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Bowman v. Prudential Insurance Company of America

United States District Court, W.D. Arkansas, Harrison Division

May 30, 2017

CURTIS BOWMAN PLAINTIFF
v.
PRUDENTIAL INSURANCE COMPANY OF AMERICA DEFENDANT

          MEMORANDUM OPINION AND ORDER

          TIMOTHY L. BROOKS, Judge

         Now before the Court are Plaintiff Curtis Bowman's Motion for Leave to Amend Original Complaint (Doc. 36) and Brief in Support (Doc. 37); a Response in Opposition (Doc. 38), filed by Defendant Prudential Insurance Company of America ("Prudential"); and a Reply (Doc. 39), filed by Mr. Bowman. For the reasons explained herein, the Motion for Leave to Amend is DENIED as futile, and the case will be dismissed with prejudice.

         I. BACKGROUND

         Mr. Bowman is a highly educated professional. He holds a law degree and is a certified public accountant ("CPA"). In the year 2000, he purchased a long-term disability insurance policy offered through The American Institute of Certified Public Accountants. The policy, serviced by Prudential, offered a maximum benefit of $6, 000 per month. Mr. Bowman asserts that he never missed a payment on the policy.

         At some point, Mr. Bowman became President of Bowman & Associates, which is a CPA firm located in Mountain Home, Arkansas. According to the Complaint (Doc. 1), he became depressed sometime in October of 2014 and sought medical care from Dr. Thomas Walden. He was diagnosed with depression, generalized anxiety disorder, and insomnia disorder. Then on January 1, 2015, Mr. Bowman attempted to commit suicide by intentionally overdosing on Effexor, an antidepressant. He was transported by ambulance to Baxter County Regional Medical Center, where he was monitored overnight and released the following day. On January 2, 2015, Mr. Bowman took some time off from his job running his CPA firm, on his doctor's advice, and sought therapy and medical care for his depression. He returned to work on January 26, 2015, all the while taking various medications that his doctors had prescribed, and continuing to attend regular appointments with his doctors. On or about February 1, 2015, however, he and his doctors determined that his mental health was not improving, and, as of February 6, 2015, he stepped down from his position at the head of the CPA firm that bore his name. Mr. Bowman then placed both his law and CPA licenses in inactive status.

         In March of 2015, Mr. Bowman filed a claim for disability benefits under the long-term disability policy serviced by Prudential, and he provided the company with proof of his mental illness. Based on the information supplied by his treating doctors, Prudential approved his request for benefits on June 4, 2015, and began paying him $4, 000 per month. See Doc. 1-6. In a letter dated June 12, 2015, Prudential informed Mr. Bowman that his benefits were being raised to the maximum of $6, 000 per month. See Doc. 1-7.

         Several months passed, and on November 13, 2015, Prudential notified Mr. Bowman in a letter that it was currently reviewing his claim for benefits. It asked him to: (1) provide a completed form entitled "Activities of Daily Living Request"; (2) call Prudential's office to provide a current update on his medical condition; (3) ensure that his treating providers, Drs. Walden and Brown, supplied Prudential with copies of his medical records from October 1, 2015, through the present; and (4) complete a "Capacity Questionnaire." (Doc. 1-8, p. 1). Even though the letter asked Mr. Bowman to provide all this information by February 11, 2016, Mr. Bowman asserts that his benefits were cut off without explanation in late December of 2015. What he neglects to mention in the body of his Complaint is that his treating psychiatrist, Dr. Walden, sent a letter to Prudential on December 15, 2015-which is attached to the Complaint-that stated that "nothing has changed" with regard to Mr. Bowman's status, and that he declined to provide further information at this time, as "disability evaluation and continuous updating of disability status is not within the scope of services rendered at our clinic." (Doc. 1-12).

         Shortly after this time, Mr. Bowman began calling Prudential multiple times a week to ask why his benefits were being terminated. He did so from about December 29, 2015, through January 25, 2016. At some point during this time, his benefits were reinstated. Call logs attached to the Complaint (Doc. 1-9, p. 14) indicate that certain medical records from Drs. Walden and Brown were faxed to Prudential on February 4, 2016. On or about February 16, 2016, a Prudential representative told Mr. Bowman by phone that his disability claim was under review, but that his benefits would be extended through February 29, 2016. Id. at 15. This "end date" for receiving benefits was revised again on February 25, 2016, when a Prudential agent informed Mr. Bowman that the review of his claim was ongoing, but that he would be paid benefits through September 30, 2016. Id. at 19. Mr. Bowman asserts that the constant uncertainty surrounding the review of his disability claim caused him to experience severe anxiety.

         On or about June 29, 2016, an adjuster working for Prudential named MaryStratton contacted Mr. Bowman and asked him several questions regarding his medical condition and the last day that he worked at his CPA firm for wage or profit. It appears there arose a dispute between Prudential and Mr. Bowman at that time as to whether Prudential had appropriately logged Mr. Bowman's last day of work as having occurred in early 2015, rather than in late 2014. This dispute was important because the amount of benefits owed under the policy was calculated by considering the policyholder's average income for the years prior to the last day of work. If, for example, an insured's last day of work was in 2015, rather than 2014, the insured's calculation of benefits would be different, and also, the insured would be permitted to take advantage of a policy change implemented by Prudential for claims made in 2015, which effectively increased the total number of years that an insured could receive benefits.

         Ms. Stratton also asked Mr. Bowman, during that same phone call on June 29, what it was, specifically, about being a lawyer and accountant that he could no longer perform-since he admitted that he was perfectly able to work as an adjunct professor, teaching law at the local college. Mr. Bowman responded to Ms. Stratton that it was "too difficult to deal with attorneys and tax returns, " and that he "gets shivers just thinking about it." Id. at 22. He explained that "teaching is a lot different . . . more low key with less anxiety and [is] enjoyable for him and fulfilling." Id.

         On September 9, 2016, Ms. Stratton penned a follow-up letter to Mr. Bowman, in which she advised him that the internal review of his medical file had been completed, and Prudential had decided to terminate his long-term disability benefits. The letter stated:

As noted above, based on the internal psychiatrist's review of the updated medical records on file, you have been psychiatrically stable since April of 2016. The current medical records do not support any psychiatric impairment that would preclude you from performing the material and substantial duties of your own occupation.

(Doc. 1-10, p. 3).

         Prudential's reviewing psychiatrist was Dr. Kevin Hayes. He reviewed the medical reports provided by Mr. Bowman's treating physicians and noted that although Mr. Bowman continued to receive follow-up monitoring and take medications for both anxiety and depression, his condition had remained stable since his suicide attempt, and he had not relapsed. Dr. Hayes observed that since the suicide attempt, Mr. Bowman had maintained a seemingly healthy lifestyle and had found part-time work that he found enjoyable, teaching classes about ten hours per week at the local college. See Doc. 1 -11, p. 31. Dr. Hayes also determined that Mr. Bowman: (1) was maintaining basic psychiatric stability by continuing with his regular medication, (2) had denied any depressive symptoms or excessive anxiety since his suicide attempt, (3) reported stable sleeping habits to his doctors, (4) only saw his doctors every three or four months, (5) served on the board of the chamber of commerce along with teaching college classes every semester, (6) had reported to his therapist, Dr. Brown, that he was enjoying life and planning two excursions, and (7) had reported to his psychiatrist, Dr. Walden, that the only anxiety-producing event he had experienced lately was when Prudential cut off his disability benefits for a brief period of time in December of 2015. Id. at 32-33.

         In reviewing the medical file, Dr. Hayes surmised that Mr. Bowman was suffering from "professional burnout, " rather than a continuing, debilitating psychiatric condition. Id. at 34. In addition, Dr. Hayes noted that he had attempted to contact Drs. Walden and Brown at their shared office to discuss Mr. Bowman's case, but was told by a receptionist/office manager that they "would not speak to [Dr. Hayes] re any disability-related issue." Id.; Doc. 1-9, p. 23. Instead, Drs. Walden and Brown supplied Prudential with their clinical notes from their visits with Mr. Bowman over the last few months, and with identical, rather cursory, one-sentence letters addressed to Ms. Stratton, that each read: "My opinion regarding Mr. Bowman's disability status has not changed since our last communication." (Docs. 1-14, 1-15).

         On September 23, 2016, Mr. Bowman's attorney sent a letter to Ms. Stratton, demanding reinstatement of Mr. Bowman's benefits. On September 26, 2016, Prudential denied the demand in writing. Then, on October 3, 2016, Mr. Bowman sent a letter of appeal to Prudential. Mr. Bowman admits that it is Prudential's stated policy to review any appeal within 45 days; however, Mr. Bowman filed suit in this Court on October 27, 2016, only 24 days after filing his appeal, and before a decision on the appeal had been made. Mr. Bowman also filed a Motion for Temporary Restraining Order or Preliminary Injunction (Doc. 6) in this Court shortly after filing the Complaint, in an effort to force Prudential to immediately resume making benefit payments to Mr. Bowman while the merits of the case were still ...


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