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Gonzalez v. Great American Insurance Co.

United States District Court, W.D. Kentucky, Louisville

January 30, 2018

JUAN GONZALEZ, PLAINTIFF
v.
GREAT AMERICAN INSURANCE CO., et al., DEFENDANTS

          MEMORANDUM OPINION AND ORDER

          Thomas B. Russell, Senior Judge United States District Court.

         This matter is before the Court on several motions. First, Defendant Great American Insurance Company filed a Motion for Summary Judgment on All Claims Against Non-Trucking Liability Policy, [R. 4], and a Motion for Summary Judgment on All Claims Asserted Against the Occupational Accident Policy, [R. 5]. Plaintiff Juan Gonzalez responded, [R. 12; R. 16-1]. Secondly, Gonzalez filed a Motion for Extension of Time to Complete Discovery, [R. 14]. Great American responded, [R.17], and Gonzalez replied, [R. 21]. Finally, Gonzalez filed a Motion to Amend/Correct his Memorandum in Opposition to Great American's Motion for Summary Judgment, [R. 16]. Great American responded, [R. 18], and Gonzalez replied, [R. 20]. This matter is now ripe for adjudication. For the reasons stated herein: Great American's Motion for Summary Judgment on All Claims Against Non-Trucking Liability Policy, [R. 4], is GRANTED; Great American's Motion for Summary Judgment on All Claims Against the Occupational Accident Policy, [R. 5], is DENIED WITH LEAVE TO REFILE; Gonzalez's Motion for Extension of Time to Complete Discovery, [R. 14], is GRANTED IN PART AND DENIED IN PART; and Gonzalez's Motion to Amend/Correct his Memorandum in Opposition to Great American's Motion for Summary Judgment, [R. 16], is GRANTED.[1]

         BACKGROUND

         This case arises from a motor vehicle accident that occurred on November 15, 2013 in Jefferson County, Kentucky, in which Juan Gonzalez, a truck driver, was injured. [R. 1-1 at 3 (Jefferson Circuit Court Complaint).] At the time of the accident, Gonzalez was transporting packages for Cowan International Group. [R. 15-1 at 1 (Gonzalez Affidavit).] Following treatment for his injuries at the emergency room at Norton Audubon Hospital, [R. 16-3 at 99-168 (Medical Records attached to Lamb Affidavit)], Gonzalez received medical attention from his primary care physician, Dr. Juan Polo, [Id. at 169-178], Dr. James Heaphy and Jerry Morris of the Morris Medical Group, [Id. at 89-98], and Dr. Madhusudhan Yakkanti and Dr. Edward Tillet of the Shea Orthopedic Group, [Id. at 179-186]. He was prescribed various medications and physical therapy for pain in his neck, lower back, and left shoulder, [Id. at 170; 179]. He also had an independent medical examination by Dr. Richard Sheridan on May 13, 2014, in which Dr. Sheridan found that the treatment up to that date had been necessary, but Gonzalez was capable of returning to full duty work as a truck driver and required no further treatment. [Id. at 187-192 (Independent Medical Evaluation).] Despite Dr. Sheridan's conclusion, Gonzalez explains that he was unable to work following his accident until February 23, 2015. [R. 15-1 at 2.] Furthermore, Gonzalez states that he did not return to his previous employment but to a different employer where the work is not as strenuous. [Id.]

         Gonzalez is insured by Great American Insurance Group (“GAI”) under both a Non-Trucking Liability and Physical Damage Policy (“NTL policy”) [R. 4-1 at 1-2 (Deanna Ware Affidavit)[2], and an Occupational Accident Insurance Policy (“OAP”), [R. 5-1 at 2-3 (Lynn Canterbury Affidavit)]. Under the OAP, GAI paid Gonzalez $9, 776.74 in Temporary Total Disability benefits and $7, 976.73 in medical expenses. [Id.] On July 10, 2014, GAI notified Gonzalez's counsel that his Temporary Total Disability benefits on his OAP claim were suspended as of July 7, 2014 due to Dr. Sheridan's assessment. [Id. at 55 (Suspension of Benefits Letter).] Under the NTL policy, GAI found that there was no coverage available to Gonzalez for no-fault benefits due to the fact that the policy only provides coverage for when the vehicle is utilized for personal use. [R. 4-1 at 1.]

         This suit was originally filed in Jefferson Circuit Court on November 14, 2016 by Gonzalez, [R. 1-1 at 1], and subsequently was removed to this Court on May 10, 2017, [R. 1 (Joint Notice of Removal)]. Gonzalez also initiated a worker's compensation suit that is currently pending before Administrative Law Judge Chris Davis. [R. 16-3 at 196 (Judge Davis Order).] Specific to GAI, Gonzalez claims that GAI is obligated to pay him “benefits under the No. Fault Act (KRS 304.39-120) and occupational injury benefits pursuant to the insurance policy . . ..” [R. 1-1 at 4.] On September 14, 2017, GAI filed the two motions for summary judgment that are now before the Court. [R. 4; R. 5]. On October 25, 2017, Gonzalez filed a Motion for Extension of Time to Complete Discovery, [R. 14], and on October 30, 2017, he filed a Motion to Amend his Response to the motions for summary judgment, [R. 16].

         STANDARD

         Summary judgment is appropriate when the record, viewed in the light most favorable to the nonmoving party, reveals “that there is no genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law.” Fed.R.Civ.P. 56(a). A genuine dispute of material fact exists where “there is sufficient evidence favoring the nonmoving party for a jury to return a verdict for that party.” Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 249 (1986). The Court “may not make credibility determinations nor weigh the evidence when determining whether an issue of fact remains for trial.” Laster v. City of Kalamazoo, 746 F.3d 714, 726 (6th Cir. 2014) (citing Logan v. Denny's, Inc., 259 F.3d 558, 566 (6th Cir. 2001); Ahlers v. Schebil, 188 F.3d 365, 369 (6th Cir. 1999)). “The ultimate question is ‘whether the evidence presents a sufficient disagreement to require submission to a jury or whether it is so one-sided that one party must prevail as a matter of law.'” Back v. Nestlé USA, Inc., 694 F.3d 571, 575 (6th Cir. 2012) (quoting Anderson, 477 U.S. at 251-52).

         As the party moving for summary judgment, the defendant must shoulder the burden of showing the absence of a genuine dispute of material fact as to at least one essential element of Plaintiff's claims. Fed.R.Civ.P. 56(c); see also Laster, 746 F.3d at 726 (citing Celotex Corp. v. Catrett, 477 U.S. 317, 324 (1986)). Assuming the defendant satisfies its burden of production, the plaintiff “must-by deposition, answers to interrogatories, affidavits, and admissions on file-show specific facts that reveal a genuine issue for trial.” Laster, 746 F.3d at 726 (citing Celotex Corp., 477 U.S. at 324).

         DISCUSSION

         The Court will address each motion filed by the parties in turn.

         I. The Occupational Accident Policy

         In response to GAI's Motion for Summary Judgment on the claims concerning the OAP, Gonzalez filed a Rule 56(d) motion for more time to conduct discovery. “Before ruling on summary judgment motions, a district judge must afford the parties adequate time for discovery, in light of the circumstances of the case.” Plott v. Gen. Motors Corp., Packard Elec. Div., 71 F.3d 1190, 1195 (6th Cir. 1995); Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 250 n. 5 (1986). However, the burden is on the party claiming insufficient time to conduct discovery to file a motion and supporting affidavit pursuant to 56(d). Cacevic v. City of Hazel Park, 226 F.3d 483, 488 (6th Cir. 2000). “The importance of complying” with Rule 56(d)'s affidavit requirement “cannot be overemphasized.” Id. “Beyond the procedural requirement of filing an affidavit, Rule [56(d)] has been interpreted as requiring that a party making such a filing indicate to the district court its need for discovery, what material facts it hopes to uncover, and why it has not previously discovered the information.” Id. If a “[p]laintiff's affidavit makes only general and conclusory statements regarding the need for more discovery, ” then denial of their request for more discovery is proper. Ironside v. Simi Valley Hosp., 188 F.3d 350, 354 (6th Cir. 1999); Emmons v. McLaughlin, 874 F.2d 351, 356 (6th Cir. 1989).

         Courts have considered a No. of factors in deciding whether additional discovery is appropriate, including “(1) when the appellant learned of the issue that is the subject of the desired discovery; (2) whether the desired discovery would have changed the ruling below; (3) how long the discovery period had lasted; (4) whether the appellant was dilatory in its discovery efforts; and (5) whether the appellee was responsive to discovery requests.” Plott, 71 F.3d at 1196 (collecting cases). The decision of the district court to grant or deny a Rule 56(d) motion is reviewed for abuse of discretion, and a district court does not abuse its discretion to deny additional discovery when the requested discovery would be irrelevant to the underlying issues to be decided in the dispositive motion. Brown v. Tax Ease Lien Servicing, LLC, No. 3:15-CV-208-CRS, 2017 WL 6940734, at *8-9 (W.D. Ky. May 25, 2017) (citing In re Bayer Healthcare and Merial Ltd. Flea Control Products Marketingand Sales Practices Litigation,752 F.3d 1065, 1074 (6th Cir. ...


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