu rt he r a lle g e s th a t B ann e r s ho uld have re qu e ste d th e me dic a l r e c or ds of Dr . E lio n, wh o B oyle listed on a document not par t of the for

mal Application, bef

ore issuing the Policy . Ba nner rejoins that none of

Boy le’s re prese ntations placed B anner on notice that he w as takingthe presc ription medications that Ba nner a sserts would have been material to its decision to issue the Pol ic y . B ann e r i s c or

re c t. An insurer

has a r ight to re ly

on the insured’ s statements in an insuranc e application. Burlington Ins. Co. , 398 F. Supp. 2d at 157. An insure r is also entitled to truthful responses on the insured’ s application. Id. Only wher e the insure r has a ctual knowledg e of a ny misrepre sentation at the time of a pplication does it waive its rig ht to conduct an investig ation. For example, in Saxe , the insuranc e ag ent had a ctual knowledg e that the a pplicant was hospitaliz ed, eve n though the hospitaliz ation was not re prese nted on the application. 134 F.2d at 31. Although the ag ent fa iled to inform the main offic e of the hospitaliz ation, the insurer was char g ed with ac tual notice of the hospitaliz ation and ther efor e wa ived its right to re scind a policy6

based on this information. Id. ; see also Gov ’t Employe es Ins. Co. v. Gov an , 451 A.2d 884, 886 (D.C. 1982) (f

inding that whe re insure r had a ctual knowledg e that the insure d had mis re pr e se nte d h e r d

ri vin g re c or d at th e tim e of a pp lic a tio n, the ins ur e r w a ive d a ny ri g ht t o v oid the policy on the g rounds of that misrepr esentation). Her e, ther e is no undisputed evidenc e that B anner had ac tual knowledg e of B oyle’s presc ription medication use at the time of Boy le’s Application. Moreover , there is no evidence that even if

Ba nner ha d reque sted the medica l rec ords of Dr . Elion, it would have lear ned of the full ext ent of B oyle’s pre scription medication use. The ref ore, the Court finds that Ba nner did not waive its rig ht to conduct an investig ation within the contestability period. 2. The

Cour t Ca nnot Conc lud etha t Ba nne r Wa s Ent

itl e d to Re sc ind the Po lic y as a M att e r o f L aw. Ba nner c ontends that Boy

le misrepre sented his state of he alth on the Application by not disclosing his consultations with various doctors a nd his prescr iption medication use. Ba nner contends these omissions wer e mater ial: had B anner known about these consultations and Boy le’s pre scription medication use, it would not have issued the Policy to Boyle. Ther efor e, Ba nner a sserts that it was entitled to resc ind the Policy and thus not require d to pay out the Policy ’s bene fits to Thorpe. Thorpe rejoins that B anner has not proven that Boyle’s alleg ed mis re pr e se ntatio ns we re fa lse a s a matte r o f l aw o r t

hat th e mis re pr e se ntatio ns we re mate ri a l to Ba nner. An ins ur anc e po lic y

may be re sc ind e d und e r D ist

ri c t of Col umb ia

law p ur su ant t o D .C. Cod e § 3 1- 43 14 (2 00 3) . T he sta tut e pr ov ide s: The fa lsity

of a state ment in the application of a ny policy of insuranc e shall not bar the ri g ht t o r e c ov e ry

the re un de r u

nle ss s uc h f

a lse sta te me nt w a s ma de wi th i nte nt t oMaryland has e nacte d a substantially simil ar statute. See Md. Code Ann., Ins. § 12-207. 3 D.C. Code § 31-4703 provides, in pe rtinent part, “ no statements by the insured sha ll be 4 used in defe nse of a

claim under

the policy

unless the statements ar e in a wr itten application and a copy of the stateme nts are e ndorsed upon or attache d to the policy

when issued.” D.C. Code § 31-4703(a )(3) (A)( iii). Maryland has e nacte d a similar statute: “Unle ss a copy of the a pplication for the issuanc e of a

life insuranc e . . . policy

. . . is attache d to or otherwise made a part of the policy or contra ct when issued the application is not admissible in evidence in a proc eeding relating to the policy

or contra ct.” M.D. Code A nn., I ns. § 12-206(a )(2) . Although the parties dis c us s a lle g e dly

fa lse state me nts that B oyle ma de on do c ume nts he c omp le te d w ithhis Application, including the Non-Me dical De clar ations which B anner admitted are not part of the Application or Policy , some of these documents we re not include d with the Policy at the time of iss ua nc e . T he re fo re , th e Court wi ll o nly c on sid e r t

he sp e c if ic re sp on se s th a t w e re inc lud e d w ith the Policy at the time of issuanc e, as la id out in Ex hibit 1 to Ex hibit A appended to B anner ’s Motion for Summary

J udg ment. 7 dece ive or unless it materia lly aff ecte d either the acc eptanc e of the risk or the ha zard a s s u m e d b y t h e c o mp an y. 3 A f a lse state me nt b ars pa

y me nt u nd e r t he po lic y if the state me nt w a s ma de wi th t he int e nt t o dece ive or if it mater ially aff ecte d the insurer ’s ac cepta nce of the risk. J

oh ns on v . Pru de nti al I

ns . Co. of Am. , 589 F. Supp. 30, 33 (D.D .C. 1983). Fa lsity and mater iality

may be questions of law
or qu e sti on s o f f

a c t, d e pe nd ingon

the c ir c ums tanc e s. Prudential Ins. Co. of Am. v. Saxe , 134 F.2d 16, 25 ( D.C. Cir. 1943). Ba nner a lleg es that some of B oyle’s re sponses to specific questions in the Application are false a s a matter of

law. Thorpe r ejoins that the truth of B oyle’s stateme nts present a jury 4 question, as the Court should not make cr edibility choice s as a matter

of law when B oyle attested that his answer s were true to the be st of his knowledg e and be lief. F ur the rm or e , B ann e r c on te nd s th a t a ll o f B oyle ’s a lle g e dly fa lse a ns we rs we re mate ri a l to Ba nner; ha d Ba

nner known the true a

nswers, it would not have issued Boy le the Policy . Thorpe rejoins that B oyle’s alleg ed pre scription druguse and ba ck pain we re immater ial to Ba nnerBa nner w as aw are of some medica tion Boyle had take n beca use on the Non- Medica l 5 Dec laration form, not included in the Policy , Boy le disclosed that he ha d taken Cele x a for three months
. 8 beca use its underwr iters testified that they do not investigate pre scription druguse and B anner ’s Under writing Criteria a

nd Requirements Manua l (“Unde rwritingManual” ) does not re commend denying a n application bec ause of

back pa in. A fa lse statement is materia l if it “conce rns a matter which would re asonably

cause the insurer to c onsider either

not issuing the policy

beca use of incr ease d risk, or issuing the policy with an incre ased pr emium.” Burlington Ins. Co. v. Okie Dok ie, Inc
. , 398 F. Supp. 2d 147, 156 (D.D.C. 2005) ( internal c itation and quotation marks omitted). In other wor ds, a fa lse statement is material if it aff

ects the insure r’s de cision as to whether and at what rate to insure the individual. Johnson , 589 F. Supp. at 34. Th e Court

wi ll a dd re ss e a c h a lle g e dly

fa lse ans we r i n th e Ap pli c a tio n a nd its mate ri a lity in turn.
a. Question 5(c) Question 5(c) on Part I Iof the Application asked, “Within the past 5 y ear s, have you: taken a ny medication? ” B oyle marke d the box “y es.” ( Def .’s Mot. Summ . J ., Ex . 1 to Ex . A.) As explained in Section I , su pra , th e Ap pli c a tio n r e qu ir e d a ny ans we r o f “ y e s” to b e e xpla ine d in f u l l d e t a i l , i n c l u d i n g t h e “ d a t e , n a tu r e o f i l l n e s s o r i n j u r y, nu mb e r

o f a t t a c k s , d

u r a t i o n , s e v e r i t y, treatment, results, name, a ddress a nd telephone numbe r of doc tors, hospitals, or clinics involved.” (

Id. ) B oyle did not list any medications on the Application where space was provided. Boy

le sig ned Part I Iof the Application, attesting “ to the best of [his] knowledg e and 5 belief, the answe rs provided he rein a re true and complete .” (

Id. ) B anner

contends that B oyle’s9

answe r is false a s a matter of law bec ause B anner ’s investig ation reve aled that B oyle filled many presc riptions for a va

riety of medications, including pain killers, muscle r elaxers, sleep a ids, and antidepre ssants, within the five y ear s prec edinghis application for the Policy . For example, Ba nner’ s investiga

tion revea led that B oyle filled a pr escr iption for Diazapam ten da y s befor e he signe d the Application on which he decla red his answ ers we re true and complete
. Th or pe argue s th a t B oyle ’s re sp on se s c ann ot b e fa lse a s a matte r o f l aw b e c a

us e B oyle attested the a

nswers w ere true to his knowledg e and be lief, so the Court must apply a subjec tive test into Boyle’s state of

mind, which is inappropriate at the summary judgme nt stag e. Thorpe relies on Sk

inn e r v . A e tna Life& Cas

. , 804 F.2d 148 ( D.C. Cir. 1986), but this case does not stand direc tly

for this proposition. I n Skinner , the D.C. Circuit held that the appr opriate te st for deter mining whe ther a

n insured’s a

nswers a re true or fa lse when the insured atteste d the answe rs
are true to his knowledg e and be lief is twofold: “whe ther in fa ct the insured be lieved his answe r to be true, a

nd if so, whether

that belief c an be r econc iled with the fac ts within hi s knowledg e.” Id. at 149. In Skinner , the cour t found the insured’ s answer s failed that test whe re he repr esente d
on his a pp lic a tio n h e ha d n e ve r b e e n tr e a te d f or any sic kn e ss, dis e a se or

inj ur y wi thi n th e pa st five y ear s, but his medical history reve aled that he had re peate dly soug ht medical assistanc e for chest pa ins and breathing diff iculties. The cour

t ag ree d with the insured that attestingone’s own
answe rs ar e made to the best of his knowledg e and be lief cr eate s a subjective te st, but reasone d that on e ’s ow n k

no wl e dg e and

be lie f i s n ot s o s ub

je c tiv e that it

c an n e ve r b e fo un d f

a lse a s a matter of la

w. The insure d’s re prese nted belief is viewed in the lig ht most favorable to him, but

“ on ly so fa r a s th a t be lie f i s n ot c le arl y c on tr a dic te d b y

the fa c tua l kn ow le dg e on wh ic h it is based.” Id. Thus, wher e the “ inesca pable implications” of f

actua l knowledg e cle arly

contra dict10

the insured’ s repr esente d knowledg e and be lief, the Court ca n deter mine falsity

as a matter of law. The re cord pr ovides sufficie nt evidence to determine that Boyle’s answ er to Que stion 5(c) is f a lse a s a matte r o f l aw. B oyle ans we re d h e too k p re sc ri pti on me dic a tio n b ut f

a ile d to dis c los e f u l l an d c o mp l e t e d e t a i l s . T h e r e c o r d i n d i c a t e s B o yl e f

i l l e d a p r e s c r i p t i o nf

o r D i a z a p a mt e nd ays befor e he sig ned the Application and decla red his answ ers we re true and complete . Thorpe contends that B oyle’s answ er to Que stion 5(c) is not false be cause he answ ere d in the aff irmative, but Boy

le did not provide full and c omplete details to his affir mative answe r as require d by

the Application. The pharma cy rec ords show that B oyle filled dozens of pr e sc ri pti on s w ith in t

he fi ve y e a

rs pr e c e din g his Ap pli c a tio n th a t w e re ne ve r d isc los e d o n h is Application. The Court ne ed not assume that he took those presc riptions, as Thorpe attested that Boy le sometimes used medication to treat his pain and help him sleep. A s in Skinner , wher e the uncontra dicted fa ctual knowledg e contr avene d the insured’ s attested knowledg e and be lief, 804 F .2 d at 14 9, the re c or d h e re c le a rl y c on tr a dic ts B oyle ’s re pr e se ntatio n th a t hi s a ns we r w a s f

ull
and c omp le te . T he re fo re , th e Court de te rm ine s th at B oyle ’s ans we r t o Q ue sti on 5( c ) i s f a lse a s a matter of la

w. Th e Court

fi nd s, ho we ve r, that th e mate ri a lity of B oyle ’s ans we r t o Q ue sti on 5( c ) i s in g enuine dispute. The Senior Vice President of Unde rwritingat B anner attested that ha d Ba

nner known of B oyle’s extensive presc ription drug use, B anner would not have issued the Policy
. Willi am Sk e lto n, a

Se nio r Und e rwri tin g Con su lta nt f or B ann e r, te sti fi e d th a t ov e ru se of pa in medications, or usingthem other than a s presc ribed, c an af fec t the applicant’ s health and r isk ofB ann e r r e lie s h e avil y on the te sti mony

of Dr s. Gr os sma

n, Sha ff e r, and El ion to e sta bli sh 6 that Boy le’s druguse is materia l as a matter of law be cause the doctors testified that had they known B oyle was se eingother doc tors to obtain medication, they would have be en conc erne d about addiction. Thorpe counter s this testi mony with a phar

macolog ical expert, who testified that Boy le’s pre scription medication use w as within the rec ommended ther apeutic dosa g e, and there fore Boy

le was not likely

addicted to the me dications. The Court, howe ver, ne ed not consider the testimony

of Drs. G rossman, Shaff er a nd Elion and Thorpe ’s phar macolog ical expert beca

use neither

party has conc lusively

established whe ther B oyle was a ddicted to any me dic a tio ns . F ur

the rm or e , th e te sti mony

on wh e the r B oyle wa s a dd ic te d is ir re le va nt: the on ly issue befor e the Court is whethe r B oyle’s pre scription medication use w as mater ial from an insurer’ s perspe ctive. 11 mortality , and that the use of multiple medications by an applica

nt may prese nt an addiction issue that Ba nner w ould need to rule out. B ut S ke lto n s e e min g ly

c on tr a dic te d h is o wn

te sti mony

by statin g tha

t pa in m e dic a tio ns , used as pr escr ibed, would have littl e impact on morta lity . (Pl.’s Opp’n to Mot. Summ . J ., Ex . 7
a t1 4 1
. ) C o r e y D o l l ar

h i d e , t h e B an n e r

u n d e r w r i t i n g o f f i c i a l w h o w o r

k e d o nB o yl e ’ s P o l i c y, testified that the fa ct that an a pplicant took presc ription medication alone w ould not be something that would chang e an insure d’s classific ation. Rather, the unde rwriter car es about how the drug s were beingtaken, f or what conditions they

wer e pre scribed, a

nd whether

the
a pp lic ant w a s ta

kin g the me dic a tio n und e r a do c tor ’s su

pe rv isi on . ( Pl. ’s Op p’ n to Mo t. S umm . J ., Ex . 6 at 96.) L awr ence Schneider , Ba nner’ s ag ent who sold Boy le the Policy , also testified that he does not e x pect a

n applicant to put down eve ry medication bec ause the applicant may not
wa nt t o d isc los e it o r t

he a pp lic ant m ay

have fo rg ott e n a

bo ut t he me dic a tio n. (P l.’ s O pp ’n to Mot. Sum m. J ., Ex . 5 at 82-3.) T here fore , Ba nner’ s own testimony

does not establish as a matter of law that Boyle’s pre scription druguse would have materia lly altere d Ba

nner’ s decision on whether and how to insure B oyle. 6Thorpe c ontends that Morton’s testimony is inadmissi ble bec ause it is unsworn. B anner 7 rejoins that his testimony is admissibl e bec ause a dmissibi lity at trial is not a pre requisite for a dmi ssi bil ity

a t th e summa

ry jud g me nt s ta g e . T he Court ne e d n ot r e a c h th e me ri ts o f t his argume nt, a s B ann e r i nc lud e d a De c laratio n o f R os s A . M or ton in i ts r e ply , d e c lari nghis statements ar e true and cor rec t and ar e within his personal knowle dg e.

12 The pa rties’ e x pert witnesse s’ testimony also reve als a g enuine dispute of material fa ct on the mater iality

of B oyle’s pre scription medication use. Thoma s Holdridg e, Thorpe ’s insuranc e expert, testified that a re asonable underwriter c ould have a ssessed an e x tra pre mium based on Bo yl e’ s p re s cr i p t i o nm ed i ca t i o nu s e i f i twa s s h o wn t h at t h e d ru gs we re b ei n g ab u s ed
. Ho l dri d ge also stated in his expert opinion report that had B anner known about the medic ations presc ribed to B oyle pr ior

to i ssu ingthe Pol ic y , it

wo uld no t ha ve c a us e d B ann e r t o d e c lin e c ov e ra g e to B oyle . H e did , h ow e ve r, te sti fy that ha d B oyle ’s pr e sc ri pti on dr ug us e be e n k

no wn , a re a so na ble underwriter c ould have a ssessed an e x tra pre mium for a policy
. Ross Morton, Banne r’s insura nce unde rwritingexpert, offe rs a diff ere nt opinion on what
a re a so na ble un de rwri te r w ou ld d o. Hi s e xpe rt op ini on su bmi ssi on a tte sts that “ a

re a so na ble 7 underwriter . . . would have dec lined the application for life insura nce on Mr . Boy

le, had they been a war e of his true medical history , espec ially as it relate s to his use of presc ription medication.” ( Def

.’s Mot. Summ . J ., Ex . B at 3.) F ina lly , B ann e r’ s U nd e rwri tin g Ma nu a l pr ov ide s n o in sig ht i nto wh e the r a lle g e dly excessive pre scription medication use w ould be mater ial to Ba nner. G iven the conf

licting statements from B anner ’s own ag ents, plus the conflictingstatements of the pa rties’ e x pert wi tne sse s, in c on

jun c tio n w ithno fu

rt he r e vid e nc e a

bo ut h owB ann e r w ou ld e va luate presc ription medication use ac cordingto its Underwriting Manual, the Court c oncludes that the13

materia lity

of B oyle’s answ er to Que stion 5(c) re mains in ge nuine dispute, and ther efor e summary judgme nt is inappropriate.

b. Q ue st ion 3( k) Question 3(k) on Par

t I Iof the Application asked, “Within the past 10 y ear s, have you been tr eate d or diag nosed by a member

of the medic al profe ssion as having : Any bone or joint disease, a rthritis, gout, ba ckac he, sciatica, loss of extremity or def ormity ? ” B oyle marke d the box “no.” ( Def

.’s Mot. Summ . J ., Ex . 1 to Ex . A.) B oth parties agree that on Fe bruar y 26, 2004, Boy le saw D r. L

ucy Chang for muscle ache s and bac k problems, but Dr. Changdid not treat Boy le for ba ckac he. (Pl.’s Opp’n to Mot. Summ. J ., Ex . 20.) B anner alleg es, howe ver, that Boy le’s nondisclosure of his visits wit h other doc tors who pre scribed him pain medic ation, alleg edly for ba ckac he, re nders his answe r to Question 3(k) f alse a s a matter of

law. Thorpe
re joi ns that B oyle did

no t c on sid e r h is i nte ra c tio ns wi th t he oth e r d oc tor s w ho pr e sc ri be d h im pain medication as formal tre atments or consultations, but rathe r re g arde d them as informa l interac tions. Thorpe also cla ims that Boyle disclosed a visit with Dr. Elion on a for m not part of the forma l Application; theref ore, B anner

was on notice and should have reque sted medica l
rec ords from Dr . Elion. The re cord indicates that some doctors tre ated B oyle for ba ck pain. Dr . Shaffe r testified that B oyle ha d “ c hr on ic pa in i n h is l owba c k” and that D r. Sha ff

e r t re a te d th is p a in. (D e f. ’s Mo t. Summ. J ., Ex . N at 11.) D r. Grossman a lso testified that he treated B oyle “if his bac k or nec k
wa s b oth e ri nghim .” (D e f. ’s Mo t. S umm . J., Ex. M a t 8. ) T ho rp e a lso a tte ste d th a t B oyle “sometimes took medication whe n he wa s experiencingmusculoskeletal ac hes and pa ins.” (Pl.’s Opp’n to Mot. Summ J ., Ex . 1 ¶ 9.) This uncontr overte d evidenc e neg ates B oyle’s answ er that14

he wa s not treated w ithin the past ten y ear s for ba ckac he. The ref ore, B oyle’s answ er to Que stion 3(k) is fa lse as a matter of law
. See Sk inner , 804 F.2d at 152. The Court, howe ver, c oncludes that the materiality of B oyle’s answ er to Que stion 3(k)
re ma ins in g e nu ine dis pute . B ann e r’ s U nd e rwri tin g Ma nu a l do e s n ot r e qu ir e a

re po rt fr om a doctor if the patient has bee n treated by or has c onsulted with a phy sician re g ardingback pa in. Moreove r, Dollarhide testified that bac k pain is not a condition that raises a ny red f lag s in the
un de rwri tin g pr oc e ss n or

is i t so me thi ngB ann e r w ou ld i nv e sti g a te in c onne c tio n w ith deter mining a policy

classification. Holdridge also testified that B oyle’s history of chr onic low back pa in would not have re quired a n insurance company

to char g e an e x tra pre mium or decline
cover ag e. The ref

ore, summar

y judgme nt is inappropriate a s to the materiality of B oyle’s answ er to Question 3(k). c. Question 6(a) Q u e s t i o n6 ( a ) o nP artII o f t h e Ap p l i c a t i o na s k e d , “ A r e yo u : n o w b e i n g t r e a t e d b y a ph y sic ian o r o the r l ic e ns e d me dic a l pr a c tit ion e r?” B oyle mark e d th e bo x “y e s. ” (D e f. ’s Mo t. Summ. J ., Ex . 1 to Ex . A.) B oyle listed Dr. Changas the phy sician who wa s curr ently treating him . ( De f. ’s Mo t. S umm . J., Ex. 1 to E x. A. ) B ann e r m a int a ins tha t B oyle ’s fa ilure to d isc los e his tr e a tme nt b y

the oth e r d oc tor s w ho pr e sc ri be d h im m e dic a tio n r e nd e rs his ans we r f a lse a s a
matte r o f l aw. Th or

pe re joi ns that B ann e r w a s at le a st o n n oti c e a bo ut s ome of

B oyle ’s vis its to Dr. Elion bec ause B oyle disclosed his visits on a form not part of the formal Application. Thorpe also maintains that it is di sputed whethe r B oyle would have understood this question to require him to li st informal consultations with the doctors who pre scribed him medica tion.15

Th e Court

c ann ot f ind B oyle ’s ans we r t o Q ue sti on 6( a ) f a lse a s a matte r o f l aw. Whil e it is true that the Application asked for “full and c omplete” de tails, Schneider testified that it is rar e to p ut d ow n o n a

n a pp lic a tio n a

se c on d d oc tor

wh o is c ur

re ntl y tr e a tin g the a

pp lic ant i f t

he fi rs t doctor ha s all of the information about the applicant. Even if B oyle’s answ er is fa lse as a matter of law , the Court cannot f ind it to be material
as a matter of law . Skelton testified that had B anner known that B oyle was be ing tr eate d by multipl e doctor s and re ceivingpresc riptions for pain medication, it would have aff ecte d Skelton’s underwr iting dec ision because “doctor shopping,” or re ceivingpresc riptions from multipl e doctor s without each doc tor’s knowledg e, is indicative of a n addiction issue that nee ds to be under

written. Schneide r’s testimony , howeve r, puts materia lity in ge nuine dispute. I f the “g ener al pra ctice w ith other insuranc e ag ents,” a nd specific ally

Schneider ’s pra ctice a s Ba nner’ s insurance ag ent, is not to li st mult iple doctors, then B anner ’s asser tion that had it known of all of the other doc tors treating B oyle, it would not have issued the Policy , is placed in dispute. Ske lto n’ s te sti mony

a ff ir me d th is p os iti on

wh e n h e te sti fi e d th a t it

is u p to the un de rwri te rs , a s a matter of disc retion, to reque st recor ds from a se cond doctor identified in the Application. There fore , summary

judgme nt is inappropriate on the materia lity of B oyle’s answ er to Que stion 6 ( a )
. 3. The Cond ition P re c e de nt U

po n Whic h Ban ne r Re lie s D oe s N ot R e nde r the Policy Invalid. B ann e r a lle g e s th a t e ve n if it w a s n ot e nti tle d to re sc ind the Pol ic y , B oyle fa ile d to me e t a valid condition prec edent in orde r for the Policy

to be ef fec tive in the first place . Thorpe r ejoins that the condition prec edent on whic h Ba nner r elies would re nder statutes that limi t an insuranc eAt the time the Saxe de c isi on wa s r e nd e re d, the a

pp lic a ble Di str ic t of

Col umb ia

statut e 8 was D.C. Code § 35-414. T he cur rently applicable statute, § 31-4314, and § 35- 414 are essentially

identical. 16 c omp any ’s ri g ht t o r e sc ind a po lic y nu ll a nd vo id, and is the re fo re inv a lid . T he Court a g re e s w ith Thorpe. Ba nner c ontends that Boy

le fa iled to meet the condition pre cede nt that “only if the pe rs on (s ) t o b e ins ur e d is (a re ) a c tua lly

in t he state of

he a lthand

ins ur a bil ity re pr e se nte d in

Part s Iand I Iof thi s a pp lic a tio n a

nd any su pp le me nts the re to” wi ll the Pol ic y take e ff e c t. ( De f. ’s Mo t. Summ. J ., Ex . 2 to Ex . A.) B anner alleg es that B oyle was not in the state of health re prese nted on the Application bec ause he failed to disclose his history of pre scription druguse and va rious medical c onsultations both i n the per iod prior to the Application and in the pe riod betwe en the Application and the de livery of the Policy
. Th e Court

fi nd s th a t th e c on dit ion

pr e c e de nt u

po n w hic h B ann e r r e lie s is inv a lid . Wh ile persua sive, the ca ses applying V irg inia law to which B anner points are not binding rules of decision for

this Court. L ooking to District of Columbi a law on point, the Court conc ludes the D.C. Circuit’s decision in Saxe , 134 F.2d 16, is binding . I n Saxe , the insurer relied on a condition prec edent r equiringstatements to be true befor e the insura nce policy

took effe ct. 134 F.2d at 24-25. Ther e, the c ourt rea soned that any misstatement would keep the policy from taking eff ect a nd there fore nullify

the protec tions for the insured in D.C. Code § 31-4314, which forbids an insura

nce c ompany

from voiding a policy

on any misrepre sentation unless the misrepre sentation was made with the intent to deceive or wa s material to the insure r’s de cision
makin g pr oc e ss. Id. at 25. B eca use the c ondition prece dent nullified the g overningDistrict of 8 Columbi a statute, the c ourt held that it was invalid. Id.17

Th e same re a so nin g a

pp lie s h e re . U nd e r B ann e r’ s in te rp re tatio n, any mis state me nt, whether made in g ood or bad f

aith and whe ther mate rial or immater ial to Ba nner, w ould rende r the Policy void beca

use B oyle would not have be en in the state of health re prese nted on the Ap pli c a tio n. L ike wi se , s uc h a n inte rp re tatio n w ou ld n

ull if y the pr ote c tio ns a ff

or de d to B oyle in D.C. Code § 31-4314, which pr ohibits Banner from voiding the Policy

unless Boy

le’s misrepre sentations wer e made with the intent to deceive or we re material to B anner ’s dec ision making proce ss. There fore , Ba nner’ s motion for summary judgme nt on Thorpe’ s brea ch of
c on tr a c t c la im mus t be de nie d b e c a us e the c on dit ion

pr e c e de nt u

po n w hic h B ann e r b a se s it s motion is invalid. C. Thor pe ’s Tor ti ous Re fusalto P ayP e r th e Co nt r ac t C lai m B ann e r c on te nd s th a t it

is e nti tle d to summa

ry jud g me nt o n T ho rp e ’s tor tio us re fu sa l to pa y pe r t he c on tr a c t c la im b e c a

us e the Di str ic t of

Col umb ia

do e s n ot p e rm it a

pa rt y to r e c ov e r i n tort for a n insurance company ’s fa ilure to pay benef its under an insura

nce c ontrac t. Thorpe rejoins that the District of Columbia per mits pl aintiffs to rec over a g ainst insurance companies f or nonpay ment wher e the insure r wa s oppressive a nd dishonest in avoiding liability , thus breac hing the duty of g oo d f a ithand fa ir de a lin g inh e re nt i n e ve ry c on tr a c t. B ann e r’ s p os iti on ha s me ri t. The District of Columbia does not re cog nize an independe nt tort for bad f aith brea ch of an insuranc e contr act. Fireman’s Fund I ns. Co. v. CTIA , 480 F. Supp. 2d 7, 9 (D.D .C. 2007). Nor doe s the District of Columbia rec og nize a cause of ac tion in tort for bad fa ith denial of an insurance claim. W

ashington v. Gov’t Em

ployee s Ins. Co. , 769 F. Supp. 383, 387 (D.D .C. 1991). Only wher e a br eac h of contra ct assumes the c hara cter of a w illful tort can a plaintiff sustain a
cause of ac tion in tort and recove r punitive damag es. Fireman’s Fund I ns. Co. , 480 F. Supp. 2d18

a t 12 -1 3. Th e ins ur e r’ s c on du c t mu st m e rg e wi th a n in de pe nd e nt, re c og nize d w ill fu l to rt to permit rec overy

under this rule. Id. a t 13 ; see also Serev. Group Hospitalization, Inc. , 443 A.2d 33, 37 (D.C. 1982) (pe rmitting re cover y of punitive damag es whe re the conduct of the bre aching party assumed the c hara cter

of intentional infliction of emotional distress). B eca use the District of Col umb ia

do e s n ot r e c og nize a

c a us e of a c tio n f or ba d f a ithde nia l of

an in sura nc e c la im, Thorpe c annot re cover

punitive damag es in tort for a ny alleg ed bre ach of

contra ct by

Ba nner. Thorpe ma intains that she can r ecove r compe nsatory and punitive damag es in a bre ach of contra ct claim eve n wher e the insure r’s c onduct does not g ive rise to an inde pendent tort. Thor pe pr inc ipa lly

re lie s o n th is C ourt ’s de c isi on inCentral Armature W

orks v. Am . Motorists Ins. Co. , 520 F. Supp. 283 (D.D .C. 1980). I n that case , the cour t permitted the plaintiff to re cover punitive damag es in a bre ach of

contra ct claim whe re the insurer’ s conduct wa s “oppre ssive or in willful and wa nton disreg ard” of the insure d’s rig hts under the c ontrac t. Id. at 292. B ut the majority of
case law in the District of Columbia still denies rec overy of punitive damag es for

a bre ach of contra ct eve n wher e the br eac h is “willful, wanton, or malicious.” Se re , 443 A.2d at 37 (inter nal
c itatio ns omi tte d) ; see also Gre enwich Ins. Co. v. I CE Contractors, Inc. , 541 F. Supp. 2d 327, 33 4 ( D. D. C. 2 00 8) (s tatin g that pu nit ive dama g e s a

re unre c ov e ra

ble in a br e a c h o f c on tr a c t c la im,
e ve n w he re the br e a c h is wi llf ul, wa nto n, or ma lic iou s) ; Choharis v. State Farm Fire & Cas. Co. , 961 A.2d 1080, 1090 (D.C. 2008) ( denying punitive damag es eve n wher e, if prove d, the bre ach was willful, wanton or

malicious). This Court has previously declined to e x tend the re asoning of Central Armature W orks to subsequent ca ses, see Fire man’s Fund Ins. Co. , 4 80 F . Su pp . 2 d at 15 (n oti ngthat Central Armature W

orks i s a “ qu e s t i o n a

b l e s o u r c e o f

l aw ” ) , an d

c o n t i nu e s t o d o s o h e r e . A c c o r d i n g l y,19

beca use the District of Columbia does not re cog nize a tort for ba d faith denia l of an insura nce claim, and be cause Ba

nner’ s conduct doe s not assume the cha rac ter of a

n independe nt, willful tort, the Court g rants summary judgme nt for B anner

on Thorpe’ s tortious refusal to pay per the
c on tr a c t c la im. III . C ON CL USI ON For the fore g oing r easons, it is this 14th day of Jul y 2009, here by ORDERED that de fe nd ant’ s mo tio n f or summa ry jud g me nt [# 25 ] is GR

ANTED a s to plaintiff’s tortious ref

usal to pay

per the contra ct claim; and it is further ORDERED that de fe nd ant’ s mo tio n f or summa ry jud g me nt [# 25 ] is DENIED as to the pla int if f’ s b re a c h o f c on tr a c t c la im.

Henr y H. Kenne dy , J r. United States District J udg e