Karen Varta BABIKIAN, Plaintiff-Appellee, v. the PAUL REVERE LIFE INSURANCE COMPANY, Defendant-Appellant

OVERVIEW

The Paul Revere Life Insurance Company (“Paul Revere”) appeals the district court’s grant of summary judgment for Karen Varta Babikian, holding that it was obligated to provide Babikian with lifetime maximum benefits of one million dollars for treatment of her breast cancer. We reverse and remand.

FACTS AND PROCEDURAL BACKGROUND

In August 1989, Paul Revere issued a group health insurance policy (“the group policy”) insuring employees of IPC Films, Inc., and its affiliates. As an employee of Fonda Films, Inc., an affiliate of IPC and a participating employer, Babikian was insured by the group policy issued by Paul Revere. The group policy provides for an “individual lifetime maximum benefit” of one million dollars. It also provides that it terminates on the date the employee ceases working. Pursuant to the group policy’s conversion privilege, an employee can obtain a converted, individual policy through Paul Revere (“the converted policy”) in the event the group policy terminates. The group policy expressly provides that the benefits under the converted policy will not be the same as those under the group policy.

In July 1991, Babikian was diagnosed with breast cancer,…