Searching over 5,500,000 cases.


searching
Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.

Marzette v. Lincoln National Insurance Co.

United States District Court, W.D. Tennessee, Western Division

November 29, 2017

SHELTON SHERROD MARZETTE, Plaintiff,
v.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY, Defendant.

          ORDER

          SAMUEL H. MAYS, JR. UNITED STATES DISTRICT JUDGE

         Plaintiff Shelton Sherrod Marzette brings this action against Defendant The Lincoln National Life Insurance Company (“Lincoln National”), challenging the denial of insurance benefits.

         Before the Court is Lincoln National's Motion for Judgment on the Administrative Record, dated March 27, 2017. (ECF No. 27; cf. ECF No. 27-1.) Marzette responded on April 19, 2017. (ECF No. 28.) Lincoln National replied on April 25, 2017. (ECF No. 29.)

         For the reasons below, the Motion for Judgment on the Administrative Record is GRANTED.

         I. Background

         Plaintiff was employed by Pat Salmon and Sons, Inc. (“Salmon”) as a tractor trailer truck driver. (ECF No. 22-6 at 869.)[1] Plaintiff participated in a group voluntary accidental death and dismemberment insurance plan (“Plan”) available to Salmon employees. (ECF No. 22-2 at 58-60.) Defendant provided the Plan benefits.

         Under the Plan, insured persons like Plaintiff are entitled to benefits if they “sustain[ed] a covered accidental bodily injury while insured” that caused, among other things, a “Loss of Hearing in One Ear.” (Id. at 84.) The Plan defines loss of hearing as “permanent and total deafness in [one] ear” that “cannot be corrected to any functional degree by any aid or device.” (Id. at 85.) The loss of hearing “must result directly from the injury and from no other causes.” (Id. at 84.)

         Defendant has the authority to “manage this Policy and administer claims under it” and to “interpret the provisions and resolve questions arising under this Policy.” (Id. at 100.) Defendant's decisions are “conclusive and binding, ” subject to the insured person's right to sue. (Id.)

         Plaintiff represents that, on July 31, 2014, while driving to Denver, Colorado for Salmon, he became dizzy and began experiencing pain in his left ear. (ECF No. 22-6 at 870.) On August 1, 2014, Plaintiff visited the Emergency Department at the Veterans Administration Hospital to consult a doctor about his condition. (Id. at 819.) Hospital records from that visit show that Plaintiff said he had felt “dizzy since [July 31] when he woke up and thought it would go away.” (Id. at 818.) Plaintiff also told doctors that his left ear was stopped-up. (Id.) Plaintiff was diagnosed with vertigo, given a prescription, and discharged from the hospital. (Id.)

         Plaintiff returned to the doctor on August 3, 2014, and complained that he felt dizzy and that his left ear was stopped-up. (Id. at 813-14.) Plaintiff was again diagnosed with vertigo and discharged. (Id. at 811.)

         Plaintiff returned to the doctor on August 5, 2014, and complained that his vertigo continued. (Id. at 807.) Plaintiff told doctors that a virus might be causing his condition. (Id.) Plaintiff was given a work excuse and discharged. (Id.)

         On August 7, 2014, Plaintiff went to the doctor for an audiology consultation. (Id. at 804.) Plaintiff complained of “sudden left ear hearing loss and dizziness (nausea, vomiting, unsteadiness, ‘drunk feeling') which first started last week.” (Id. at 803.) Plaintiff was given an audiology exam, which revealed some hearing loss in the left ear. (Id. at 806.) The hearing loss was described as “a precipitous high-frequency deficit at 4khz to 8khz.” (Id.) The exam revealed that Plaintiff had “[n]ormal hearing through speech frequencies.” (Id.) Plaintiff was told to return in a week for another exam and reevaluation. (Id.)

         Plaintiff returned to the doctor on August 14, 2014. (Id. at 802.) Plaintiff reported that “his vertigo/imbalance seems to have improved some, ” but complained of hearing loss in his left ear. (Id. at 800.)

         On September 22, 2014, Plaintiff received another hearing evaluation. (Id. at 793.) The evaluation “revealed normal hearing sensitivity” and “excellent” speech recognition for both ears. (Id.) Plaintiff asked the doctor for hearing aids, but the doctor said that hearing aids were “not warranted at this time since there ...


Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.