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Felton v. Hartford Life and Insurance Company

United States District Court, D. Maryland

March 22, 2019

WILLIAM! FELTON
v.
HARTFORD LIFE & INSURANCE COMPANY

          MEMORANDUM

          CATHERINE C. BLAKE UNITED STATES DISTRICT JUDGE

         This insurance dispute arises between William J. Felton and Hartford Life and Accident Insurance Company ("Hartford").[1] Pending before the court is Hartford's motion to dismiss the complaint as untimely, and for failure to state a claim (ECF No. 10). For the reasons outlined below, the court will deny Hartford's motion. The issues have been briefed and no oral argument is necessary. See Local Rule 105.6 (D. Md. 2018).

         BACKGROUND

         This case arises from Hartford's June 8, 2016, denial of Felton's claim for Total Disability. (CompL Ex 1 ["Letter Contesting Denial"] at 2, ECF No. 2). Prior to the initiation of this suit, Felton worked as a counselor for the Anne Arundel County school system and was covered under a disability policy Hartford provided to the Teacher Association of Anne Arundel County. (Id. at 1-2). Under the policy, Total Disability is defined as:

         Your disability while covered under the Policy resulting:

(a) from Sickness, disease or Complication of Pregnancy; or
(b) directly from accidental bodily Injuries and independently of all other causes; which requires the regular care of a duly licensed physician or surgeon, and completely and continuously prevents You:
(a) from performing any of Your occupational duties during the first 104 weeks of the period of Total Disability; and
(b) from engaging, during the remainder of the period of Total Disability, in any occupation or employment for which You are fitted by education, training and experience.

(Compl. Ex 2 [the "Policy"] at 1, ECF No. 2). In other words, a claimant will not qualify for Total Disability unless their disability not only precludes them from holding their current position of employment, but also precludes them from holding that same position in any other work environment. (Id.).

         Hartford denied Felton's claim for Total Disability because, by its account, "all of your doctors do not see any limitation that would preclude you from working in your occupation as a counselor in a different work environment or for another employer. Global psychiatric impairments precluding occupational function are not substantiated." (Letter Contesting Denial at 1-2 (quoting the June 8, 2016, letter Hartford's Senior Ability Analyst, -Tricia L. Neild-Barry, sent Felton)). Hartford concluded that Felton's condition might prevent him from working in his current position as a counselor in the Anne Arundel school system, but it did not preclude him from working as a counselor in any other work environment. (Letter Contesting Denial at 2; The Policy at 1).

         Felton alleges that Hartford improperly denied his claim of Total Disability. (Compl. at 1). As Hartford recognized in its motion to dismiss, this case is essentially an appeal from the September 20, 2017, Final Order of the Maryland Insurance Administration ("MIA"), which affirmed Hartford's denial of benefits. (Def.'s Mot. at 2).

         ANALYSIS

         Resolution ...


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