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AKINS v. WASHINGTON METRO. AREA TRANSIT AUTH.

January 26, 1990

MARK M. AKINS, Plaintiff,
v.
WASHINGTON METROPOLITAN AREA TRANSIT AUTHORITY, ET AL., Defendants


Gerhard A. Gesell, United States District Judge.


The opinion of the court was delivered by: GESELL

GERHARD A. GESELL, United States District Judge

 In this dispute over an insurance contract, the plaintiff, Mark Akins, and the defendants, Washington Metropolitan Area Transit Authority ("WMATA") and Mutual Benefit Life Insurance Company ("Mutual"), have all moved for summary judgment. The motions have been briefed and orally argued.

 Plaintiff worked for WMATA from 1967 to 1984. Pursuant to his employment, he was eligible for and obtained optional long-term disability insurance. In 1973, WMATA arranged with Mutual to provide this insurance for its employees, replacing another insurer.

 Akins was covered by this Mutual policy when, on May 11, 1982, he was robbed by an assailant, who stabbed him in the chest. The knife pierced his heart, and he required emergency surgery.

 Following the stabbing and his release from the hospital, Akins experienced fatigue, inability to concentrate, shortness of breath, and chest pains. He returned to work in June 1982 but was never able fully to resume his duties.

 On December 18, 1983, Akins applied for disability benefits pursuant to his policy with Mutual. He submitted an Attending Physician's Statement of Disability from Dr. William Flynn, a psychiatrist. Flynn diagnosed Akins as having a mental disorder and prescribed psychotherapy. He stated that Akins was unable to work, make decisions, or deal with stress and suffered memory lapses and problems with interpersonal relations. The findings of several other physicians and psychologists support Dr. Flynn's conclusions.

 The record is clear that it was the stabbing and not some prior or intervening factor that triggered Akins' mental disability. Dr. Flynn's Statement of Disability indicated that Akins' problems arose "following his stabbing," and he elsewhere indicated that Akins, in October 1983, remained "preoccupied with details of the attack." Dr. Flynn has subsequently diagnosed Akins as suffering from post-traumatic stress disorder.

 Akin's policy with Mutual provides that an employee who becomes "totally disabled . . . as a result of accidental bodily injury [or] sickness" is entitled to benefits of about 60 percent of his salary until age 65. However, Section B7 of the policy states that the policy provisions "do not provide benefits for . . . any total disability caused by . . . mental or nervous disease or disorder" except that a person suffering from "disability due to . . . mental or nervous disease or disorder" is entitled to 24 months of benefits.

 Mutual began paying Akins benefits pursuant to the policy on January 14, 1984. However, by letter dated April 23, 1984, Mutual advised Akins that because his "main disabling condition" was "psychological in nature," benefits would be terminated on January 13, 1986 -- or sooner if Akins overcame his disability.

 On January 13, 1986, Mutual ceased paying Akins benefits. On January 3, 1989, Akins filed the present action.

 Akins asserts that Mutual breached its insurance contract by failing to continue payments through age 65. He also argues that WMATA breached its employment contract with him by switching him to Mutual without making clear to him that Mutual, unlike the previous carrier, limited benefits for mental disabilities. As Akins acknowledges, his two contract claims are mutually exclusive; if Mutual has breached its contract with Akins, then WMATA has not breached its alleged contract. *fn1"

 Before addressing the merits, the Court must consider Mutual's claim that Akins failed to sue within the three-year District of Columbia statute of limitations period on contract actions. D.C.Code § 12-301(7).

 Akins filed suit within three years of the 1986 termination of benefits but not within three years of the 1984 notification by Mutual of its ...


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