Kelly v. Provident Life & Accident Insurance Co.

Facts

Plaintiff was a General Agent for General American Life Insurance Company. In the early 1980s, defendant issued plaintiff two own-occupation disability insurance policies that would provide a combined benefit of $5,500 per month in the event plaintiff became disabled. In May 1986, plaintiff began seeing a psychologist and was diagnosed with depression, dysthymic disorder, and schizoid personality disorder. In September 1986, plaintiff filed for complete disability and began receiving benefits. Defendant paid on plaintiff’s disability claim for thirteen years, however it investigated plaintiff’s claim during that time. During its investigation defendant notified various law enforcement agencies suggesting that plaintiff was committing insurance fraud. On August 18, 1999, defendant sent plaintiff a letter terminating his benefits. Plaintiff and plaintiff’s doctor sent a number of letters in response. In November 2000, defendant sued plaintiff and his insurance companies for various claims of fraud and conspiracy. Plaintiff contacted defendant’s lawyer seeking a settlement and plaintiff was advised that defendant would put its case on hold while the lawyer looked into settlement. On April 11, 2001, plaintiff learned that a default judgment had been entered against him and the companies causing plaintiff to become distressed. On July 2 and July 5, 2001, plaintiff and defendant’s attorney attended evaluation conferences with the judge and a settlement agreement was reached on November 21, 2001.