Lee v. Metropolitan Life Insurance

ORDER DENYING PLAINTIFF’S MOTION FOR SUMMARY JUDGMENT; GRANTING IN PART AND DENYING IN PART DEFENDANT’S MOTION FOR SUMMARY JUDGMENT

Introduction

Corliss Lee has brought this suit against Metropolitan Life Insurance Company (“Metlife”), alleging breach of contract, breach of the implied duty of good faith and fair dealing, and violations of California’s Unfair Competition Law, California Business and Professions Code § 17200 et seq., arising from Metlife’s repeated denials of Lee’s claims for benefits under a long-term care policy. The parties have filed cross-motions for summary judgment. Lee’s motion is denied in full. Metlife’s motion is granted in part and denied in part.

Background

Lee’s policy provided coverage for the cost of a caregiver in the event that a physical or mental disability prevented her from caring for herself. As is relevant to this case, Lee would be eligible for benefits upon giving Metlife satisfactory proof that she was “Chronically Ill.”

White Deck, Ex. B at MET-LEE 000026.

Between April 2008 and November 2011, Lee filed four claims for benefits under the policy. Metlife denied each claim. Twice, Lee appealed the denials though Metlife’s internal…