January 08th, 2018

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US Court of Appeals for the Fifth Circuit Opinions
Cox v. Provident Life & Accident Insurance Co.

Docket: 16-60831
Opinion Date: December 29, 2017
Judge: Jerry Edwin Smith
Areas of Law: Contracts, Insurance Law

Plaintiff appealed the district court's grant of summary judgment for Provident on breach-of-contract and tortious-breach-of-contract claims stemming from two disability insurance policies that Provident issued to plaintiff. The Fifth Circuit held that plaintiff presented sufficient evidence to raise a genuine dispute of material fact as to whether his disability resulted from injury and arthritis, in which case he would be entitled to lifelong benefits. Therefore, the court reversed the grant of summary judgment as to the breach-of-contract claim. Even if plaintiff had not waived his claim for punitive damages based on the theory that Provident tortiously breached the contract, he failed to offer evidence showing that Provident lacked an arguable reason for administering his claim under the sickness provisions. Accordingly, the court affirmed as to this issue.

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