FILED U.S. COURT OF AP P E A LS E LE V EN T HC IRC U IT APRIL12 , 2006 THOMAS K. KAH

N CLERK [ P UB L I S H] I N THE UN I TE D STATE S C OU RT OF APPE ALS F O R T H E E L E V E N T H C IR C U IT

________________________ N o. 05- 10816

________________________ D . C . D ocketN o. 02 -020 94 -C V -R W S -1 D R . A L L E N G I D D E N S , P l ai nt i ffC ou nt er -D ef

endant A p p e lle e , v ersu s THE E QU I TABL E L I FE ASSURANCE S O C I E T Y O F T H E U N I T E D S T A T E S , D ef endant - C ou nt er -C l ai m ant A p p e lla n t, S T A N L E Y H O W E L L , D e f e n d a n t.

________________________ A pp ea l fr om the U ni t ed S t at es D i stri ctC ou rt f o rth e N o r th e rn D is tr ic t o f G e o r g ia

_________________________ ( A p r i l12, 2006)2

B efo re C A RN E S , H U L L an d P R Y O R , C i rcu i tJu d g es. H U L L , C i rc ui tJudg e: In thi s di vers i ty c as e, pl ai nt i ff D r. A l l en G i dd ens ( “ G i dd ens” ) s ued defe nd antT he E qu i t abl e L i fe A ss urance So ci ety of the U ni t ed S t at es (“ E qu i t abl e” ) for di sabi l i ty benef

i t s und ertw o p ol i ci es . T he di stri ctcourtgrant ed part i al s um m a ry j udgm e nti n f

a vorof E qui t a bl e a nd pa r t i a l s um m a ry j udgm e nti n f a vorof G i dde ns , c onc l udi ng tha tG i dde ns w a s e nt i t l e d t o pa y m e ntunde rthe pol i c i e s f or one of hi s c l a i m s . E qui t a bl e appe a l s the gr a ntof s um m a ry j udgm e ntt o G i dde ns a n d th e d e n ia l o f

its s u m m a ry ju d g m e n t m o tio n .

I . B AC KG RO UN D In 19 86 and 1 98 8, E qu i t abl e i ss ued t w o d i sabi l i ty i ncom e i nsurance pol i ci es (the “ P ol i ci es ”) t o G i dd ens. T he P ol i ci es di d n otre qu i re G i dd ens t o b e di sabl ed f r om a ny oc c upa t i on butonl y f r om hi s “ r e gul a roc c upa t i on. ” S pe c i f i c a l l y , the P ol i c i e s de f

i ne d the t e r m “ y ourr e gul a roc c upa t i on” a s “ the oc c upa t i on ( or oc c upa t i ons , i f

m or e tha n one ) i n w hi c h y ou a r e r e gul a r l y e nga ge d f orga i n or profi tatthe t i m e y ou becom e di sabl ed. ” T he P ol i c i e s pr ovi de d f orc e r t a i n be ne f

i t s t o be pa i d t o G i dde ns i n the e ve nt o f “ T o t al D i sab i l i ty, ” d efi n ed as fo l l o w s: T O T A L D IS A B IL IT Y m ean s yo u r i n ab i l i ty d u e t o i n j u ry o r si ck n ess t o eng age i n the subst ant i al and m at er i al du t i es of your re gu l ar3

oc c upa t i on. I tw i l l notbe c ons i de r e d t o e xi s tf ora ny t i m e y ou a r e not un der the re gu l arca re and at t endance of a doct or. T he P ol i c i e s e a c h a l s o c ont a i ne d a r i de rpr ovi di ng a ddi t i ona l c ove r a ge f or

“ R esi d u al D i sab i l i ty” d efi n ed as fo l l o w s: R E S I D U A L D I S A B I L I T Y m e a ns y ouri na bi l i ty due t o i nj ury or s i c k n e s s t o p e r f

o r m: ( 1) one orm or e of

the s ubs t a nt i a l a nd m a t e r i a l dut i e s of y our oc c upa t i on; or (2) the subst ant i al and m at er i al du t i es of your occupat i on for a s m uch tim e a s is u s u a lly r e q u ir e d to p e r f o r m th e m . . . . T h is ap p e a l p r im a r ily c o n c e rn s w h e th e rG id d e n s is to ta lly o ro n ly p a r tia lly d is a b le d f

r o m h is r e g u la ro c c u p a tio n . W e f ir s t r e v ie w th e u n d is p u te d e v id e n c e . A . G i d d en s’ s D en tal P ract i ce G i dd ens pra ct i ce d g ener al dent i stry fr om 19 83 un t i l 19 94 i n H aw ki nsvi l l e, G eorgi a. In 19 94 , he sol d h i s pra ct i ce t o ano ther dent i stand cancel l ed hi s dent al
m a l pr a c t i c e l i a bi l i ty i ns ur a nc e pol i c i e s . A c c or di ng t o G i dde ns , i tw a s hi s i nt e nt i on to o p e n a n o th e rd e n ta l o f f ic e in M a c o n , G e o r g ia in a b u ild in g h e h a d p r e v io u s ly a c q u ir e d . H o w e v e r , G id d e n s b e c a m e ill in 1 9 9 4 , a n d h is h e a lth d id n o t p e r m it h im to o p e n th e p r a c tic e in M a c o n . N e v e r th e le s s , h e r e m a in e d a lic e n s e d d e n tis t u n til D e c e m b e r3 1 , 1 9 9 9 , a n d c o n tin u e d to s u b s c r ib e to c e r ta in p r o f e s s io n a l jo u rn a ls in the f i e l d of de nt i s try . A ts om e poi ntf ol l ow i ng the s a l e of

hi s pr a c t i c e , G i dde ns appl i ed for apo si t i on as a dent i stw i th the S t at e M er i tS ys t em . F urtherm ore, D r.4

G i dde ns t e s t i f

i e d tha the c ont i nue s t o pe r c e i ve hi s pr i m a ry pr of e s s i on a s tha tof de nt i s try , a nd tha ti tw a s hi s i nt e nt i on t o ope n a de nt a l of f i c e i n M a c on unt i l the tim e h e b e c a m e d is a b le d in 1 9 9 8 . B. G i dde ns ’ s R e a l Es t a t e D e v e l o pm e nt / I nv e s t m e nt W hi l e pra ct i ci ng dent i stry and fol l ow i ng the sa l e of hi s dent al prac t i ce , G id d e n s a ls o e n g a g e d f o rp r o f it in r e a l e s ta te d e v e lo p m e n t a n d in v e s tm e n t. G i dde ns a nd hi s w i f

e ow ne d tw o c om pa ni e s , G i dde ns C ons truc t i on C o. , I nc . a nd O a k L a nd & D e ve l opm e ntI nc . , thr ough w hi c h G i dde ns pa r t i c i pa t e d i n the d e v e lo p m e n t o f

r e a l e s ta te . T h r o u g h th e s e c o m p a n ie s , G id d e n s b o u g h t r e a l e s ta te a n d d e v e lo p e d a s u b d iv is io n . T h e r e c o r d s h o w s th a t f o r ty - th r e e r e s id e n tia l lo ts w e r e de ve l ope d a nd s ol d by G i dde ns ’ s c om pa ni e s , a nd i ndi c a t e s the a ddr e s s of e a c h lo t a n d w h e n e a c h lo t w a s s o ld . G id d e n s a ls o d e v e lo p e d c o m m e r c ia l p r o p e r ty an d w as i n v o l v ed w i th resi d en t i al ren t al p ro p ert i es. G id d e n s ’s p r in c ip a l d u tie s in h is r e a l e s ta te b u s in e s s w e r e e n tr e p r e n e u r ia l, f i na nc i a l , pl a nni ng, c oor di na t i ng, a nd othe ra dm i ni s tr a t i ve dut i e s . A l though G i dde ns ha d a c ons truc t i on c om pa ny a nd de ve l ope d pr oj e c t s , he pe r f or m e d no p h y s ic a l lab o ro n th e jo b s ite s , b u t s u b c o n tr a c te d o u t a ll th e p h y s ic a l lab o rto i n d ep en d en tsu b co n tract o rs. G i d d en s w as ab l e t o en g ag e i n th e real est at e b u si n ess5

w i th hi s w i f

e ’ s a s s i s t a nc e unt i l 1998, w he n hi s he a l th no l onge rpe r m i tt e d hi s doi ng s o. I n a n a f

f i da vi t , G i dde ns de s c r i be d the “ f unc t i ona l r e qui r e m e nt s a nd t a s ks f or the occupat i on of construct i on m anagem entand real es t at e devel op m ent ” a s fo l l o w s: en trep ren eu ri al v i si o n an d en erg y; p l an n i n g real est at e p ro j ect s; sel ect i o n o f h o u se p l an s an d m at eri al s; sel ect i o n o f co n tract o rs; s upe r vi s i on of

c ons truc t i on s upe r i nt e nde nt ( s ) ; pe r i odi c i ns pe c t i on of c ontr a c t or s ' w or k qua l i ty ; f i na nc i a l m a na ge m e ntof de ve l opm e nta nd construct i on proj ec t s; supervi se com pl i ance w i th b ui l di ng and o ther re gu l at ory c od es ; proj ec tsc hedu l i ng ; pay bi l l s; pay c on tra ct ors; w ork w i th ba nks , gove rnm e nta ge nc i e s , a nd f i na nc i a l c ons ul t a nt s a s ne e de d; c a l c ul a t i ng the f

e a s i bi l i ty of

pr oj e c t s , r e vi e w i ng s i t e s , a nd pl a nni ng f or c o n tin g e n c ie s ; a n d c o o r d in a tio n [ o f ] d e a lin g s w ith r e a lto r s a n d a g e n ts . C. Gi d d e n s ’ s T wo Cl a i ms G id d e n s s u b m itte d tw o c la im s to E q u itab le u n d e rth e P o lic ie s , o n e in F e b ru a ry 1 9 9 5 ( th e “1 9 9 5 c la im ” ) a n d o n e in F e b ru a ry 1 9 9 9 ( th e “1 9 9 9 c la im ” ) . G i dde ns ’ s 1995 c l a i m a s s e r t e d tha the w a s di s a bl e d due t o pa i n i n hi s l e f thi p; h o w e v e r , h e f

a ile d to r e s p o n d to E q u itab le ’s r e q u e s ts f o rin f o r m a tio n p u r s u a n t to the P ol i ci es . A s are sul t , the di stri ctcourtgrant ed E qu i t abl e s um m ary j ud gm entas t o the 1995 c l a i m . G i dde ns doe s notc ha l l e nge the di s tr i c tc our t ’ s c onc l us i ons on th is is s u e o n ap p e a l. T h u s , th is ap p e a l c o n c e rn s o n ly h is 1 9 9 9 c la im .Rul e26 re quire s th at a pa rt y prov ideto o ther p artie s th eidentity of any e xpe rt wi tne ss 1 wh o ma y beus e d topre sent evide nc eat trial. R ule26 fu rt her re quire s th at th epa

rt y su bmit a repor t prepa red a nd signe d by

the expert witness and c ontaining, a mong other thing s, “a complete statement of all opinions to be expressed and thebasis and re asons there for.” Fe d.R.Civ.P . 26(a) (2)( B) . 6 In O ct ob er19 98 , D r. G i dd ens began suffe ri ng fr om sy m pt om s s uch as f a tig u e a n d a b d o m in a l p a in . H e s o u g h t tr e a tm e n t a t th e M a y o C lin ic in J a c k s o n v ille , F lo r id a , w h e r e D r . R o lla n d C . D ic k s o n d ia g n o s e d h im w ith c ry o g e n ic c i rrhos i s , a c ondi t i on of the l i ve r . A f

t e rbe i ng di a gnos e d, G i dde ns s ubm i tt e d the 19 99 cl ai m , as se rt i ng thathe w as on a w ai t i ng l i stfor al i ver tra nspl ant , w as d is a b le d , a n d w a s u n a b le to p u r s u e h is p r o f e s s io n s o f

d e n tis try a n d r e a l e s ta te d e v e lo p m e n t. I n M a y 1 9 9 9 , D r . G id d e n s u n d e rw e n t liv e r - tr a n s p la n t s u r g e ry . S i nc e the tr a ns pl a nt , hi s l i ve rt e s ta nd r e na l f unc t i ons ha ve r e turne d t o nor m a l , but G id d e n s s till h a s n u m e r o u s h e a lth p r o b le m s . A s to h is h e a lth p r o b le m s , G id d e n s p r o d u c e d te s tim o n y a n d R u le 2 6 r e p o r ts of tw o tre at i ng ph ys i ci ans, w ho bo th sup po rt ed G i dd ens’ s di sabi l i ty c l ai m s. D r. 1 J a m e s R ic h a r d S p iv e y , a g a s tr o e n te r o lo g is t, tr e a te d G id d e n s d u r in g h is p o s ttr a ns pl a ntr e c ove ry a tthe M a y o C l i ni c . D r . S pi ve y t e s t i f i e d tha tnotw i ths t a ndi ng D r . G i dde ns ’ s i ni t i a l l y pos i t i ve l i ve rf unc t i on f ol l ow i ng the i m pl a nt a t i on of the a l l ogr a f t , G i dde ns c ont i nue s t o e xpe r i e nc e num e r ous a dve r s e s y m pt om s , i nc l udi ng nu m bn es s i n h i s f

i ng er s, hand tre m ors, gastroi nt es t i nal di ff i cul t i es , chroni c s l ee p7

di sturbances a nd fa t i gu e, anxi ety, depres si on , and sho rt -t erm m em ory l oss. D r. S pi ve y opi ne d tha tthos e s y m pt om s w e r e the r e s ul tof both G i dde ns ’ s di s or de ra nd the ef fe ct s of hi s m edi ca t i on . B as ed on hi s r evi ew of the enum er at ed “ funct i on al re qu i re m ent s a nd t as ks” of dent i stry and real es t at e devel op m entdi sc usse d abo ve, D r . S pi ve y f

ur the ropi ne d tha tG i dde ns “ i s una bl e t o pe r f or m s ubs t a nt i a l por t i ons of the dut i e s of

” a de nt i s torr e a l e s t a t e de ve l ope r , “ ora ny othe re m pl oy m e nt k n o w n to [D r. S p iv ey ] ap p ro x im atin g th e s am e liv elih o o d as [th o se p ro fe ss io n s], gi ven h i s per sonal ci rc um st ance s, i ncl ud i ng hi s e xp er i ence , educat i on , and p hysi ca l a nd m e nt a l c apabi l i t i e s . ” I n hi s de pos i t i on, D r . S pi ve y c l a r i f i e d tha tby

“ su b st an t i al p o rt i o n s” o f th e d u t i es, h e m ean tm o sto f th e d u t i es. D r. S p i v ey al so e xpl a i ne d how G i dde ns ’ s he a l th c ondi t i ons a nd m e di c a t i ons c oul d a f f e c tc ogni t i ve funct i on i ng , i ncl ud i ng entre preneuri al vi si on , as w el l as ener gy and p hysi ca l c ap a b ilitie s . G i dd ens a l so pres ent ed t es t i m on y of ase cond tre at i ng ph ys i ci an, D r. M ary P a tr ic e W e b s te r , w h o h a s s e r v e d a s G id d e n s ’s p s y c h ia tr is t s in c e 2 0 0 0 , tr e a tin g h is depres si on as soci at ed w i th h i s l i ver f ai l ure, tra nspl ant , and com pl i ca t i on s. D r. W ebst er ’ s a ff

i davi tpres ent s e ss ent i al l y the sa m e c on cl usi on s a s thatof D r. S pi vey w i th regard t o G i dd ens’ s di sabi l i ty. In her deposi t i on , D r. W ebst erfurther t es t i fi ed that , i n h erop i ni on , G i dd ens c ou l d n otperf orm the du t i es of ei ther dent i stry or re al8

es t at e devel op m enton a c on si st entbasi s. D r. W ebst ercl ar i fi ed thati n h er a f f i da vi t , w he n s he s a i d G i dde ns w a s una bl e t o pe r f or m “ s ubs t a nt i a l por t i ons ” of h is d u tie s , s h e m e a n t th e “v a s t m a jo r ity ” o f

th e d u tie s . S h e f

u rth e rs ta te d : “I t c o u ld po t ent i al l y m ea n al l the du t i es , bu tm y — I t end n ott o speak i n absol ut es . ” D r. W e bs t e rnot e d tha tG i dde ns ’ s pr i m a ry pr obl e m s , i n he rvi e w , w e r e hi s de pr e s s i on a n d c o g n itiv e p r o b le m s . I n a d d itio n to h is d o c to r s ’ r e p o r ts a n d te s tim o n y , G id d e n s a ls o s u b m itte d h is a f f id a v it s ta tin g th a t h e c o n tin u e s to b e u n a b le to w o r k a s a d e n tis t o rr e a l e s ta te d ev el o p er, as fo l l o w s: S in c e m y liv e rf

a ilu r e a n d liv e rtr a n s p la n t, I h a v e b e e n u n a b le to pe r f or m m os tof

the dut i e s of

e i the rof m y oc c upa t i ons , a s a de nt i s tor i n resi d en t i al real est at e d ev el o p m en t . W h i l e I am n o tt o t al l y h el p l ess, I a m una bl e t o r e s um e e i the rof the s e oc c upa t i ons , ora ny w or k of w h ic h I a m a w a r e ap p r o x im a tin g th e s a m e liv e lih o o d , in k e e p in g w ith m y b ack g ro u n d , ci rcu m st an ces, an d p h ysi cal an d m en t al cap ab i l i t i es. D . E q u i tab l e’ s P ay m en ts W h e n it r e c e iv e d th e 1 9 9 9 c la im , E q u itab le b e g a n p a y in g to ta l d is a b ility b en efi t s w h i l e i n v est i g at i n g th e cl ai m . A ft er an i n -h o u se m ed i cal rev i ew i n A u g u st 2000, how e ve r , E qui t a bl e c onc l ude d tha tthe r e w a s “ no c urr e nts i gni f i c a nt i m pa i r m e nttha tw oul d pr e c l ude [ G i dde ns ] f r om pe r f or m i ng m os tof

the dut i e s of h is o c c u p a tio n a l d e s c r ip tio n [ ,]” a n d E q u itab le c o n tin u e d to m a k e b e n e f it p a y m e n tsEquitable never re quested nor perfor med any independent medical evaluation of 2 Giddens. Rather , it simply reviewed the me dical information. Eq uit a blealsofi le d a

motion to e xcludethete stimony of Gi dd e ns ’stre atingphysic ians , 3 Drs. Spivey

and Webster, whic h the district court denied. We reje ct Equitable’s a rguments on appeal that the district court abuse d its discretion in admitti nghis doctors’ testimony . Gen. Ele c. Co. v. J oiner, 522 U.S. 136, 143, 118 S. Ct. 512, 517 (1997) (statingthat the district court’s e vide nti ary

ruling s, inc ludingDa

ub e rt ruling s, arereviewe d f

or an a bu seof dis c retio n) . B oth treating doc tors had conduc ted extensive review s of Giddens’s me dical history and interacted 9 onl y pur s ua ntt o a r e s e r va t i on of r i ght s . E qui t a bl e di s bur s e d a t ot a l of $60, 790. 98 2 in b e n e f its to G id d e n s u n d e rth e r e s e r v a tio n o f r ig h ts . I n S e pt e m be r2001, E qui t a bl e r e por t e dl y l e a rne d tha tG i dde ns ha d not a c tiv e ly p r a c tic e d d e n tis try f o rf o u ry e a r s b e f

o r e h e b e c a m e d is a b le d a n d th a t h is re al es t at e pursui tw as es se nt i al l y “ pass i ve” i n n ature. E qu i t abl e r equest ed c l a r i f i c a t i on f r om G i dde ns . I n M a r c h 2002, E qui t a bl e t e r m i na t e d the pa y m e ntof b e n e f its to G id d e n s . E . L i t i gat i on I n J une 2002, G i dde ns f i l e d s ui ti n s t a t e c our ts e e ki ng be ne f i t s unde rthe P ol i c i e s , pl us i nt e r e s ta nd e nha nc e d da m a ge s f orba d f a i th f a i l ur e t o pa y pur s ua nt t o O . C . G . A . § 33- 4- 6. E qui t a bl e f i l e d a c ount e r c l a i m s e e ki ng r e c ove ry of the $ 6 0 ,7 9 0 .9 8 p a id to G id d e n s u n d e ra r e s e r v a tio n o f r ig h ts . I n J u ly 2 0 0 2 , E q u itab le
r e m ove d the c a s e t o f

e de r a l di s tr i c tc our t . A f t e rthe di s c ove ry pe r i od e xpi r e d, G i d d en s fi l ed a m o t i o n fo r p art i al su m m ary j u d g m en tan d E q u i t ab l e fi l ed a cro ssm o t i o n fo r su m m ary j u d g m en tas t o al l cl ai m s. 3wi th him a nd c on c lude d th at hewa s una bleto p e rf

or m va ri ou s ac tiv iti e s a s a

re sult o f his me dic al c on dition s. Whil ec e rt ain o ther t e sts wereavaila ble , th epa

rticula r evide nc ein t

hisc a se sh ow s th at th edo c tor s’ op ini on s w e resu ff ic iently re lia ble , w ith out f

ur ther t e sting , n ot o nly

a s to Giddens’s medic al condition but also as to which job tasks he c ould not perfor m. 10 O n N ove m be r1, 2004, the di s tr i c tc our te nt e r e d a n or de r( 1) gr a nt i ng s um m a ry j udgm e ntt o E qui t a bl e a s t o a l l c l a i m s e xc e ptthe 1999 c l a i m , a nd ( 2) gr a nt i ng G i dde ns ’ s m ot i on f ors um m a ry j udgm e nta s t o the 1999 c l a i m ba s e d on hi s be i ng t ot a l l y di s a bl e d f r om hi s r e a l e s t a t e oc c upa t i on. G i dde ns v. T he E qu i t abl e L i fe A ss urance So c’ y of U ni t ed S t at es , 35 6 F . S up p. 2d 13 13 (N . D . G a. 20 04 ). T he di stri ctcourtdet erm i ned t hatG i dd ens w as engaged i n the “ re gu l ar oc c upa t i on” of

r e a l e s t a t e de ve l ope ra tthe t i m e he be c a m e di s a bl e d i n 1998 a nd th a t G id d e n s w a s to ta lly d is a b le d w ith r e g a r d to th a t o c c u p a tio n . I d . a t 1 3 3 1 . A s to d e n tis try , th e d is tr ic t c o u r t a g r e e d w ith G id d e n s th a t d e n tis try c o u ld a ls o b e c o n s id e r e d h is “r e g u la ro c c u p a tio n ,” b u t th a t f a c t is s u e s e x is te d a s to w hether G i dd ens had perm anent l y aband on ed dent i stry or on l y t em po ra ri l y c ea se d dent i stry du e t o ci rc um st ance s bey on d h i s c on trol . Id. at13 27 -28. T he di stri ct courtdet erm i ned t hattho se fa cti ss ues, ho w ever , di d n otprec l ud e s um m ary ju d g m e n t o n G id d e n s ’s d e n tis try c la im b e c a u s e if G id d e n s w a s e n g a g e d in h is d e n tis try o c c u p a tio n a t th e tim e o f h is d is a b ility , th e e v id e n c e s h o w s h e is u n a b le to perf orm the subst ant i al and m at er i al du t i es of a dent i stand i s di sabl ed fr om that o c c u p a tio n a s w e ll. I d . a t 1 3 3 1 n .9 .“ We re view thedis tric t c ourt ’sgra nt o f s umm ary

judgment deno vo , a

pp lyingthesame 4 le g al st andard s th at boun d th edis tric t c ourt , a nd viewingall f

a c ts a nd re a so na bleinf e renc e s in the light most favorable to the nonmovingparty . Summary judgment is appropriatewhen ‘ there is n o g e nuineiss uea s toany materi al f

a c t and . . . th emov ingpa

rt y is entitle d toa

judgment a s a matter of la

w.’”Cruz v. P ublixSuper Mkts., Inc., 428 F .3d 1379, 1382 (11th Cir. 2005) (quotingFe d.R.Civ.P . 56(c) ) (other quotation marks and c itation omitted).

11 G i dde ns the n f

i l e d a m ot i on f

ors um m a ry j udgm e nta s t o da m a ge s , w hi c h the di stri ctcourtgrant ed i n p artand d eni ed i n p art . T he di stri ctcourtent er ed j udgm e ntf

orG i dde ns i n the a m ountof $442, 604. 82 f

orunpa i d be ne f

i t s a nd i nt e r e s ta nd $16, 165. 96 a s a r e f und of pr e m i um pa y m e nt s , f

ora t ot a l j udgm e ntof $ 4 5 8 , 7 7 0 . 7 8 . Th e d i s tr i c tc o u r td e n i e d r e l i e f o n G i d d e n s ’ s b a d f

a i th c l a i m. E qui t a bl e now appe a l s the di s tr i c tc our t ’ s gr a ntof pa r t i a l s um m a ry j udgm e nt t o G i dd ens on t he 19 99 cl ai m and d eni al of i t s s um m ary j ud gm entm ot i on as t o that c l a i m. 4 I I . DI S CUS S I ON W e a ddr e s s the i s s ue s E qui t a bl e r a i s e s a boutG i dde ns ’ s de nt i s try oc c upa t i on a n d th e n h is r e a l e s ta te o c c u p a tio n . A . G i d d en s’ s D en ti st ry P ract i ce In th e d i stri ctco u rtan d o n ap p eal , G i d d en s cl ai m s h e h ad d u al o ccu p at i o n s – d e n tis try a n d r e a l e s ta te d e v e lo p m e n t – a n d is to ta lly d is a b le d f r o m b o th . E q u itab le cont ends thatG i dd ens had abando ned h i s dent i stryprac t i ce ye ar s pri or t o h i s l i ver tr a ns pl a nt , tha ta s a m a tt e rof l a w de nt i s try w a s nothi s “ r e gul a roc c upa t i on” a ttheUnder Georg ia law, “ [t ]he words used in the policy areto be g iven their usual a nd 5 c omm on signif ic anc eand

areto b ec on str

ue d in the ir ordin ary me aning .”L ars on

v. Ge org ia Fa rm Bureau Mut. Ins. Co., 520 S.E.2d 45, 46 (Ga. Ct. App. 1999) (c itation omitted). 12 tim e o f h is d is a b ility , a n d th a t th u s th e d is tr ic t c o u r t e rr e d in d e n y in g E q u itab le s u mma ry j u d g me n to n h i s d e n t i s try c l a i m. T h e P o l i ci es d efi n e “ reg u l ar o ccu p at i o n ” as “ th e o ccu p at i o n (o r o ccu p at i o n s, i f mo r e th a n o n e ) i n w h i c h y o u a r e r e g u l a r l y e n g a g e d f o rg a i n o rp r o f

i ta tth e t i me you b ec om e di sabl ed, ” notov erthe course of the i nsured’ s l i fe . (E m ph as i s a dd ed. ) T h e o r d in a ry m e a n in g o f “r e g u la r ,” a s u s e d in th is c o n te x t, is “[ c ]u s to m a ry , u s u a l, ornor m a l . ” A m e r i c a n H e r i t a ge D i c t i ona ry of the E ngl i s h L a ngua ge ( F our th E d. 20 00 ) a tp. 14 71 . A tthe t i m e G i dd ens bec am e di sabl ed, he had n otprac t i ce d 5 de nt i s try i n ove rf

oury e a r s . W e thus r e a di l y c onc l ude tha tG i dde ns w a s not

“ r e gul a r l y ” e nga ge d i n de nt i s try a tthe t i m e he be c a m e di s a bl e d, e ve n i f he i n t en d ed t o retu rn t o d en t i stry atso m e p o i n ti f h i s h eal th p erm i tt ed . A cco rd i n g l y, the di stri ctcourterre d i n d enyi ng E qu i t abl e s um m ary j ud gm enton the dent i stry is s u e . B . R e al E s t at e O c c u p at i on T hi s c onc l us i on, how e ve r , doe s notpr e ve ntG i dde ns f r om r e c ove r i ng benefi t s i f he w as t ot al l y di sabl ed fr om hi s r ea l es t at e occ up at i on . In the di stri ct c our t , E qui t a bl e a s s e r t e d tha tG i dde ns ’ s r e a l e s t a t e e nde a vorw a s m e r e l y a “ pa s s i ve13

i nve s tm e nt ” a nd nota n oc c upa t i on. T he di s tr i c tc our tr e j e c t e d tha ta r gum e nt , a nd concl ud ed thatG i dd ens had a r ea l es t at e occ up at i on , st at i ng that th e o n l y ev i d en ce n o w i n th e reco rd as i trel at es t o D r. G i d d en s’ i nvol ve m e nti n r e a l e s t a t e de ve l opm e nts how s tha thi s a c t i vi t i e s w e nt w e l l be y ond tha tof

a c a s ua l i nve s t orw ho s i m pl y pl a c e s m one y i n a g iv e n c o m m o d ity w ith h o p e s o f a n ap p r e c ia tio n in v a lu e . R a th e r , it s h o w s th a t h e h a d s ig n if ic a n t a d m in is tr a tiv e d u tie s in c o n n e c tio n w ith thatent erpri se . G id d e n s , 3 5 6 F .S u p p .2 d a t 1 3 2 8 . T h e d is tr ic t c o u r t a ls o e x p la in e d th a t E q u itab le h a d f a ile d to c ite a n y a u th o r ity h o ld in g th a t “a n e n te rp r is e e n g a g e d in f o rp r o f it c a nnotc ons t i tut e one ’ s ‘ r e gul a roc c upa t i on’ w he n i ti s s ubj e c t i ve l y pe r c e i ve d by the i ns ur e d ( orhi s a ge nt s ) a s a n ‘ i nve s tm e nt . ’ ” I d. O n appe a l E qui t a bl e doe s notc ha l l e nge the di s tr i c tc our t ’ s de t e r m i na t i on thatG i dd ens had a r ea l es t at e occ up at i on and w as i nv ol ved i n thatoccupat i on at th e tim e o f

h is d is a b ility . R a th e r , in th e d is tr ic t c o u r t a n d o n ap p e a l E q u itab le a r gue s ( 1) tha ti s s ue s of f a c te xi s ta s t o w ha tthe s ubs t a nt i a l a nd m a t e r i a l dut i e s of G i dd ens’ s r ea l es t at e occ up at i on ac tual l y w er e, (2) thatthe P ol i ci es re qu i re that G id d e n s m u s t b e u n a b le to p e r f o r m a ll o f

th o s e s u b s ta n tia l a n d m a te r ia l d u tie s in order t o b e t ot al l y di sabl ed, and (3) thatG i dd ens f ai l ed t o p rove he w as di sabl ed fro m al l su ch d u t i es. W e tu rn t o th o se i ssu es. C . S u b s t an t i al an d M at e r i al D u t i e s of R e al E s t at e O c c u p at i onEquitable stresse s that Giddens testified only to the “func tional requirements and tasks,” 6 and not the substantial and material duties, of his re al estateoccupation. Equitable in essence argues that Giddens f

ailed to use the c orre ct terminology . We rejec t Equitable’s argument that thereis a fac tual issue simply beca use Giddens failed to use themag ic words “ substantial and material” in his aff idavit. The use of

the term “func tional requirements and tasks” w as per haps inartf

ul; however , it is clear that the point of Gi dd e ns ’ste stimony

wa s th at th ee le mentslis te d a s “ fu nc tio nal re quire mentsand ta sk s”werein fac t th esu

bs tanti al and

materi al dutie s o f his o c c up atio n. Hi s te stimony , re g ardle ss o f t heterm s used, is evidenc e of thesubstantial and material duties involved, and Equitable did not introduce any evidenc e to under

mine Giddens’s testimony on this point . 14 A s not e d a bove , the P ol i c i e s pr ovi de tha t“ t ot a l di s a bi l i ty ” m e a ns the i ns ur e d’ s “ i na bi l i ty due t o i nj ury ors i c kne s s t o e nga ge i n the s ubs t a nt i a l a nd
m a t e r i a l dut i e s of

[ the i ns ur e d’ s ] r e gul a roc c upa t i on. ” I n hi s a f f i da vi t , G i dde ns de s c r i be d the “ f

unc t i ona l r e qui r e m e nt s a nd t a s ks f orthe oc c upa t i on of

c ons truc t i on m an ag em en tan d real est at e d ev el o p m en t ” as fo l l o w s: en trep ren eu ri al v i si o n an d en erg y; p l an n i n g real est at e p ro j ect s; sel ect i o n o f h o u se p l an s an d m at eri al s; sel ect i o n o f co n tract o rs; s upe r vi s i on of

c ons truc t i on s upe r i nt e nde nt ( s ) ; pe r i odi c i ns pe c t i on of c ontr a c t or s ' w or k qua l i ty ; f i na nc i a l m a na ge m e ntof de ve l opm e nta nd construct i on proj ec t s; supervi se com pl i ance w i th b ui l di ng and o ther re gu l at ory c od es ; proj ec tsc hedu l i ng ; pay bi l l s; pay c on tra ct ors; w ork w i th ba nks , gove rnm e nta ge nc i e s , a nd f i na nc i a l c ons ul t a nt s a s ne e de d; c a l c ul a t i ng the f

e a s i bi l i ty of

pr oj e c t s , r e vi e w i ng s i t e s , a nd pl a nni ng f or co n t i n g en ci es; an d co o rd i n at i o n [o f] d eal i n g s w i th real t o rs an d ag en t s. G i dd ens, 35 6 F . S up p. 2d at13 18 -19. T he du t i es l i st ed i n G i dd ens’ s a ff i davi tar e ba s i c a l l y e ntr e pr e ne ur i a l , f i na nc i a l , pl a nni ng, c oor di na t i ng, a nd a dm i ni s tr a t i ve du t i es . T hu s, the re cord show ed w hatG i dd ens’ s s ub st ant i al and m at er i al du t i es w e r e i n hi s r e a l e s t a t e oc c upa t i on. 615

B e c a us e E qui t a bl e doe s notnow di s put e tha tG i dde ns w a s e nga ge d i n the occupat i on of re al es t at e devel op m ent , the qu es t i on w e m ustansw erfor s um m ary ju d g m e n t p u rp o s e s is w h e th e r , v ie w in g th e e v id e n c e in th e lig h t m o s t f a v o r a b le to E qu i t abl e, any genui ne i ss ue of m at er i al fa ctprec l ud es a f i nd i ng thatG i dd ens w as una bl e t o pe r f

or m the s ubs t a nt i a l a nd m a t e r i a l dut i e s of hi s r e a l e s t a t e de ve l opm e nt oc c upa t i on. E qui t a bl e di d notpr e s e nte xpe r te vi de nc e a boutthe s ubs t a nt i a l a nd
m a te r ia l d u tie s o f

G id d e n s ’s r e a l e s ta te v e n tu r e . R a th e r , E q u itab le p r im a r ily as se rt s thattw o i t em s i n the re cord cont ra di ctG i dd ens’ s t es t i m on y a nd cr ea t e f ac t i s s ue s a s t o w ha thi s r e a l e s t a t e dut i e s w e r e . E qui t a bl e ’ s br i e f poi nt s t o ( 1) G i dde ns ’ s r e pr e s e nt a t i on t o the S oc i a l S e c ur i ty A dm i ni s tr a t i on i n hi s M a y 1999 W o r k H is to ry R e p o r t th a t th e “d e v e lo p m e n t w o r k w a s a ll ‘[ s ]u b c o n tr a c te d to . . . in d e p e n d e n t c o n tr a c to r s ’ r a th e rth a n p e r f o r m e d b y G id d e n s h im s e lf ,” a n d ( 2 ) h is a tto rn e y ’s r e p r e s e n ta tio n in a le tte r , d a te d S e p te m b e r5 , 2 0 0 1 , th a t th e r e a l e s ta te bus i ne s s w a s “ a pa s s i ve i nve s tm e nt. . . m a na ge d pr i m a r i l y by hi s w i f e . ” T he d is tr ic t c o u r t p r o p e r ly r e je c te d th is a r g u m e n t. A s f or G i dd ens’ s r epre se nt at i on s, i n the S oci al S ec uri ty r eporthe i dent i fi ed hi s j ob t i t l e a s “ R ea l E st at e D evel op m ent ” a nd l i st ed hi s r at e of pay as $3 0, 00 0 p erThe re cord indicates that Giddens’s wif e ac tually filled out at least par

t of the report, but 7 Giddens signed the f

orm and attested to its truth.

16 ye arand h i s hou rs as tw o t o fi ve per day, fi ve days per w ee k. G i dd ens des cr i bed 7 h is d e v e lo p m e n t jo b b y c o m p le tin g th e S o c ia l S e c u r ity r e p o r t a s f o llo w s : R at e o f P ay P er (

C i r cl e O ne) H o urs pe r day D ays pe r week $3 0, 00 0 H our W eek M ont h ( Y ear ) 2- 5 hr s a day 5 In thi s job , did y o u: U se machines , t o o l s o r equi p m ent ? Y es ( exp l ai n be l o w) 9 N o T9 U se t echni cal know l ed ge o r s ki l l s? Y es ( exp l ai n be l o w) T9 N o 9 W ri t e repo rt s o r com p l et e f o rms? Y es ( exp l ai n be l o w) T9 N o 9 D e s c r i be t h i s j ob . W h a tdi d y ou do a l l da y ? (If yo u n e e dm o re sp a c e , w rite in th e “ R e m a rks” se c tio n .) D eve l op ed L a n d fo r C o m m e rc ia l an d R e sid e n tial u se . S u b c o n tra c te d o u t all w o rk to ind e p e n d e n t co n tra c to rs . In thi s job , how m any t o t al hours each da y did y o u: W a l k ? 1 h r . K n e e l ? (B e n dleg s to re st o n kn e e s.) 0 St a n d? 0 Cr ou c h ? (B e n dleg s a n db a c kd o w n & fo rw a rd .) 0 Si t ? 1 h r . Cr a w l ? (Mo v e o n h a n ds & kn e e s.) 0 C l i m b ? 0 H an d l e, gra b o r gra sp b i g o bje cts? 0 St oo p? (B e n dd o w n a n dfo rw a rda t w a ist.) 0 W rit e, t yp e o r ha nd l e sm all o bje cts? 2 hrs. Lif t i ng and C arry i ng (Ex

p la in w h a t yo u li

fted, h o w fa r y o u c a rrie dit , a n dh o w o

ften y o u d idth is.) d i d not real l y l i f

tor carry any t hi ng. O n th e n e x t p a g e u n d e r“R e m a r k s ,” G id d e n s s ta te d : “R e a l E s ta te D evel op m entw as m ai nl y a n i nv es tm ent . W e had no em pl oyee s a l l w ork w as s ubc ontr a c t e d out . ” G i dde ns a l s o r e s ponde d “ no” t o the que s t i on of w he the rhe s upe r vi s e d pe opl e i n the de ve l opm e ntj ob.17

A s f orthe r e pr e s e nt a t i ons of G i dde ns ’ s f

or m e ra tt or ne y , R a nda l l P . H a rr i s on, thi s i s w hathe st at ed i n a S ept em ber 5, 20 01 , l ett ert o E qu i t abl e: T h e real est at e d ev el o p m en tw as a p assi v e i n v estm en tfo r [G i d d en s] thatw as m anaged pri m ar i l y by hi s w i fe . Itre qu i re d l i tt l e physi ca l a c tiv ity a s h e d id n o n e o f th e p h y s ic a l w o r k . T h e r e a l e s ta te devel op m entconsi st ed of re nt al prop erty a nd devel op m entof a s ubdi vi s i on. T he s e i nve s tm e nta c t i vi t i e s oc c ur r e d dur i ng a pe r i od f r o m J u n e , 1 9 8 5 u n til O c to b e r , 1 9 9 8 . A s a r e s u lt o f th e f a m ily r e l oc a t i ng, hi s w i f

e w a s nota bl e t o c ont i nue w i th the m a na ge m e ntof th ese i n v estm en t s w h i ch resu l t ed i n th e sal e o f m an y o f th e asset s. D uri ng hi s deposi t i on , H arri son exp l ai ned t hatthe ph ra se “ pass i ve i nv es tm ent , ” a s us e d i n tha tl e tt e r , m e a ns “ a r e a l e s t a t e i nve s tm e ntw he r e y ou ow n pr ope r ty but you’ re no tm anagi ng i tac t i vel y f rom day t o d ay . . . . A n exam pl e of thati s w hen you h ave . . . ac re age r ea l es t at e thatyou’ re ho l di ng for i nv es tm entpu rposes . ” H arri son rel i ed on G i dd ens’ s 199 9 S oci al S ec uri ty r eportas w el l as other com m un i ca t i on s f

rom G i dd ens i n d evi si ng the t erm “ pass i ve i nv es tm ent . ” H a rr i s on r e f

e r e nc e d tha t1999 r e por ta nd a tt a c he d a c opy of i tt o the S e pt e m be r5, 2001, l e tt e r . A s w e ha ve a l r e a dy s how n, i n the r e por t , G i dde ns i ndi c a t e d tha the d id n o t p e r f

o r m p h y s ic a l w o r k , a n d h e a ls o c h a r a c te r iz e d th e o c c u p a tio n a s “m a in ly a n i nve s tm e nt . ” G i dde ns s t a t e d i n the r e por t , how e ve r , tha the “ de ve l ope d l a nd f or com m er ci al and res i dent i al use, ” a nd he i nd i ca t ed thathe “ use[ d] t ec hn i ca l know l e dge ors ki l l s ” t o do s o. G i dde ns a l s o s a i d tha the ha d t o “ w r i t e r e por t s or c o m p le te f

o r m s ” a s p a r t o f

h is o c c u p a tio n .18

V i e w i ng the e vi de nc e i n the l i ghtm os tf a vor a bl e t o E qui t a bl e , the r e i s no e vi de nt i a ry ba s i s f

orc onc l udi ng tha tthe s ubs t a nt i a l a nd m a t e r i a l dut i e s of G i dde ns ’ s r e a l e s t a t e de ve l opm e ntoc c upa t i on i nc l ude d a ny a c t i ve m a na ge m e ntor p h y s ic a l w o r k . H a rr is o n ’s le tte ra n d th e 1 9 9 9 r e p o r t to th e S o c ia l S e c u r ity A d m in is tr a tio n , h o w e v e r , s h o w th a t h is d u tie s in th is “p a s s iv e in v e s tm e n t” r e qui r e d hi m t o us e “ t e c hni c a l know l e dge ors ki l l s . ” T hus , the ty pe of pa s s i ve i nv es tm enti n rea l es t at e devel op m entthathad b ee n h i s occ up at i on re qu i re s ex p ert i se an d k n o w l ed g e i n i n v est i n g . Itreq u i res, ata m i n i m u m , th e b u si n ess s a vvy , br a i n pow e r , a nd r e s e a r c h s ki l l s t o be a bl e t o di s t i ngui s h a good i nve s tm e nt f r om a ba d one . G i dde ns ow ne d hi s ow n r e a l e s t a t e c om pa ny , O a k L a nd & D e ve l opm e nt , I nc . , a nd E qui t a bl e doe s notdi s put e tha the w a s the br a i n, a l though
n o t th e b r a w n , b e h in d th a t o p e r a tio n . T h is d ef in it io n o f p as siv e in v es tm en t i s c o n sisten t w ith G id d en s’s d e s c r ip tio n d u r in g h is d e p o s itio n o f h is d u tie s a s in c lu d in g , in p a r t:

“ en trep ren eu ri al v i si o n an d en erg y; p l an n i n g real est at e p ro j ect s; sel ect i o n o f h o u se p la n s a n d m a te r ia ls ; s e le c tio n o f c o n tr a c to r s ; . . . s u p e r v is [ in g ] c o m p lia n c e w ith b u i l d i n g an d o th er reg u l at o ry co d es; p ro j ectsch ed u l i n g ; . . . w o rk [i n g ] w i th b an k s, gove rnm e nta ge nc i e s , a nd f i na nc i a l c ons ul t a nt s a s ne e de d; c a l c ul a t i ng the19

f e a s i bi l i ty of

pr oj e c t s , r e vi e w i ng s i t e s , a nd pl a nni ng f orc ont i nge nc i e s ; a nd coordi nat [i ng ] deal i ng s w i th rea l t ors a nd agent s. ” G i d d e n s ’ s u n c o n tr o v e r t e d me d i c a l e v i d e n c e s h o w s th a th e s u f f e r s f r o m a ho stof ph ys i ca l cond i t i on s a s w el l as m ent al i m pai rm ent s. D r. S pi vey i dent i fi ed G id d e n s ’s im p a ir m e n ts a s in c lu d in g “c h r o n ic s le e p d is tu rb a n c e s w h ic h le a d to chroni c f at i gu e, po or copi ng abi l i t i es , chroni c a nx i ety a nd depres si on , [a nd ] short te r m m e m o ry lo s s .” H is m e d ic a tio n s c a u s e “c o g n itiv e p r o b le m s in c lu d in g s h o r tt e r m m e m ory l os s , i na bi l i ty t o c onc e ntr a t e orf unc t i on, i na bi l i ty t o s l e e p, a nd o n g o in g d e p r e s s io n .” D r . W e b s te rte s tif ie d in h e rd e p o s itio n th a t in a d d itio n to d e p r e s s io n , G id d e n s “h a s a u d ito ry a n d v is u a l h a llu c in a tio n s ” a n d s id e e f f e c ts to h is
m e d ic in e in c lu d in g “f

o r g e tf u ln e s s a n d c o n f

u s io n .” E qu i t abl e di d n otperf orm an i nde pe nde ntm e di c a l e va l ua t i on of G i dde ns . T he t e s t i m ony of D r s . S pi ve y a nd W e b s te rs ta n d s u n r e f

u te d . T he he a r tof

G i dde ns ’ s c l a i m i s tha tgi ve n hi s c ogni t i ve pr obl e m s a nd phy s i c a l a i l m e nt s , he c a nnotpe r f or m the e ntr e pr e ne ur i a l , f i na nc i a l , pl a nni ng, co o rd in atin g , an d ad m in istrativ e d u ti es o f h is re al es tate o cc u p atio n . G id d en s’s m edi ca l evi dence and hi s doct ors’ t es t i m on y e st abl i shed thathe ca nn otperf orm m o s t o rth e m a

jo r ity o f th o s e d u tie s a n d th u s c a n n o t e n g a g e in h is r e a l e s ta te20

oc c upa t i on. W e a l s o a gr e e w i th the di s tr i c tc our t ’ s f ol l ow i ng a s s e s s m e ntof E qui t a bl e ’ s pos i t i on:

. . . w h i l e p l aci n g i n o rd i n at e em p h asi s o n t est i m o n y th atD r. G i d d en s’ engagem enti n rea l es t at e devel op m entdi d n oti nv ol ve phys i c al l abor, E qu i t abl e f

ai l s t o app re ci at e the un cont ra di ct ed t es t i m on y of D r. G i dde ns ’ phy s i c i a ns tha thi s c hr oni c f a t i gue , de pr e s s i on, a nxi e ty , a nd short -t erm m em ory l oss pre cl ud e D r. G i dd ens f rom perf orm i ng even the adm i nistrat i ve d u tie s a tte n d a n t to th a t e n te rp r is e . G i dde ns , 356 F . S upp. 2d a t1329. T he doc t or s t e s t i f i e d tha tG i dde ns s uf

f e r s f r om ha l l uc i na t i ons , m e m ory l os s , f or ge t f ul ne s s , i na bi l i ty t o c onc e ntr a t e a nd c onf us i on, an d E q u i t ab l e d i d n o tp resen tan y m ed i cal ev i d en ce t o th e co n trary. T h ese s y m pt om s obvi ous l y r e s ul ti n a di m i ni s he d i nt e l l e c tua l c apa c i ty , gr e a t l y hi nde r i ng G i dd ens’ s abi l i ty t o thi nk and reas on on a dai l y bas i s. A s are sul t , he i s no l on ger a bl e t o e xe r c i s e the “ t e c hni c a l know l e dge ” a nd “ s ki l l s ” tha the i de nt i f i e d a s j ob d u t i es i n h i s sw o rn st at em en tt o th e S o ci al S ecu ri ty A d m i n i strat i o n . A cco rd i n g l y, the di s tr i c tc our tdi d note rri n thi s r e ga r d. D . T ot al D i s ab i l i t y F r om R e al E s t at e O c c u p at i on W h ile th e r e is a lo t o f

d is c u s s io n in th e b r ie f

s a b o u t G id d e n s ’s d u tie s , it is b u t a p r e lu d e to E q u itab le ’s m a in d e f e n s e , w h ic h is b a s e d o n th e p o lic y la n g u a g e . E qui t a bl e a r gue s the P ol i c i e s r e qui r e tha tG i dde ns be una bl e t o pe r f or m a l l of

the s u b s ta n tia l a n d m a te r ia l d u tie s o f h is r e a l e s ta te o c c u p a tio n in o r d e rto b e to ta lly di sabl ed. E qu i t abl e s tre ss es thatG i dd ens i s unabl e t o p er form on l y m ostor aTh edis tric t c ourt c on c lude d th at th is a

rgument w a s raise d f

or thefirs t timein a

reply 8 brief a nd thus need not be c onsidered. G iddens, 356 F.Supp.2d at 1325 n.7. In any event, the district court re

jected theargument on the merits, noting that the evidenc e esta blished Giddens wa s una bleto p e rf

or m “ su bs tanti al po rtion s”of

theoc c up atio nal dutie s a nd thu s w a s to tally disabled under

the Policies. I d. On appe al, Equitable points out that, in fact, it first raised the argument in oppositi on to Giddens’s cross-motion for partial summary judgment, and thus the issue was properly

before the district cour

t. Equitable’s opposition brief does statethat Giddens inc or re c tly “ c ontend s th at th epo lic ie s sh ould b ere a d tome an th at heis totally dis a ble d if heis unable to perform ‘most,’ but not all, of the substantial and material duties of his re gular occupation,” and that Giddens’ s “interpretation would render nug atory the terms of theResidual Disability Income riders”a

nd is inconsistent with Georg ia ca se law. ( Opposition Brief , R-4-64 pp. 12-17.) Thus, Equitabletimely raised theissue. In divers ity

c a se s, theCourt

is b ound by thea pp lic a blestatelaw g ov e rningthec ontra c t, 9 in t hisc a seGe org ia

law. Se eCla

nto n v . Inter. Net G lob al, L .L .C. , 4 35 F .3 d 1 31 9, 13 23 (1 1th Cir. 2006). 21 m a jo r ity o f h is s u b s ta n tia l, m a te r ia l d u tie s . E q u itab le c o n te n d s th a t if G id d e n s is a b le to p e r f

o r m e v e n o n e o f

h is s u b s ta n tia l, m a te r ia l d u tie s , h e is n o t to ta lly di s a bl e d, butonl y pa r t i a l l y orr e s i dua l l y di s a bl e d. E qui t a bl e thus c ont e nds the d i stri ctco u rterred i n g ran t i n g su m m ary j u d g m en ti n fav o r o f G i d d en s. 8 B e c a us e thi s de f

e ns e i s ba s e d on the pol i c y l a ngua ge , w e f i r s tr e vi e w the G eo rg i a l aw reg ard i n g co n stru ct i o n o f i n su ran ce co n tract s an d th en th e P o l i ci es. 9 1. G eorgi a L aw U n d e rG e o r g ia la w , th e r ig h ts o f th e p a r tie s to a n in s u r a n c e p o lic y s h o u ld no tbe expand ed beyond the t erm s of the po l i cy . B al dw i n v . S t at e F arm F i re & C a s . C o. , 590 S . E . 2d 206, 208 ( G a . C t . A pp. 2003) . “ I n appl y i ng the rul e s of c o n s tru c tio n to a n in s u r a n c e c o n tr a c t, th e te s t is n o t w h a t th e in s u r e rin te n d e d its22

w o r d s to m e a n , b u t r a th e rw h a t a r e a s o n a b le p e r s o n in th e in s u r e d ’s p o s itio n w o u ld unde r s t a nd the m t o m e a n. ” W . P a c . M ut . I ns . C o. v. D a vi e s , 601 S . E . 2d 363, 368- 6 9 ( G a . C t. A p p . 2 0 0 4 ) ( q u o ta tio n m a r k s a n d c ita tio n o m itte d ) . W h e r e th e la n g u a g e o f

th e c o n tr a c t is u n a m b ig u o u s a n d o n ly o n e r e a s o n a b le in te rp r e ta tio n is p o s s ib le , th e c o n tr a c t m u s t b e e n f o r c e d a s w r itte n . S ap p v . S ta te F a r m F i r e & C a s . C o. , 486 S . E . 2d 71, 73 ( G a . C t . A pp. 1997) . H ow e ve r , w he n a po l i cy i s a m bi gu ou s, or i s c apabl e of tw o rea sonabl e i nt erpret at i on s, i ti s c on strued i n the l i ghtm os tf

a vor a bl e t o the i ns ur e d a nd a ga i ns tthe i ns ur e r . D a vi e s , 601 S . E . 2d a t369; E r i e I nde m . C o. v. L a s c a l a , 424 S . E . 2d 820, 821- 22 ( G a . C t . A pp. 1992) . I nde e d, “ [ p] ol i c i e s of i ns ur a nc e w i l l be l i be r a l l y c ons true d i n f a vorof the o b je c t to [ b e ] a c c o m p lis h e d , a n d c o n d itio n s a n d p r o v is io n s th e r e in w ill b e s tr ic tly c ons true d a ga i ns tthe i ns ur e r , a s the y a r e i s s ue d upon pr i nt e d f or m s , pr e pa r e d by e xpe r t s a tthe i ns ur e r ’ s i ns t a nc e , i n the pr e pa r a t i on of w hi c h the i ns ur e d ha s no voi c e . ” D a vi s v. U ni t e d A m . L i f e I ns . C o. , 111 S . E . 2d 488, 492 ( G a . 1959) ( q u o ta tio n m a r k s a n d c ita tio n o m itte d ) . G e o r g ia c o u r ts in s tru c t th a t d is a b ility p r o v is io n s s h o u ld b e g iv e n a “p r a c tic a l a n d r e a s o n a b le ” c o n s tru c tio n a n d n o t a

“ s tr i c ta nd l i t e r a l ” one . J ohn H a nc oc k M ut . L i f e I ns . C o. v. P os s , 267 S . E . 2d 877, 8 8 1 ( G a . C t. A p p . 1 9 8 0 ) ( c ita tio n o m itte d ) .23

I n a ddi t i on, the i nt e rpr e t a t i on of a n i ns ur a nc e pol i c y , i nc l udi ng the d e te r m in a tio n a n d r e s o lu tio n o f a m b ig u itie s , is a q u e s tio n o f la w f o rth e c o u r t to de c i de . O . C . G . A . § 13- 2- 1; C l a us s e n v. A e tna C a s . & S ur . C o. , 888 F . 2d 747, 749 (1 1 th C i r. 1 9 8 9 ). W e n o w tu rn t o th e P o l i ci es. 2. T he P ol i c y L a ngua ge A s n o te d e a r lie r , th e P o lic ie s d e f in e “T o ta l D is a b ility ” a s th e in a b ility to

“ engage i n the subst ant i al and m at er i al du t i es of your re gu l aroccupat i on . ” G i dd ens’ s P ol i ci es prot ec thi m agai nstdi sabi l i ty f rom hi s ow n “ re gu l ar oc c upa t i on” a nd do notr e qui r e tha tG i dde ns be di s a bl e d f r om “ a ny ” oc c upa t i on or “c o m p a r a b le ” o c c u p a tio n s . T h u s , w e lo o k to th e d u tie s o f h is r e a l e s ta te oc c upa t i on. F u r th e r , w e a g r e e w ith E q u itab le th a t G id d e n s d id n o t p r o v e th a t h e c o u ld notpe r f or m a l l s ubs t a nt i a l , m a t e r i a l dut i e s butr a the rpr ove d tha the c oul d not pe r f or m m os torthe m a

j or i ty of s uc h dut i e s . F ore xa m pl e , G i dde ns t e s t i f i e d tha the c a n n o t p e r f

o r m “m o s t o f

th e d u tie s ” o f

h is r e a l e s ta te o c c u p a tio n a n d is u n a b le to re sum e thatoccupat i on . F urther, D rs . S pi vey a nd W ebst ert es t i fi ed thathe w as u n a b le to p e r f

o r m “s u b s ta n tia l p o r tio n s o f th e d u tie s o f

” h is r e a l e s ta te devel op m ent . B y “ subst ant i al po rt i on s, ” D r. S pi vey m ea nt“ m ost ” a nd D r. W ebst erm ea nt“ the vastm aj ori ty. ” A m on g G i dd ens’ s s ub st ant i al , m at er i al du t i es24

tha the i s una bl e t o pe r f or m a r e hi s appl i c a t i on of e ntr e pr e ne ur i a l vi s i on a nd ener gy, hi gh er -l evel pl anni ng of re al es t at e devel op m entproj ec t s, fi nanci al
m a na ge m e ntof

de ve l opm e nta nd c ons truc t i on pr oj e c t s , a nd de t e r m i ni ng the f e a s i bi l i ty of

pr oj e c t s . A l though G i dde ns , a c c or di ng t o the e vi de nc e , pe rhaps rem ai n s ab l e t o p erfo rm a few d u t i es – i n cl u d i n g sel ect i n g h o u se p l an s, m at eri al s, a n d c o n tr a c to r s – th e te s tim o n y o f G id d e n s a n d D r s . S p iv e y a n d W e b s te rin d ic a te thathe i s unabl e t o p er form m ostor the vastm aj ori ty of the subst ant i al , m at er i al d u tie s o f r e a l e s ta te d e v e lo p m e n t, a n d th u s is to ta lly d is a b le d f r o m h is r e a l e s ta te o c c u p a tio n . E q u itab le ’s m a in a r g u m e n t o n ap p e a l is th a t G id d e n s m u s t b e u n a b le to p e r f o rm a ll s u b s ta n tia l a n d m a te r ia l d u tie s o f h is o c c u p a tio n in o r d e rto b e to ta lly d is a b le d . T h e p r o b le m f o rE q u itab le is th a t th e T o ta l D is a b ility c la u s e in its P ol i c i e s doe s noti de nt i f y w ha tpe r c e nt a ge of

“ the ” dut i e s the i ns ur e d m us tbe una bl e t o pe r f

or m . T he c l a us e doe s nots a y “ a l l ” s ubs t a nt i a l a nd m a t e r i a l dut i e s or “m o s t” o ra n y p e r c e n ta g e . F u rth er, th e p art i es h av e n o tci t ed , an d w e can n o tl o cat e, an y d eci si o n b y a G e o r g ia ap p e lla te c o u r t c o n s tru in g th e s a m e la n g u a g e in a d is a b ility p o lic y . H ow ever , the E i gh th C i rc ui thas c on strued the sa m e l angu age i n a di sabi l i ty pol i cy a nd de t e r m i ne d tha ti ti s a m bi guous . D ow dl e v. N a t ’ l L i f e I ns . C o. , 407 F . 3d 967,In Dowdle, the insure d paid an additional premium to obtain an “own oc cupation” rider 10 to the disability

policy , which expanded his protec tion by defining“occupation” as the occupation of the insured at the time of disability . 407 F.3d at 968. Thus, Dowdle’s policy was eff ectively the same a s Giddens’s. F urther, theResidual Disability definition in Dowdle’s policy define d “par

tial disability” as ina

bility to perfor m “one or more”of the important daily duties of his occupation, which is simi lar to Giddens’ s Poli cies. 25 97 0 (8t h C i r. 20 05 ) ( appl yi ng M i nn es ot a l aw t o p ol i cy defi ni ng t ot al di sabi l i ty a s i na bi l i ty “ t o pe r f

or m the m a t e r i a l a nd s ubs t a nt i a l dut i e s of a n oc c upa t i on” a nd concl ud i ng thatam bi gu i ty e xi st ed because “ [t ] he po l i ci es ’ defi ni t i on s of ‘ t ot al di s a bi l i ty ’ a r e s us c e pt i bl e t o di f f e r i ng i nt e rpr e t a t i ons , be c a us e the pol i c i e s do not sp eak i n t erm s o f ‘ an y, ’ ‘ al l , ’ ‘ so m e, ’ o r ‘ th e m o sti m p o rt an tp art ’ o f [th e i n su red ’ s] d u tie s ” ) . W e a g r e e w ith th e E ig h th C ir c u it th a t th e p o lic y la n g u a g e h e r e is

10
a m bi guous . W e do nots ugge s ttha t“ a l l ” i s a n unr e a s ona bl e i nt e rpr e t a t i on of the pol i c y l a ngua ge , butw e do s a y tha t“ m os t ” orthe “ m a j or i ty ” of

the s ubs t a nt i a l a nd
m a t e r i a l dut i e s i s a l s o a r e a s ona bl e i nt e rpr e t a t i on i f a n i ns ur e d i s una bl e t o e nga ge in h is r e g u la ro c c u p a tio n a s a r e s u lt o f h is in a b ility to p e r f

o r m m o s t o rth e m a

jo r ity o f th o s e d u tie s . C o n s tru i n g th e P o l i c i e s i n f a v o ro f Gi d d e n s a n d a g a i n s tE q u i t a b l e , we concl ud e G i dd ens m ay es t abl i sh t ot al di sabi l i ty i f he c anno tengage i n h i s r ea l e s t a t e oc c upa t i on be c a us e he i s una bl e t o pe r f or m m os torthe va s tm a j or i ty of the su b stan ti al an d m ater ial d u ti es o f h is o cc u p atio n . A s o u tl in ed ab o v e, G id d en s’sWe re c ognizethat G idde ns argue s th at summa ry judgment s ho uld

beup he ld in h is 11 favor beca use Equitable f

ailed to pre sent evidenc e that he c ould perfor m even oneof the su bs tanti al and

materi al dutie s o f his re al e stateoc c up atio n. Ho wever, Eq uit a ble ’spo sition

is that the Policies requirethat Giddens show he is una ble to perf

orm all substantial and material duties and that he ha s not done so beca use his doctors testified only that he ca

nnot perfor

m the vast majority

of his duties and did not say all duties. Equitable did not need to controvert the doctors’ te stimony

beca use its positi on is their testimony did not establish total dis ability under 26 evi dence es t abl i shed i nabi l i ty t o p er form m ostof hi s i m po rt antdu t i es and an in a b ility to e n g a g e in h is r e a l e s ta te o c c u p a tio n . T ha tG i dde ns m a y be a bl e t o pe r f or m one orm or e of

the s ubs t a nt i a l a nd
m a t e r i a l dut i e s a s s oc i a t e d w i th tha toc c upa t i on s i m pl y doe s notpr e c l ude a s how i ng o f to ta l d is a b ility u n d e rth e te r m s o f th e P o lic ie s , a s E q u itab le c la im s . E v e n if G i dde ns c a n pe r f

or m a f e w s ubs t a nt i a l a nd m a t e r i a l dut i e s – i nc l udi ng, f or e x a m p le , s e le c tin g h o u s e p la n s , m a te r ia ls , a n d s u b c o n tr a c to r s – h is a b ility to p e r f o rm th o s e ta s k s in is o la tio n s till w o u ld n o t a llo w G id d e n s to c o n tin u e in h is
r e a l e s ta te d e v e lo p m e n t o c c u p a tio n b e c a u s e h e is u n a b le to p e r f o r m h is entre preneuri al , fi nanci al , pl anni ng , coordi nat i ng , and adm i ni stra t i ve du t i es , w hi ch
w e r e the he a r tof

hi s r e a l e s t a t e oc c upa t i on. S e e D ow dl e , 407 F . 3d a t972 (c on cl ud i ng thatsurgeon w ho coul d n o l on ger s t and l on g eno ug h t o p er form o rth o p ed i c su rg ery b u tco u l d co n d u cto ffi ce v i si t s, see p at i en t s, read x -rays, p erfo rm IM E s, i n t erp retd at a, an d p ro m o t e referrals w as t o t al l y – n o tresi d u al l y – di sabl ed because he coul d n otperf orm “ the m osti m po rt antsubst ant i al and m at er i al du ty” ). 11theterm s o f t hePol ic ie s. See, e.g ., South, 177 S .E. at 500 (“ The policy provided that total disability . . . exis ted 12 wh e never t

heins ure d w a s ‘ rend e re d who lly, c ontin uo us ly, a nd perm anently

un a bleto eng ag ein any occupation or perf

orm any work for any kind of compensation of financial value duringthe remainde r o f his l if

e .’ ” ); John so n, 20 S.E .2 d at 76 2 ( statingthat po lic y prov ide d f

or bene fits when the insure d beca

me “totally

and per manently disabled . . . from eng ag ing in a ny occupation and performingany

work for compensation or profit”); B arron, 30 S.E.2d at 880 (statingthat ins uranc epo lic y

de fine d to tal di sa

bil ity a s “ any imp air ment o f mind

or bo dy whic h c ontin

uo us ly renders it impossi ble for theinsured to follow a g ainful occupation”); Cato, 138 S.E. at 790 (s tatingthat di sa

bil ity wo uld bede e me d to tal and

perm anent i f “ su c h disa

bil ity pre suma bly wi ll duringlifetime prevent such employee f rom pursuingany

occupation for wag es or profit”); Clo e r, 15 2 S. E. 2d

at 85 8 ( “ Th ec la

us ein t hedis a bil ity ri der . . . re a ds that th eins ure r w ould waive thepremiums should the insured ‘be come totally disabled as the result of bodily injury or 27 3 . E q u itab le ’s A r g u m e n ts E qu i t abl e a rgues thatG eorgi a l aw com pel s the i nt erpret at i on thatt ot al d is a b ility e x is ts o n ly w h e r e th e in s u r e d is u n a b le to p e r f o r m a ll o f

th e s u b s ta n tia l,
m a te r ia l d u tie s o f

h is o c c u p a tio n . E q u itab le c ite s s e v e r a l G e o r g ia c a s e s th a t it cl ai m s co m p el th i s d efi n i t i o n o f “ t o t al d i sab i l i ty. ” S ee, e. g . , C l o er v . L i fe & C as. Ins. C o. of T enness ee , 15 2 S . E . 2d 85 7 (G a. 19 66 ); M ut . L i fe Ins. C o. of N ew Y ork
v. B a rr on, 30 S . E . 2d 879 ( G a . 1944) ; M e tr o. L i f e I ns . C o. v. J ohns on, 20 S . E . 2d 76 1, 76 2 (G a. 19 42 ); P rudent i al Ins. C o. of A m . v. S ou th, 17 7 S . E . 49 9, 50 2 (G a. 19 34 ); C at o v . A etna L i fe Ins. C o. , 13 8 S . E . 78 7 (G a. 19 27 ). T he s e c a s e s f

a i l t o s uppor tE qui t a bl e ’ s pos i t i on be c a us e the pol i c y l a ngua ge in te rp r e te d in th o s e c a s e s w a s s u b s ta n tia lly d if f e r e n t f r o m th e r e le v a n t la n g u a g e in th is c a s e . I n th o s e c a s e s , th e p o lic ie s d e f in e d “to ta l d is a b ility ” a s th e in a b ility to pe r f or m “ a ny oc c upa t i on” or“ a ny w or k. ” H e r e , by c ontr a s t , the P ol i c i e s de f i ne 12disease so a s to be wholly prevented thereby

from eng ag ing in a

ny occupation or employ

ment for wag e or profit.’”) . Georg ia cour

ts recognize a distinction between “ occupational” policies, which provide 13 bene fits o f t

heins ure d isdis a

ble d f ro m a pa rticula r o c c up atio n, vers us “ no n- oc c up atio nal” disability insurancepolicies, which providebenef its only if the insured is disabled f rom any occupation or g ainful ac tivity . See Parker v. Prudential Ins. Co. of Am., 482 S.E.2d 483, 485-86 (Ga . Ct. App. 1997). The Policies in this case a re oc cupational, but the policies in the c ases c ited by Equitable are non-oc cupational. 28 t ot a l di s a bi l i ty a s the i na bi l i ty t o pe r f or m “ the s ubs t a nt i a l a nd m a t e r i a l dut i e s of your re gu l aroccupat i on , ” w i tho utre gard t o w hether the i nsured coul d d o o ther ki nd s of w ork. M ore i m po rt ant l y, no ne of the po l i ci es i n these G eorgi a c as es 13 cont ai ned t he l angu age a ti ss ue here – “ the subst ant i al and m at er i al du t i es . ” I f a ny thi ng, E qui t a bl e ’ s c a s e s s how how G e or gi a c our t s l i be r a l l y c ons true di sabi l i ty pol i ci es i n favor of i nsureds a nd stri ct l y a gai nsti nsurer s. In the ca se s E qui t a bl e c i t e s , the G e or gi a c our t s r e j e c t e d the i ns ur e r s ’ c l a i m s tha tthe
r e qui r e m e ntof

i na bi l i ty t o pe r f

or m “ a ny oc c upa t i on” or“ a ny w or k” m e a nta ny ga i nf ul e m pl oy m e nt . S e e B a rr on, 30 S . E . 2d a t883; J ohns on, 20 S . E . 2d a t762; S outh, 177 S . E . a t501. I ns t e a d, the G e or gi a c our t s c ons true d the l a ngua ge of in a b ility to p e r f

o r m “a n y w o r k ” o r“a n y o c c u p a tio n ,” in f a v o ro f th e in s u r e d , to m ea n i nabi l i ty t o p er form subst ant i al po rt i on s of the i nsured’ s ordi nary e m pl oy m e ntora ny othe re m pl oy m e ntappr oxi m a t i ng the i ns ur e d’ s s a m e l i ve l i hood as h e m i g h tfai rl y b e ex p ect ed t o fo l l o w g i v en h i s p erso n al ci rcu m st an ces, i nc l udi ng hi s e xpe r i e nc e , e duc a t i on, phy s i c a l a nd m e nt a l c apa c i t i e s . S e e B a rr on,Ev e n E quita ble ’sany-o c c up atio n c a se s h avelanguag esug g e stingthat to tal di sa bil ity 14 does not require that all duties are close d to the insured, but only that “substantially

all” of the materi al dutie s arec los e d totheins ure d. Se e , e .g ., South, 17 7 S. E. at 50 2 ( “ I f t heins ure d isso incapacitated that substantially all of the material ac tiviti es of a ny [employ ment approximating thesameliv e lih oo d a s th eins ure d’ s o rdina ry e mpl oy ment] a rere a so na

bly c los e d tohim , h eis totally disabled within the meaningof the policy .” (emphasis added) ); J ohnson, 20 S.E.2d at 764 (s tatingthat “ tot al di sa

bil ity un der t hepo lic y e xists on ly

wh e n th eins ure d isinc a

pac itate d to perf orm substantially

all of the duties of his employ ment”); B arron, 30 S.E.2d at 883 (“Total disability is inability

to do substantially

all of the material ac ts nece ssary to the transac tion of the insured’s oc cupation, in substantially his customary

and usual manner.”) (quotingCato, 138 S.E. 787); Cloer, 152 S.E.2d at 859 (c oncludingthat the jury charg e wa s correct be causeit was in line wi th Johns on , where“ thi s c ourt in a full b e nc h d e c isi on

c lari fi e d th eme aningof

tot al di sa bil ity by statingthat ‘ tot al di sa

bil ity un der t hepo lic y e xists on ly

wh e n th eins ure d isinc a

pac itate d to perf orm substantially

all of the duties of his employ ment’”) ; Equicor, Inc. v. Stamey, 454 S.E.2d 5 5 0 , 5 5 2 ( G a . C t . Ap p . 1 9 9 5 ) ( s t at i n gth atun d e r B ar ro nan d o th e r p re c e d e nt , “ ‘ t o t aldi s a

b i l i ty’ require s only

that the insured beunable to perform substantial portions of his ordinary e mpl oy ment o r a ny oth e r empl oy

ment a pp ro ximatingthesameliv e lih oo d . . . .” ); Trave lersIns . Co. v. Stanley , 1 60 S.E .2 d 8 76 , 8 78 (G a . Ct . App . 1 96 8) (“As summa ri zed in t hefirs t he a dn ote of theJohn so n c a se , th eins ure d istot ally dis a ble d when ‘ heis s o in c a

pac itate d th at su

bs tanti ally all of the material ac tiviti es of his employ ment, or any

simil ar employ

ment, approximating the same livelihood, arerea sonably closed to him. Inability

of the insure d to perfor

m one or moreof the substantial duties of such employ ment, if this be less than substantially all such duties, does not constitute total disabili ty under suc h a policy .’”) .

29 30 S . E . 2d a t883; J ohns on, 20 S . E . 2d a t762; S outh, 177 S . E . a t501. I n doi ng s o, the G eorgi a c ou rt s s tre ss ed thatthe w ord “ occupat i on ” m ust“ be construed a c c or di ng t o the f

a c t s a nd c i r c um s t a nc e s of the e xe c ut i on of

the c ontr a c t , i nc l udi ng the obj e c t s t o be e f

f e c tua t e d the r e by . ” S outh, 177 S . E . a t501; s e e a l s o C a t o, 138 S . E . a t791 ( c ons trui ng t ot a l di s a bi l i ty l a ngua ge a nd s t a t i ng tha t“ [ p] ol i c i e s of i ns ur a nc e w i l l be l i be r a l l y c ons true d i n f a vorof the obj e c tt o be a c c om pl i s he d, a nd p ro v i si o n s th erei n w i l l b e stri ct l y co n stru ed ag ai n stth e i n su rer”). T h u s, i n th ese c a s e s the G e or gi a c our t s c ons true d “ a ny ” oc c upa t i on a s oc c upa t i ons appr oxi m a t i ng th e in s u r e d ’s liv e lih o o d . T h e o b je c t to b e a c c o m p lis h e d in G id d e n s ’s P o lic ie s is 14Indeed, ta king E quitable’s argument to the logic al extreme would nullify the Total 15 Disability clause . Residual Disability , by its definition, includes the inability to perfor m one or moreof themateri al dutie s; a

lit e ral re a dingwo uld

inc ludea tot al in a bil ity to p e rf or m all d uti e s, sin c eall d

uti e s arec le arly

“ on eor more ”dutie s.

30 t ot al di sabi l i ty c ov er age i f he i s unabl e t o p er form so m any s ub st ant i al and m at er i al d u tie s th a t h is r e g u la ro c c u p a tio n is r e a s o n a b ly c lo s e d to h im . T h a t p o in t is c le a r ly
r e a c h e d in G id d e n s ’s c a s e . E q u itab le f

in a lly a r g u e s th a t to ta l d is a b ility m u s t m e a n th e in a b ility to perf orm al l of the m at er i al and sub st ant i al du t i es because t o i nt erpretthe t erm othe rw i s e w oul d nul l i f

y the “ R e s i dua l D i s a bi l i ty ” c l a us e . T he P ol i c i e s de f i ne

“ re si du al ” di sabi l i ty a s the i nabi l i ty “ t o p er form . . . on e or m ore of the subst ant i al a n d m a te r ia l d u tie s o f

[ th e in s u r e d ’s ] o c c u p a tio n .” T h is a r g u m e n t is u n p e r s u a s iv e . Q u ite o b v io u s ly , th e r e is a c o n tin u u m o f d is ab ility . I f

th e in s u r e d is u n a b le to perf orm on l y “ on e or m ore” of m any m at er i al occupat i on al du t i es , then t he i nsured
w o u ld n o t b e to ta lly d is a b le d . W h e r e th e in s u r e d , s u c h a s G id d e n s , is u n a b le to pe r f or m m os torthe m a

j or i ty ( butnota l l ) of

the m a t e r i a l dut i e s a nd thus c a nnot e nga ge i n hi s r e gul a roc c upa t i on, the i ns ur e d ne ve r the l e s s i s t ot a l l y di s a bl e d f r om hi s r egul aroccupat i on , and t hi s i nt erpret at i on do es no tnu l l i fy the R es i du al D is a b ility c la u s e . A t s o m e p o in t, a lin e m u s t b e d r a w n w h e r e th e d is a b ility 15 becom es so se vere , and aff ec t s s uch a l ar ge perce nt age of the i nsured’ s m at er i al a nd s ubs t a nt i a l dut i e s , tha tthe di s a bi l i ty i s t ot a l r a the rtha n r e s i dua l . T he l a ngua geBe causeEquitable re lies so heavily on Metro. Life Ins. Co. v. J ohnson, 20 S.E.2d 761 16 (G a . 1 94 2) , w edis c us s th at c a sein m orede tail. In Johns on , th epo lic y prov ide d f

or bene fits when the insure d beca

me “totally

and per manently disabled . . . from eng ag ing in a ny occupation and performingany

work for compensation or profit.” I d. at 762. J ohnson concerned diff erent policy terms than Giddens’ s Poli cies a nd does not control. In any event, a s noted in footnote 18 supra, Ge org ia cour

ts read Johnson as we do, a nd J ohnson, if any

thing, supports Giddens’s re c ov e ry be c a us etheJohn so n c ourt

tw ic estate d th at to tal di sa bil ity e xists wh e n th eins ure d is unable “to perfor

m substantially

all of the duties of his employ ment.” I d. at 764-65. Equitable nonethe less argues that other la nguag e in J ohnson establishes the rulethat total disability require s inability

to perfor m all duties. W e disagree . J ohnson does g o on to state that “although [the insured] is unable to perform some or even many of the substantially

material activities of his employ

ment,” he is not totally

disabled “so longas [he] has capac ity to perfor m any substantial part of his duties.” Id. (empha sis added). At other points, the J ohnson court stated that an insure d was not totally disabled “if a

ny substantially

material activities of the employ ment remain open to the insured,”and that a c ase of total disability

is presente d if the insured is unable to perfor m “any substantial part of his ordinar y duties.” I d. (empha sis added). However, Johns on did not indicate that no sing le duty (even a material and substantial one) c ould remain open to the insured. That an insured must be una ble to perf

orm “a ny substantial part” of

his duties as a whole is significantly different than Equitable’ s sugg ested requirement that he be una ble to perf

orm each and every

substantial duty . Here, Giddens’ s evidenc e shows that he is una ble to perf

orm “the va st majority” of his substantial and material duties, including themost important duties, and thus he ha s shown that he is unable to perfor m “any substantial part of his duties.” 31 o f th e R e s i d u a l Di s a b i l i ty c l a u s e d o e s n o ts u g g e s twh e r e th a tl i n e s h o u l d b e d r a wn and cert ai nl y does notre qu i re thati tbe draw n o nl y w here E qu i t abl e s ug gest s. If E qu i t abl e m ea ns “ al l ” i n i t s T ot al D i sabi l i ty c l ause , then E qu i t abl e m ay m ake that si m p l e ch an g e t o i t s p o l i cy fo rm s. 16 I I I . CONCL US I ON F or the foregoi ng re as on s, w e a ff i rm the di stri ctcourt ’ s gra ntof sum m ary j ud gm enti n favor of G i dd ens a s t o h i s 199 9 d i sabi l i ty c l ai m re gardi ng hi s r ea l e s t a t e oc c upa t i on. W e r e ve r s e the de ni a l of s um m a ry j udgm e nti n f a vorof E qui t a bl e a s t o hi s 1999 di s a bi l i ty c l a i m a s t o hi s de nt i s try oc c upa t i on.32

A F F IR M E D i n p art, R E V E R S E D i n p art.