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[DO NOT PUBLISH]
IN THE UNITED STATES COURT OF APPEALS
FOR THE ELEVENTH CIRCUIT
________________________
No. 19-14032
________________________
D.C. Docket No. 6:17-cv-02208-JA-EJK
LLOYD WICKBOLDT,
Plaintiff - Appellant,
versus
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY,
A foreign corporation,
Defendant - Appellee.
________________________
Appeal from the United States District Court
for the Middle District of Florida
________________________
(December 1, 2020)
Before MARTIN, LUCK, and BRASHER, Circuit Judges.
MARTIN, Circuit Judge:
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Lloyd Wickboldt appeals the District Court’s order denying him summary
judgment and granting summary judgment to Massachusetts Mutual Life Insurance
Co. (“MassMutual”). He claims the terms of his disability policy, and attached
riders and other documents, entitle him to a cost of living adjustment in addition to
his monthly disability benefit for the rest of his life. After careful consideration,
and with the benefit of oral argument, we affirm the District Court’s order.
I. FACTUAL BACKGROUND
In 1985, Dr. Wickboldt, then a 33-year-old dermatologist, bought a
disability insurance policy from MassMutual’s predecessor. 1 Dr. Wickboldt
purchased a basic policy (the “Basic Policy”) as well as a Cost of Living Rider (the
“COLA Rider”). One year later he bought a Lifetime Total Disability Benefits
Rider (the “Lifetime Rider”). We’ll refer to these documents collectively as the
“policy documents.”
In 2000, when he was 48 years old, Dr. Wickboldt became totally disabled.
MassMutual began paying Dr. Wickboldt $8,000 per month under the Basic
Policy. After one year, MassMutual also began paying Dr. Wickboldt an
additional sum under the COLA Rider. From May 2015 to August 2017, Dr.
Wickboldt was receiving about $16,000 per month in disability benefits under the
1
The fact that the disability policy was originally issued by a different company (which
MassMutual acquired) has no impact on this case.
2
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Basic Policy and the COLA Rider. But after September 1, 2017, and according to
its interpretation of the policy documents, MassMutual stopped paying Dr.
Wickboldt monthly benefits under the Basic Policy as modified by the COLA
Rider. It then started paying Dr. Wickboldt’s monthly payments of $8,000, which
was the new calculation of benefits provided under the Lifetime Rider. Dr.
Wickboldt, however, claims he is entitled to the additional COLA Rider benefits
for the rest of his life. He filed suit to recover those benefits.
In December 2018, Dr. Wickboldt filed for summary judgment.
MassMutual opposed Dr. Wickboldt’s motion. A few months later, the District
Court issued an order denying Dr. Wickboldt’s motion for summary judgment and
directing the clerk to enter judgment for MassMutual. The District Court found
that the policy documents were not ambiguous and the plain language indicated
that, “after September 1, 2017, Dr. Wickboldt is entitled to receive $8,000 in
benefits under the Lifetime Rider but is not entitled [to] benefits under the Basic
Policy or to past or future benefit increases under the COLA Rider.” The District
Court’s finding was based on a termination provision in the COLA Rider, which
the District Court said made “clear that benefit increases would not be paid beyond
September 1, 2017—the policy Anniversary on or after Dr. Wickboldt’s 65th
birthday.” The District Court thus rejected each of Dr. Wickboldt’s theories of
interpretation.
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II. THE POLICY DOCUMENTS
The Basic Policy sets forth several definitions that apply with equal force to
the terms in the attached riders. For example, “Maximum Benefit Period” is
defined as “The maximum length of time we’ll pay benefits, whether for total
disability, residual disability or a combination of both.” The Basic Policy pays out
benefits for Total Disability, but MassMutual will “only pay up to the maximum
benefit period.”
The COLA Rider describes itself as “provid[ing] monthly benefit increases
while you’re totally or residually disabled.” In relevant part, the COLA Rider
provides:
When We’ll Pay Monthly Benefit Increases. We’ll pay
monthly benefit increases while you’re receiving total or
residual disability benefits.
...
How Long We’ll Pay Benefit Increases. While you’re
totally or residually disabled, we’ll pay benefit increases
until the earliest of:
• the date your total or residual disability ends;
• the date the maximum benefit period under this rider
ends; [or]
• the anniversary on or after your 65th birthday.
...
Termination. This rider will end on the earliest of the
following dates:
• 31 days after the due date of any unpaid premium;
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• as of the next premium due date upon your written
request;
• the anniversary on or after your 65th birthday; [or]
• the date that your policy ends.
The Lifetime Rider says it “provides monthly total disability benefits to be
paid beyond the Anniversary on or after your 65th birthday. Benefits will be paid
for life.” The Lifetime Rider also includes the following terms:
When We’ll Pay Monthly Total Disability Benefits. If
you’re eligible,2 your monthly benefits under this rider
will start after the Anniversary on or after your 65th
birthday. We’ll make the first payment 1 month after that
Anniversary. We’ll continue to make monthly payments
as long as you remain totally disabled.
Monthly Total Disability Benefit. The largest amount of
monthly benefit you will receive under this rider is shown
on the current Coverage Page of your policy.
...
Termination. This rider will end on the earliest of the
following dates.
• 31 days after the due date of any unpaid premium,
• as of the next premium due date upon your written request,
• the Anniversary on or after your 65th birthday, 3 [or]
• the date that your policy ends.
2
There is no dispute that Dr. Wickboldt is eligible for benefits under the Lifetime Rider.
3
We do not read this termination provision as being in conflict with the provision
describing when benefits begin. Because the purpose of the Lifetime Rider “is to provide
benefits . . . beyond the age of 65,” this termination provision makes clear that the Lifetime Rider
terminates at age 65 if the insured does not become totally disabled before the age of 65. See
Oral Argument Recording at 29:15–31:03 (Nov. 18, 2020).
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Finally, the “Coverage Page” referred to in the Monthly Total Disability
Benefit under the Lifetime Rider sets forth, in pertinent part:
EFFECTIVE COVERAGE MONTHLY MAXIMUM * BENEFIT ANNUAL
DATE BENEFIT PERIOD PREMIUM
SEP 01 1985 BASIC MONTHLY $8,000 TO 65 $1,940.20
BENEFIT WITH THEREAFTER $3,049.00
ADJUSTABLE BENEFIT
SEP 01 1985 PARTIAL DISABILITY $4,000 $360.00
SEP 01 1986 LIFETIME $8,000 $475.20
ACCIDENT/SICKNESS
SEP 01 1985 COST OF LIVING RIDER $763.20
MAXIMUM 7.50%
SEP 01 1985 OWN OCCUPATION/ $8,000 THEREAFTER $220.00
PRESUMPTIVE DIS $368.80
RIDER
YOUR MAXIMUM MONTHLY BENEFIT IS $8,000
The asterisk in Maximum Benefit Period refers to the statement that “[y]our
benefit period for disability is your specified benefit period, but not beyond SEP 01
2017. . . . Your benefit period may be extended beyond SEP 01 2017 if you
qualify for benefits under the Lifetime Accident/Sickness Rider. See your rider for
details.”
III. STANDARD OF REVIEW
We review de novo a summary judgment ruling, viewing the evidence and
all factual inferences therefrom in the light most favorable to the party opposing
the motion. Grange Mut. Cas. Co. v. Slaughter,
958 F.3d 1050, 1056 (11th Cir.
2020). We also review de novo the interpretation of an insurance contract.
Id.
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IV. DISCUSSION
“Where the language in an insurance contract is plain and unambiguous, a
court must interpret the policy in accordance with the plain meaning so as to give
effect to the policy as written.” See Wash. Nat’l Ins. Corp. v. Ruderman,
117 So.
3d 943, 948 (Fla. 2013). And in construing insurance contracts, we must read the
policy documents as a whole, “endeavoring to give every provision its full
meaning and operative effect.”
Id. (quotation marks omitted). We must also avoid
simply concentrating on certain provisions to the exclusion of others.
Id.
Dr. Wickboldt argues that the Lifetime Rider “altered and enhanced” the
termination provisions in the Basic Policy and the COLA Rider in such a way as to
entitle him to COLA Rider benefits after the Lifetime Rider benefits begin. He
says the Lifetime Rider expressly “extended the maximum benefit period for all of
Wickboldt’s ‘monthly, total disability benefits’ to which he was entitled under his
entire Policy ‘for life,’” so the Lifetime Rider “did not just extend the entitlement
to benefits under only [that] portion of the Policy.”4 MassMutual, however, says
that the COLA Rider unambiguously limited the duration of coverage—in two
separate provisions—to the anniversary after Dr. Wickboldt’s 65th birthday. In
4
Dr. Wickboldt also says that if his interpretation and MassMutual’s interpretation of the
policy documents are both reasonable, then we should conclude the policy is ambiguous and
construe it in his favor. However, because Dr. Wickboldt does not argue that any provisions of
the policy documents are indeed ambiguous, he has failed to “plainly and prominently” raise this
argument and has therefore abandoned it. See Sapuppo v. Allstate Floridian Ins. Co.,
739 F.3d
678, 681 (11th Cir. 2014).
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MassMutual’s view, the Lifetime Rider neither extends monthly benefit increases
under the COLA Rider nor renews any other provision in the Basic Policy.
We thus begin with Dr. Wickboldt’s contention that the Lifetime Rider
extended all benefits he was receiving on the date the Lifetime Rider went into
effect. We do not read the Lifetime Rider to extend benefits under either the Basic
Policy or the COLA Rider. The Lifetime Rider contains its own benefits
provision, beginning one month “after the Anniversary on or after your 65th
birthday” and awarding “monthly total disability benefits [that will] be paid
beyond the Anniversary on or after your 65th birthday . . . for life.” These benefits
are “base[d] . . . on your loss of income” and “multipl[ied] . . . by the ratio of your
loss of income to your predisability income.” In other words, the Lifetime Rider
creates a new set of benefits—wholly unrelated to benefits paid out under the Basic
Policy and based on a new means of calculating those benefits—that are not due to
be paid until one month after the Anniversary on or after Dr. Wickboldt’s 65th
birthday. By the time Lifetime Rider benefits begin, benefits under both the Basic
Policy and the COLA Rider benefits have ended. Dr. Wickboldt agreed with this
interpretation before the District Court. See, e.g., R. Doc. 34: 2–3 (stating that
base monthly benefits are paid “only until the policy anniversary date following his
sixty-fifth birthday, or until September 1, 2017”). Based on the plain,
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unambiguous language of the policy documents,5 there is nothing to support Dr.
Wickboldt’s argument that the Lifetime Rider extends, restarts, or revives benefits
under the COLA Rider. See Ruderman, 117 So. 3d at 948.
Dr. Wickboldt also relies on Colt v. Massachusetts Mutual Life Insurance
Co.,
2012 WL 1739145 (Mass. Super. Ct. May 1, 2012) (unpublished), to advance
his Lifetime Rider-extension argument. In Colt, the court interpreted a policy that
appears to be identical to the one Dr. Wickboldt purchased. See
id. at *1–3. The
Colt court found the Lifetime Rider extended payment of total disability benefits
“despite clear language” limiting payment of benefits to age 65. Id. at *5. This
was based, in part, on MassMutual’s concession “that the Lifetime Rider acts to
extend the basic monthly benefit for life,” as reflected in the Coverage Page. Id.
The court thus rejected the argument that the Lifetime Rider did not also extend the
COLA Rider benefit, which was also reflected in the Coverage Page. See id.
Lending further support, the court said, was the asterisk following “Maximum
Benefit Period” on the Coverage Page, which said that “your benefit period may be
extended . . . if you qualify for benefits under the [Lifetime Rider].” Id.
5
Not only has Dr. Wickboldt failed to point to any ambiguous provision, see supra at 7
n.4, but we do not read the policy documents as being ambiguous. Under Florida law,
ambiguities arise only if the “policy language is susceptible to more than one reasonable
interpretation, one providing coverage and another limiting coverage.” Garcia v. Fed. Ins. Co.,
969 So. 2d 288, 291 (Fla. 2007). There is one reasonable interpretation of the policy documents
here, and it does not support Dr. Wickboldt’s position.
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MassMutual has not made the concession here that it did in Colt. Neither do
we read the Coverage Page as being inconsistent with the termination provisions in
the Basic Policy and the COLA Rider. 6 Rather, the Coverage Page explains
exactly how much Dr. Wickboldt is entitled to under the Basic Policy and each
Rider. Based on the plain meaning of the policy documents, the maximum
monthly benefits to which Dr. Wickboldt is entitled is $8,000—exactly what he is
receiving under the Lifetime Rider. See Ruderman, 117 So. 3d at 948.
V. CONCLUSION
For the reasons set forth above, we AFFIRM the District Court’s order
granting MassMutual summary judgment.
6
The parties presented the District Court with two different versions of the Coverage
Page. Dr. Wickboldt seems to imply that these are inconsistent, pointing out that the copy he
provided “is blank in the column for ‘Maximum Benefit Period’ for the row for the [COLA]
Rider,” whereas MassMutual’s copy says “TO 65” in the row for the COLA Rider. Dr.
Wickboldt says his version, which does not contain a maximum benefit period, should control.
But even when viewing the Coverage Page in the light most favorable to Dr. Wickboldt, see
Grange Mut., 958 F.3d at 1056, we are still required to read the policy documents as a whole,
Ruderman, 117 So. 3d at 948. And because the Coverage Page does not expressly contradict the
termination provisions in the COLA Rider, we must endeavor to give them their full meaning
and operative effect. See id.
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