“J o h n D o e ” is a p se u d o n ym w h ic h p la intiff is p e rm itt e d to us e in the fi ling s in th is c a se p u rs u a n t t o his 1 m o tio n to d o so .

T he part i es ag r ee t hat V i r gi ni a l aw g over ns D oe’ s bre ach of cont r act cl ai m, an d D i s t r i ct of Co l umbi a l aw 2 go verns hi s b ad f

ai t h cl ai m . C o unt II I of D o e’ s co m p l ai nt purp o rt s t o ass ert a cl ai m f o r “ Injunct i ve and D ecl arat o ry R el i ef
. ” As t he l ang uag e of

Co un t I I I i ndi cat es , Co un t I I I as s er t s an en t i t l ement t o t y pes of r el i ef an d do es not s et f o rt h a cl ai m or cause of act i o n. JOHN DOE, M.D., P la in t if f,
v. P ROVIDENT LIFE & AC CIDENT INSURANCE COMP ANY,

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

Ci vi l A cti on 07 -00 63 3 (H HK)

M EM OR

AN DU MOP IN ION AN D O RD ER A p hy sic ian, JohnDo e , M .D . ( “ Do e ” ), a lle g e s th at hesu ff e rs fr om P os t T ra

umatic Str e ss 1 Disorder (“PTSD”) and, as a

result, is disabled from his occ upation as an e merg ency room (“ER” ) phy sician. He filed this suit aga inst his di sability insuranceprovider, Provide nt L ife a nd Acc ident Insuranc e Company (“Provident” ), whe n Provident ref used to pay

his claim for disability benef its. Doe’s complaint asse rts cause s of ac tion for bre ach of contra ct and “bad faith” in the a dministration of his insuranc e policy
. 2 Be fore the cour

t is P rovident’s motion for summary judgme nt [ #35]. Upon consideration of the motion, the opposition thereto, and the summar y -judgment rec ord, the c ourt conc ludes that themot ion

sh ou ld b e gra

nte d in pa rt and de nie d in pa rt .A t t h e ti m e D o e c o m p le te d his d isa b ili ty i n su ra n c e a p p lica tio n , he li v e d in V irg inia , ( id

. at 1), an d s i gn ed 3 h is a p p lica tio n the re , ( id

. a t 4 ). P ro v id e n t also issu e d the d isa b ili ty i n su ra n c e p o licy to D o e w h ile h e li v e d V irg inia
. 2 I. BACKGROUND Do e e arn e d h is M .D . in

19 75 . In th e late 19 70 s, he be g an s e e inga ps yc hiatr ist , Constantine Ky

ropoulos (“K

y ropoulos”), to a ddress c erta in psycholog ical issues. Doe completed his residenc y

and wa s board- cer

tified in emerg ency

medicine in 1981. Af

ter his re sidency , Doe, an Air F orce Aca demy

graduate, worke d as an ER phy sician at Andr ews Air F orcebase a nd other milit ary hospitals until 1984. Whil e wor king f or the military , Doe a lso worked pa rt-time as a

n ER doctor for

Capital Emerg ency

Associates ( “CEA”) . Once he had f ulfilled his mil itary obligation, Doe beg an wor king f ull-time at CEA and bec ame a partne r therein 1985 or 1986. Whil e wor

king f ull-time at CEA, Doe avera g ed 24-30 c linical hours and 6- 8 non-clinica l hours per w eek. A s a par

tner, his annua l income was a pproxi mately

$150,000 to $250,000 per year . Whil e wor

king f ull-time at CEA, Doe a

pplied for a

disability insurancepolicy

from Pr ov ide nt. Do e ’s a

pp lic atio n p ro vid e d: ( a ) “ Oc c up atio n: P hy sic ian” ; (b) “ Exa c t dutie s: E .R. Phy sic ian” ; ( c ) “ Em

plo ye r: Ca

pit a l E me rg e nc y

As so c iate s, P.A .” ; and

(d) “Natur e of

bu sin e ss: Emerg ency

Medicine.” (Pl.’s Mem. in Opp’n to Mot. for Summ. J . [#41] , Ex . 3 at 1.) The 3 Pol ic y pr ov ide s, in r e le va

nt p art : Sic kn e ss m e ans sic kn e ss o r d ise a se wh ic h ma nif e sts its e lf wh ile you

r p oli c y is i n forc e. (Pl.’s Mem. in Opp’n to Mot. for Summ. J . [#41] , Ex . 2 at 4.) [Y]ou r o c c up atio n me ans theoc c up atio n ( or oc c up atio ns , if

mor e tha n o ne ) i n which you are regularly

eng ag ed at the time you become disabled. ( Id. ) Total Disability

means that due to Injuries or Sick ne ss : ( 1) you

areno t a bleto pe rf or m th e su bs tanti a l and

mate ri a ls duties of your occupation ; and (2) you are under the car e and a

ttendanceof a Phy sician. ( Id. ) (e mphasis added)
.T h i s w as n ot t h e f i r s t t i me D oe h ad men t i on ed h i s de s i r e f or e ar l y r et i r eme n t or s emi
- r et i r eme n t . I n 1989 4 h e m e n tio n e d the sa m e d e sire to K yro p o u lo s d u rin g the ra p y. ( See D e f.’ s M o t. fo r S u m m . J. [ # 3 5 ], E x . 9 a t 2 .) 3 [P artial/]Residual Disability means that due to Injuries or Sickness: (1) you are not able to do one or

more of your substantial and mate rial daily business duties or you areno t a bleto d o your u su a l da ily bu sin e ss d

uti e s f or a s mu c h ti me a s it would normally

take you to do them; (2) you have a L oss of Monthly

Income of

at least 20%; and ( 3) you are under the car e and attendanceof a Phy sician. ( Id. at 7.) A company

called E m Care ( “EC”) purcha sed CEA in 1994 or 1995. As a partne r of CEA , D oe wa s r e qu ir e d to re ma in w ithEC f or tw o ye ars fo llo wi ngthea c qu isi tio n in or de r t o obtain his full share of

the proc eeds f

rom the ac quisiti on. Doe f ulfilled that two-year

obligation, but duringthat time beg an to experienc e serious psycholog ical sy mptoms, which he alleg es we re
a re sult of his work in the ER. ( See Pl.’s Mem. in Opp’n to Mot. for Summ. J . [#41] , Ex . 38 at 118-19.) Doediscussed his sy mptoms with Ky

ropoulos, with whom he had c onsulted about psycholog ical issues includinghy perse nsitivi ty , anxiety , depre ssion, irritability , and a f acia l spasm since the 1970s. During 1997, D oe also took medication to manag e his sy mptoms, and he be g an to re du c e his wo rk ho ur s in theER. Th is r e du c tio n c oin c ide d w ithhis re c e ipt of thefu ll proce eds fr om the sale of CEA, which Doe te stified provided him with the means to pursue a
se mi- re tir e me nt. It is fr om t his tim e , whe n D oe be g an to re du c e ER w or k in 19 97 , th at hec la ims Residual Disability . In 1999, Doe be g an counse ling se ssions with a clinical social wor ker, John Sc hw artz (“ Sc hw artz”) , w ithwh om h e dis c us se d h is d e sir e to s e mi- re tir e a s w e ll. ( See Def .’s 4 Mot. for Summ. J . [#35] , Ex . 7.) In 2 00 0, Do e be g an w or

kin gin i nte rn a l me dic ine(“ I M” ) at Pric e Me dic a l ( “ Pr ic e ” ) t o
su pp le me nt h is r e du c e d E R w or k. Ac c or din gto D oe , h e c an w or k a s a n inte rn ist

be c a us e it
car ries with it less pressure than ER work. His re gular sche dule at Price is part-time, but DoeI t a ppea r s f r om t h e r ec or d t h at K y r opou l os a n d Sc h wa r t z l i k ew i s e n ev er di ag n os ed D oe wi t h PT SD n or 5 any o t her di sord er. 4 works full-time whe n he nee ds to cover f or other phy sicians. Acc ordingto Doe, the tra nsition fr om E R to I M c arrie d w ithit a signif ic ant l os s o f i nc ome . D oe late r e nte re d th e ra py wi th another clinical socia l worker , Kevin Spera (“Sper a”) , from January

2003 through Dec ember 20 04 . T hat th e ra

py a dd re sse d D oe ’s pr e vio us ps yc ho log ic a l is su e s a s w e ll a s a nxie ty re latin gto E R w o r k , a g i n g , an d

a n e wr o m ant i c r e l at i o n s h i p . ( P l
. ’ s M e m . i nO p p ’ nt o M o t . f o r S umm . J. [#41] , Ex . 7 at 1; Def

.’s Reply to Opp’n to Mot. for Summ. J . [#48] , Ex . 15 at ¶ 2.) I n 2004, Doe ended his tre atment with Spera a nd withdrew f

rom ER work complete ly . It is from this date, wh e n D oe c e a se d a ll E R w or k in 20 04 , th at hec la ims tot a l di sa bil ity . A lth ou gh D oe ty

pic a lly works a pa

rt-time sche dule at Price , he has not attempted to take on a f ull-time schedule nor

has he sought other work a s an IM phy sician. In 2005, Doe r ead a

n article about PTSD and conc luded that his sy mptoms fit the disorder. In J uly

2005, Doe c onsulted a psychiatrist, Gale Neuf eld (“Neuf

eld”) , about PTSD. Ne uf e ld d ia gno se d D oe a s su ff e ri ngfr om “ Axis I : Po st- tr a umatic Str e ss D iso rd e r, Chr on ic (309.81).” (Pl.’s Mem. in Opp’n to Mot. for Summ. J . [#41] , Ex . 9 at 8.) Ne ufeld then r efe rre d Doe to a psycholog ist, Thomas Gilmore (“G ilmore”). G ilmore diagnosed Doe as suffe ringfrom an adjustment disorder

with anxi ety

and in August 2005 beg an tre atingDoe f or esse ntially

the same sy mptoms for which Spera

had tre ated him. In contra st to Neufeld a nd Gilmore, Spera
never diagnosed Doe as suffe ringfrom post-tra umatic stress disorder

or any other disorde r, 5 (De f.’s Reply

to Opp’n to Mot. for Summ. J . [#48] , Ex . 15 at ¶ 4), a lthough Sper a did observeT he cour t obser ves t hat t hes e e xh i bi t s ar e c ont r adi ct ory i ns of ar as one i ndi cat es t hatSpera conc l uded t hat 6 D o e c o u ld no t co n tinu e his E R w o rk w h e re a s the o the r in d ic a te s tha t S p e ra ne v e r re a c h e d su c h a c o n c lus io n . T h is c o n tra d ic tio n no tw ithsta n d ing , ne ithe r le tter ind ic a te s tha t S p e ra d ia g n o se d D o e w ith P T S D o r a n y o the r d iso rd e r. T he m o st Sp era ever concluded was t hat E R wo rk was t o o s t res sf ul f o r D o e t o co nt i nue; of co urs e t hi s m ay b e t rue fo r m a n y p e o p le re g a rd le ss o f wh e the r th e y su ff e r fro m a stre ss-b a se d o r a n a n x ie ty-b a se d d isa b ili ty. 5 that Doe’ s anxi ety

and depr ession would make it difficult for him to continue workingin the ER, (Pl.’s Mem. in Opp’n to Mot. for Summ. J . [#41] , Ex . 7 at 1). 6 In Dec ember

2005, Doe submitted a disability claim to Provident, alongwith a re quired Phy sician Que stionnaire, (Pl.’s Mem. in Opp’n to Mot. for Summ. J . [#41] , Ex . 15), and G il mo r e ’ s A tt e n d in gPhy s ic ia nSt ate me nt, ( Pl
. ’ s M e m. in O p p ’ nto M o t. f

o r Summ . J. [# 4 1 ], E x. 14), which indicated that Doe suf fer ed fr om PTS D. In J anuar y 2006, Provident acknow ledg ed
rec eipt and appointed a

n ag ent, Diane Fr eema

n (“F ree man”) , to handle Doe ’s claim. The rea fter, Do e signe d a

n a uth orizatio n to re le a se re c or ds of Gi lmo re ’s tr e atme nt, (P l.’ s Me m. i n O pp ’n to Mot. for Summ. J . [#41] , Ex . 19), interview ed with Fr eema n via phone, (see Pl.’s Mem. in Opp’n to Mot. for Summ. J . [#41] , Ex . 20), and Provident r ece ived Neuf eld’s eva luation diagnosing Doe with PTSD, (Pl.’s Mem. in Opp’n to Mot. for Summ. J . [#41] , Ex . 9 at 8). Af ter Provident informed Gilmore that a summary of treatment in lieu of rec ords was f ine, (see Pl. ’s Me m. i n Opp’n to Mot. for Summ. J . [#41] , Ex . 21), Gilmore pr ovided Provident with a summary , which d ia gn o s e d

D o e a s s u f

f e r in gf r o m P T SD , ( Pl
. ’ s M e m. in O p p ’ nto M o t. f

o r Summ . J. [# 4 1 ], E x. 22). B ased on the fore g oing, Provide nt informed Doe that it would consider August 2005 — when he beg an tre atment with Gilmore — as the onse t of his alleg ed disability . ( See Pl. ’s Me m. in Opp’n to Mot. for Summ. J . [#41] , Ex . 23 at 2.) Pr ov ide nt t

he n r e qu e ste d a dd iti on a l mate ri a ls f ro m D oe to c omp le te thee va luatio n o f h is claim includinga supplementa l statement from Doe , his personal tax returns, a primary car eAl t h ou g h Spe r a pr ov i ded t h i s l et t er , h e di d n ot pr ov i de t h e medi ca l r ec or ds t h at Pr ov i den t r equ es t ed. 7 6 phy sician questionnaire , medical r ecords from Spera , and employ ment verific ations. ( See id. at 4. ) D oe pr ov ide d Pr ov ide nt w ithso me of the se mate ri a ls, name ly

his su pp le me nta l st ate me nt, (Pl.’s Mem. in Opp’n to Mot. for Summ. J . [#41] , Ex . 24), and primary car e phy sician qu e sti onna ir e , ( Pl. ’s Me m. i n O pp ’n to M ot. fo r S umm . J. [#4 1], E x. 25 ). Al so , Sp e ra se nt a letter to Provident summarizing Doe ’s treatment. The letter did not mention P TSD or any other disorder, but it did describe Doe’ s ER-related anxiety and Spera ’s opinion that Doe could not continue wor

king a s an ER phy sician. (Pl.’s Mem. in Opp’n to Mot. for Summ. J . [#41] , Ex . 7.) 7 Gilmore also provide d a supplementa l statement indicatingthat Doe’ s “PTSD sy mptoms prevent work in eme rg ency

medicine.” (Pl.’s Mem. in Opp’n to Mot. for Summ. J . [#41] , Ex . 26 at 1.) F oll ow ingthesu

bmi ssi on of the se a dd iti on a l mate ri a ls, a lic e ns e d me ntal he a lth counselor, L aurie Ghiz (“Ghiz”), re viewed D oe’s c laim on behalf of Provident and conc luded that Doe’ s claim was not suff iciently supported. ( See P l
. ’ s M e m . i nO p p ’ nt o M o t . f o r S umm . J. [#41] , Ex . 27 at 4.) She did, howe ver, r ecommend f urther r eview of

Doe’ s file if he submitted
rec ords from Gilmore and Spera . ( See id. at 4-5.) Provide nt also retaine d a vocational consultant, J ean- Marie Me rritt (“Me rritt”), who opined that Doe’ s claim should be eva luated as that of an IM phy sician, not an ER phy sician. ( See P l
. ’ s M e m . i nO p p ’ nt o M o t . f o r S umm . J. [#41] , Ex . 29.) F ree man informed D oe of the se initial determinations and re quested his medica l
rec ords from Sper a and G ilmore, (see Pl.’s Mem. in Opp’n to Mot. for Summ. J . [#41] , Ex . 32 at 1); the medica l rec ords wer e neve r submitted. Gilmore did, howeve r, submit an additional letter op ini ngthat D oe “ c ontin

ue s to e xpe ri e nc e PTSD sy mpt oms ” and

“ is n ot a bleto re tur

n to wo rk in Emerg ency

Medicine.” (Pl.’s Mem. in Opp’n to Mot. for Summ. J . [#41] , Ex . 31.)P rovident m ad e num erous at t em p t s vi a l et t er and t el ep ho ne t o ob t ai n t he m ed i cal record s f rom D o e and 8 the re le v a n t p h ysic ia n s o r c o u n se lo rs b e fo re d e n ying D o e ’s cla im . ( See D e f.’ s M o t. fo r S u m m . J. [ # 3 5 ], E x . 5 .) 7 Provident did not approve Doe ’s disability claim. Specific ally , Provident observe d that Doe ha d gradua lly

decr ease d his ER work while gradua lly incre asinghis I M work until he g ave up ER medicine in favor of IM medicine — the implication beingthat Doe g ave up E R medicine by his own fre e choic e, rather than be causeof a disability . ( See Pl.’s Mem. in Opp’n to Mot. for Summ. J . [#41] , Ex . 32 at 1.) In any event, Provident c oncluded that Doe ’s occ upation was that of an IM phy sician by

2004, the time from which heclaims Total Disability . ( Id. ) In addition, Provident observe d that Doe’ s income fr om his I M prac tice excee ded his income from his ER prac tice beg inning in 2001. ( Id. ) C on sid e ri ngthat D oe and his phy sic ians and

c ouns e lor s a ll agree that Doe is able to perfor m the duties of an IM phy sician, Provident conc luded that Doe provided insuffic ient evidenc e to establish that he is disabled f rom his occupation. ( See id. ) Provident informed Doe that he could a ppeal a nd that it would evaluate his c laim further if Doe provided medic al re cords f rom Gilmore or Sper a. ( Id. at 2. ) D oe did

no t pr ov idethe se re c or ds
. 8 By Marc h 2007, Doe ha d cea sed treatment with Gilmore. ( See Pl. ’s Me m. i n O pp ’n to Mo t. f or Summ. J. [# 41 ], E x. 38 at 12 7- 28 .) Do e fi le d th is s uit in A pril 2 00 7. Do e me t w ith Ne u fe l d d uri n g th i s l i t i gat i o n , an d

s h e r e- co n fi rm edh er

P T S D d i agn o s i s b as edo nth atm ee t i n g, their 2005 mee ting, a

nd her r eview of

Gilmore’s re cords. ( Pl.’s Mem. in Opp’n to Mot. for Summ. J . [#41] , Ex . 1.) In connec tion with thi s liti g ation, Doe a lso met with a medical e x pert
re ta ine d b y

Pr ov ide nt who c on c lud e d th at D oe do e s n ot h ave PTSD . Pr ov ide nt’ s e xpe rt , howeve r, conc luded that Doe suf fer s from various personality disorders a s well as maling ering sy mptoms of PTS D. ( See Pl.’s Mem. in Opp’n to Mot. for Summ. J . [#41] , Ex . 35 at 19.)B o th to ta l an d p a rtia l d isa b ili ty also re q u ire tha t “yo u a re un d e r th e c a re a n d a tten d a n c e o f a P h ysic ia n .” 9 P r ovi dent al s o cont ends t hat D oe i s not di s abl ed becau s e h e n eve r was un der t he car e a nd at t endan ce of a phy s i ci an f o r hi s al l eged P T SD
. D o e co unt ers t hat he was under t he care of m ent al heal t h pro f ess i o nal s f

o r nearl y t he ent i re p e rio d o f his a lleg e d d isa b ili ty an d tha t he ne e d no t sho w tha t he so u g h t t re a tm e n t sp e c ifi c a lly fo r P T S D
. P ro v id e n t’s ar g u m e n t i s a d istra c tio n . T h e re c o rd is cle a r th a t D o e w a s u n d e r th e c a re o f m e n ta l he a lth p ro fes sio n a ls f or h i s ps y chol ogi cal ai l ment s . T he pl ai n l ang uag e of t he P ol i cy r equi r es not hi ng mo r e. B y omi s s i on , D oe s ee ms t o a dmi t t h at t h e ea r l i es t pos s i bl e on s et of h i s a l l eg ed t ot al di s abi l i t y w as 2004, 10 and t hat he was worki ng pri m ari l y as an IM phys i ci an at t hat t i m e. T he reco rd i s co nsi st ent wi t h t hat ad m i ss i o n. 8 II. AN AL YSI S Doe, in ef fec t, seeks to hold Provident liable on three claims: (1) Doe ’s claim that he w as entitled to benef

its under his disability

policy for his Total Disability , (2) his cla im that he was
e nti tle d to be ne fi ts und e r h is d isa bil ity po lic y fo r h is R e sid

ua l [Part ia l] Di sa

bil ity , a nd (3 ) h is clam that Provident eng ag ed in bad f aith when it re fused to pay the insuranc e bene fits to which he a sse rt s h e wa s e nti tle d. Pr ov ide nt a sse rt s th at th e reareno mate ri a l f a c ts i n d isp uteand

that it is entitled to judgment as a matter of la

w on ea ch cla im. For the r easons that f ollow, the court conclude s that Provident is entitl ed to judgment on Doe’ s total disability and bad f aith claims but th atD o e ’ s c l a i mf

o r p art i a l d i s a

b i l i ty mu s tb e s u

b m i tt e d t o a j ur y. A. Tot al D isa bili tyCl aim Under the Policy , “Total Disability” mea ns that “you arenot able to per form the substantial and materials duties of your occupation .” Provident conte nds that Doe c annot meet th i s d e f i n i t i o n b e c a

u s e D o e ’ s o c c u

p at i o nata l l p e rt i n e ntt i m e s w a s , an d i s , th ato f anIM 9 phy sician and he indisputably is able per form the duties of a n I M phy sician. In response , Doe
c onte nd s th at heis a

n E R phy sic ian a

nd that hi s o c c up atio n w a s th at of an E R phy sic ian at le a st until 1997, when his partial disability beg an. Doe’ s position cannot be sustained.

10In re a c h ing this c o n c lus io n the c o u rt lo o k s first t o the d e finiti o n o f “o c c u p a tio n ” in the P o licy: 11

“ oc c u pa t i on me a n s t h e oc c u pa t i on ( or oc c u pa t i on s , i f mo r e t h a n on e ) i n w h i c h y ou a r e r e g u l a r l y e n g a g e d a t t h e t i me y ou become di s abl ed. ” See A t l an t i c Li f e I ns. Co
. v. W

orl ey , 172 S. E. 168, 172 ( V a. 1934) ( “ Le g al e f f ec t s h ou l d be g i v en t o t h e l an g u ag e u s ed [ i n ] a n d t h e obj ec t t o be a cc ompl i s h ed by t h e con t r ac t . ”) T h e cou r t f i n ds t h i s de f

i n i t i on e n tire ly un h e lp ful b e c a u se it us e s the ter m “o c c u p a tio n ” w ithin the d e finiti o n o f “o c c u p a tio n ” a n d thu s se e m s to p res up p o se s o m e general l y - accep t ed , ext ra- co nt ract ual de f i ni t i o n. 9 In a nutshell, Doe doe s not suffer from a “ Total Disability” within the meaningof the Policy beca use he ha s alway s been a

nd rema ins able “to pe rfor m the substantial and material duties of [his] occupation” as a phy sician. To avoid this conclusion, Doe a sks the court to find 11 that his occupation is that of a n ER phy sician rather than a phy sician. His re quest, howeve r, would have the court dra

w “too fine [a disti nction] under a common sense interpre tation of . . . ‘occ upation.’” See H

ouse v. Am . United Life Ins. Co. , 499 F.3d 443, 453 ( 5th Cir. 2007). Mo re ov e r, Do e ’s pr of

fe re d d e fi nit ion

is n ot s up po rt e d b y

thewe ight o f t

he law n or

of thefa c ts. With respe ct to the law, numerous courts that haveinterpre ted similar disability insurance policies have held that the ter m “occ upation” mea

ns a g ener al occ upation, such as a phy sician, rathe r than a

particula r job or position such as an ER phy sician. See, e .g. , Ho us e , 499 F.3d at 453-55 (f inding that tria l lawyer w as not totally disabled fr om his regular oc cupation bec ause he
c ou ld p e rf

or m th e dutie s o f a

lawye r) ; Osborne v. H

artford L ife and Acc ident Ins. Co. , 465 F.3d 296, 298-300 (6th Cir. 2006) (f inding that “ [own] [o] ccupation is a more g ener al term that seeming ly

ref ers to ca teg ories of w ork than na

rrower employ

ment terms like ‘position,’ ‘job,’ or ‘work,’ which ar e more related to a par ticular e mployee’ s individual duti es” in holdingthat president of

financ ial institution was not disabled eve n though heno longe r could travel for bu sin e ss) ; Ehrensaft v. Dime nsion W orks Inc . Long Term Disabili ty Plan , 120 F. Supp. 2d 1253, 1258-59 (D. N ev. 2000) ( findingthat “the ter m, ‘[own] occupation,’ is a g ener al desc ription, not a spec ific one” in holding that CPA workingas Controller wa s not disabled). But see, e .g.,T he cour t al s o not es t hat becau s e s om e of t hes e c as es i nv ol ved ER I SA pl ans , t he cour t s ac corded 12 de f e r e n c e t o t h e a dm i n i s t r a t or ’ s i n t e r pr e t a t i on of “ oc c u pa t i on . ” Ne v e r t h e l e s s , t h e c ou r t w ou l d r e a c h t h e s a me c o n c lus io n a b se n t an y d e fer e n c e . S ee Ho u se , 499 F. 3d a t 453- 54.

Pr ov i den t a l s o c on t en ds t h at i t i s e n t i t l ed t o s u mmar y j u dg men t on D oe’ s di s abi l i t y c l ai ms be ca u s e D oe 13 f ai l ed t o pr ov i de r ea s on abl y t i mel y n ot i ce a n d be ca u s e D oe f ai l ed t o pr ov i de t h e r equ i r ed pr oof of l os s — bot h of wh i ch a r e con di t i on s pr ec ede n t t o c ov er ag e. T h e cou r t h as e x ami n ed t h es e t wo con t en t i on s a n d f i n ds t h em t o be wi t hout mer i t . Accordi ng l y , t he cour t ne ed not addres s D oe’ s coun t er ar gu ment t hatP r ovi dent wai ved t hes e t wo 10 Raithaus v. Unum Life Ins. Co. of Am. , 335 F. Supp. 2d 1098, 1123-26 (D . Haw. 2004) (holding that insured’s “ regular oc cupation” w as a ur ologist rather than a g ener al pra ctice phy sician). Findingno controllingcase law in Virg inia, the cour t agree s with cases like Ho us e , Osborne , and Eh re ns aft , which af ford a more g ener al meaningto the term occ upation. The c ourt
no te s th at th e se c a se s inte rp re te d “ re gula r o c c up atio n” or

“ own o c c up atio n” rathe r t ha n s imp ly “occ upation,” the ter

m at issue here . The c ourt, howeve r, finds these distinctions to be of no conseque nce, e specia lly

consideringthat the term “ occupation” contains no qualifier such as “re gular”or “own,” which w ould narrow the meaningof occ upation further . Thus, the term “occ upation” should be view ed at a s least as high a leve l of g ener ality as these mor e limited terms. See O

sborne , 465 F.3d at 300 (conc luding that the distinction betwe en “r egular occupation” and “own occupa tion” is a relatively

minor differ ence ). Her e, Doe is a phy sician, 12 which occ upation encompa sses the more spe cific positions of IM phy sician and ER phy sician. Se eHo us e , 4 99 F .3 d at 45 3- 55 ; Osborne , 4 65 F .3 d at 29 8- 30 0; Eh re ns aft , 120 F. Supp. 2d at 1258-59. With respe ct to the fa cts, Doe ide ntified his occupation as “Phy sician” in his application for the disa

bility policy , and Doe conce des that he ha s been a nd rema ins able to perf

orm the duties of an IM phy sician. Consequently , Provident is entitled to sum mary judgme nt on Doe’s tot a l di sa bil ity c la im. 13cont ent i ons by f ai l i ng t o ra i s e t hem u nt i l t hi s l i t i gat i on. I n a dd i t i on, P r ovi dent cont ends t hatD oe’ s cl ai m i s t i mebar r ed bec au s e h e f

i l ed s u i t mor e t h an f

i v e y ea r s a f

t er t h e ex pi r at i on of

t h e Pol i cy ’ s t h r ee - y ea r l i mi t at i on s pe r i od. T h e c o u rt like w ise ha s e x a m ine d this c o n te n tio n a n d fi n d s it to b e w itho u t m e rit. 11 B. P artial/Residual Disab ility Under the Policy , “Residual Disability” mea ns that “you arenot able to do one or more of your s ub sta

nti a l and mate ri a l da ily

bu sin e ss d

uti e s o r you

areno t a bleto d o your u su a l da ily business duties for as muc h time as it would normally take you to do them.” A plain re adingof this provision reveals that the duties c ontemplated under the Residual Disability

provision are far more spec ific to Doe’ s particular medical pr acticethan ar e the duties c ontemplated under the Total Disability

provision, which per

tain to his occupation more g ener ally . Moreove r, the dis tin c tio n b e tw e e n r e sid

ua l and tot a l di sa bil ity ind ic ate s th at th e reis a

c ontin uum of dis a bil ity within which Doe may

be par tially disabled if he c annot per form one or more pa rticular duties wh e re a s D oe may

be tot a lly dis a ble d o nly if he c ann ot p e rf

or m mo st o r a ll o f t

he dutie s o f h is occupation. See G ladstone, MD v. Provident Life and Accide nt Ins. Co. , 533 F. Supp. 2d 1227, 12 32 -3 3 (N. D. Ga . 2 00 7) . Wh e n th e e vid e nc e in t his c a se is v ie we d in

a light m os t f

avo ra bleto Do e , th e c ourt

c on c lud e s th at a

re a so na blejur y c ou ld f ind that D oe is e nti tle d to re c ov e r o n h is claim for Re sidual Disability beca use thereareg enuine issues of material fa ct as to whe ther Doe suffe red f rom PTSD and whether

the sy mptoms of his allege d PTSD prevented him fr om perf ormingcer

tain of his specific business duties with respec t to ER medicine. C. Bad Faith Pr ov ide nt c onte nd s th at it is e nti tle d to summa

ry jud gme nt o n D oe ’s ba d f a ithc la im beca use the District of Columbia does not re cognize a tort for ba d faith bre ach of an insuranc e
c ontr a c t. A lth ou gh th e c ourt pr e vio us ly

de nie d Pr ov ide nt’ s mo tio n to dis mis s th e ba d f a ithc la im12

[#13 ], th e Di stric t of

Col umb ia

Court of Ap pe a ls h a s si nc e he ld t

hat th e Di stric t of

Columb ia does not rec ognize a tort for ba d faith ag ainst insurancecompanies in ha ndling policy

claims. Choharis v. State Farm Fire and Cas. Co. , 961 A.2d 1080, 1087-88 (D .C. 2008) (citing Fireman’s Fund I

ns. Co. v. CTIA-The W

ireless Ass’n , 480 F. Supp. 2d 7 (D.D .C. 2007)). Ac c or din g ly , th e c ourt

ho lds that Pr ov ide nt i s e nti tle d to summa ry jud gme nt w ithre sp e c t to Do e ’s ba d f

a ithc la im. III . C ON CL USI ON For the fore g oing r easons, it is this 9 day of Mar ch 2009, her eby th OR DE RE D that de fe nd ant’ s m o tio n f or summa ry jud gme nt [# 35 ] is G RANT ED in part and DE NI ED in p art .