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Hepp v. Paul Revere Life Ins. Co.

United States District Court for the Middle District of Florida, Tampa Division

July 31, 2015, Decided; July 31, 2015, Filed

CASE NO. 8:13-cv-02836-EAK-TBM

Opinion

 [*1331]  ORDER ON MOTIONS FOR SUMMARY JUDGMENT

THIS CAUSE is before the Court on Plaintiff's Motion for Summary Judgment as to Count One and Defendants' Affirmative Defenses (Doc. 145), Defendants' Motion for Summary Judgment (Doc. 149), Defendants' Response in Opposition to Plaintiff's Motion [**2]  for Summary Judgment as to Count One and Defendants' Affirmative Defenses (Doc. 153), and Plaintiff's Response in Opposition to Defendants' Motion for Summary Judgment (Doc. 154). For the reasons set forth below, Defendants' Motion for Summary Judgment (Doc. 149) is DENIED and Plaintiff's Motion for Summary Judgment (Doc. 145) is GRANTED IN PART, with respect to Defendants' Seventh, Eighth, Eleventh, Twelfth, Fourteenth, Fifteenth, Sixteenth, Seventeenth, Eighteenth, Nineteenth, and Twenty-First Defenses, and DENIED IN PART as to all other defenses and to Count One.

PROCEDURAL HISTORY

Plaintiff filed this action on November 6, 2013, against The Paul Revere Life Insurance Company, The Unum Group, and Provident Life and Accident Insurance Company for failing to pay total benefits on two long-term, own-occupation, professional disability insurance plans that Plaintiff had purchased to protect the income from his medical practice. (Doc. 1). In his Complaint (Doc. 1), Plaintiff alleges nine counts of misconduct by the Defendants. These include: (1) breach of contract, (2) violation of Chapter 624 of the Florida Statutes (bad faith), (3) breach of fiduciary duties, (4) breach of covenant of good faith and fair dealing, (5) [**3]  violation of 18 U.S.C. § 1962 (a), a Federal RICO statute, (6) violation of 18 U.S.C. § 1962 (b), a Federal RICO statute, (7) violation of 18 U.S.C. § 1962 (c), a Federal RICO statute, (8) fraud as to statements and omissions regarding the nature and quality of Plaintiff's policy, and (9) fraud as to Plaintiff's occupational determination, CPT code analysis, and claims determinations.

 [*1332]  On May 29, 2015, both Defendants (Doc. 149) and Plaintiff (Doc. 145) filed Motions for Summary Judgment. On the same day, Defendants filed a Statement of Undisputed Facts (Doc. 148), Plaintiff filed a Statement of Undisputed Facts (Doc. 146), and Defendants filed a Joint Statement of Undisputed Facts (Doc. 147) on behalf of both parties. On June 18, 2015, both Plaintiff (Doc. 154) and Defendants (Doc. 153) filed Responses in Opposition to the respective Motions for Summary Judgment. Additionally, Plaintiff (Doc. 155) and Defendants (Doc. 152) filed Statements of Disputed Facts on June 18, 2015.

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120 F. Supp. 3d 1328 *; 2015 U.S. Dist. LEXIS 100503 **

WALTER R. HEPP, M.D., Plaintiff, vs. THE PAUL REVERE LIFE INSURANCE COMPANY, PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY, and THE UNUM GROUP, Defendants,

Prior History: Hepp v. Paul Revere Life Ins. Co., 2014 U.S. Dist. LEXIS 107393 (M.D. Fla., Aug. 5, 2014)

CORE TERMS

disability, electrophysiology, specialty, Residual, electrophysiologist, fiduciary, invasive, cardiology, ambiguous, racketeering, mail, cardiologist, premiums, genuine, wire, fraudulent, omission, mutually, misrepresentation, credibility, medicine, repose, pre-disability, conjunction, proximately, Conversely, Deposition, subsidiary, nonmoving, Sickness