Gutowitz

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

Plaintiffs Erwin J. Gutowitz and Howard Gutowitz, as representative of Erwin J. Gutowitz (“plaintiffs”), filed this action on August 25, 2014, against Transamerica Life Insurance Company (“Trans-america”). 1 On April 24, 2015, Trans-america filed a motion for summary judgment. 2 Plaintiffs oppose the motion.

*1132 I. FACTUAL AND PROCEDURAL BACKGROUND

A. The Life Insurance Policy

In 1991, Erwin Gutowitz applied for a Transamerica long-term care policy. 4 Based on his application, Transamerica issued Policy No. 889530043, with an effective date of August 16, 1991. 5 As relevant here, the policy includes a Daily Nursing Home Benefit as well as a Home Health Care Benefit. 6 The policy requires that, to qualify for nursing home benefits, the insured present a physician certification stating that such treatment is medically appropriate. Charges must be incurred while the policy is in force, and the “care or services must be provided in a Nursing Home.” 7 The policy does not mandate that the insured obtain “prior approval of Nursing Home care.” 8 Furthermore, “care received at a nursing facility…