Bombaugh v. Unum Life Insurance Company of America - Insurance Dispute
Summary
The Massachusetts Appeals Court reversed a lower court's decision in favor of Maryanne Bombaugh in her dispute with Unum Life Insurance Company of America over disability benefits. The court found the policy language was not ambiguous and ruled in favor of the insurer.
What changed
The Massachusetts Appeals Court has reversed a Superior Court ruling that interpreted an ambiguous disability insurance policy in favor of the plaintiff, Maryanne Bombaugh. The original case involved a dispute over whether Unum Life Insurance Company of America was obligated to increase Bombaugh's disability benefits annually after she turned sixty-five. The Superior Court had found the policy language ambiguous and ruled for Bombaugh on breach of contract.
This appellate decision means that Unum Life Insurance Company of America's interpretation of the policy will prevail, and Bombaugh will not receive increased benefits based on the lower court's ruling. The appellate court's decision reverses the prior judgment for Bombaugh, effectively ruling in favor of the insurer on the contract interpretation issue. This outcome may impact how similar disability policies are interpreted in future disputes.
What to do next
- Review existing disability insurance policies for similar ambiguity regarding benefit adjustments.
- Consult legal counsel on potential implications for ongoing or future disability claims disputes.
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March 4, 2026 Get Citation Alerts Download PDF Add Note
Bombaugh v. Unum Life Insurance Company of America
Massachusetts Appeals Court
- Citations: None known
Docket Number: AC 24-P-946
Combined Opinion
NOTICE: All slip opinions and orders are subject to formal
revision and are superseded by the advance sheets and bound
volumes of the Official Reports. If you find a typographical
error or other formal error, please notify the Reporter of
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Pemberton Square, Suite 2500, Boston, MA, 02108-1750; (617) 557-
1030; SJCReporter@sjc.state.ma.us
24-P-946 Appeals Court
MARYANNE BOMBAUGH vs. UNUM LIFE INSURANCE COMPANY OF AMERICA &
another.1
No. 24-P-946.
Worcester. December 10, 2025. – March 4, 2026.
Present: Blake, C.J., Hand, & Toone, JJ.
Insurance, Disability insurance, Construction of policy.
Contract, Insurance, Construction of contract, Performance
and breach. Practice, Civil, Summary judgment.
Civil action commenced in the Superior Court Department on
December 30, 2021.
The case was heard by Valerie A. Yarashus, J., on motions
for summary judgment, and entry of final judgment was ordered by
her.
Joseph M. Hamilton for the defendants.
Mala M. Rafik for the plaintiff.
BLAKE, C.J. Defendant Unum Life Insurance Company of
America (Unum Life) issued a disability income policy to the
plaintiff, Maryanne Bombaugh, in 1992 and has paid benefits to
1 Unum Group.
2
her under the terms of that policy since 2008. Following a
dispute over whether Unum Life had to increase the amount of
Bombaugh's benefits annually after she turned sixty-five years
old, Bombaugh brought suit against Unum Life and its parent
company, Unum Group. On cross motions for summary judgment, a
Superior Court judge concluded that the policy language was
ambiguous and construed it in Bombaugh's favor. Judgment
entered for Bombaugh for breach of contract.2 Unum Life and Unum
Group appeal. We reverse.
Background. The following facts are undisputed. As noted,
Unum Life issued a disability income policy to Bombaugh in 1992.
The policy was intended to provide replacement income to
Bombaugh in the event that she became unable to perform the
duties of her occupation due to a disability.
The policy included a base policy plus some riders that
expanded the coverage provided for in the base policy. The base
policy provided that Unum Life would pay a total disability
benefit as follows:
"We will pay the Maximum Disability Benefit in any month
after you have satisfied the Elimination Period that:
"1. you are totally disabled; and
2 Bombaugh also brought claims for violations of G. L.
c. 93A, and breach of the implied covenant of good faith and
fair dealing. Those claims were resolved in favor of Unum Life
and Unum Group. Bombaugh did not cross-appeal, and thus, there
are no issues as to them in this appeal.
3
"2. your total disability is a result of the injury or
sickness which caused you to satisfy the Elimination
Period.
"The Total Disability Benefit will not be paid beyond the
Maximum Benefit Period."3
Under the base policy, the monthly maximum disability benefit
was $9,371, and the maximum benefit period was the later of (1)
the policy anniversary after Bombaugh turned sixty-five years
old or (2) twenty-four months after disability payments began.
As pertinent here, additional language in two riders
expanded this coverage. First, a lifetime sickness benefit
rider affected the duration of the maximum benefit period. It
provided that Unum Life would continue to pay the maximum
disability benefit "[b]eginning on the later of the policy
anniversary when your age is 65 or the end of the Maximum
Benefit Period," provided that, among other things, the total
disability "is the result of sickness which began before the
policy anniversary when your age was 60 and while this rider was
in effect."
3 "Elimination Period" was defined as "the number of days
stated on [the policy schedule] preceding the date benefits
become payable . . . , during which you are totally or
residually disabled. The Elimination Period begins on the first
day that you are totally or residually disabled."
4
Second, a cost-of-living adjustment rider affected the
amount of the maximum disability benefit and provided as
follows:
"On each anniversary of the first day of a period of
disability which began while this rider was in effect, we
will increase the Maximum Disability Benefit by multiplying
the Maximum Disability Benefit in effect on the first day
of the disability by the [Consumer Price Index for All
Urban Consumers] Factor to determine the new Maximum
Disability benefit if:
"1. you are disabled;
"2. the disability is caused by an injury that occurs, or
by a sickness that begins, after this rider became
effective; and
"3. the policy anniversary when your age is 65 has not
occurred."
The cost-of-living adjustment rider further provided, "If you
are disabled on the policy anniversary when your age is 65,
future payments for that disability will be based on the Maximum
Disability Benefit in effect on that policy anniversary."4
In 2008, Bombaugh became unable to perform the duties of
her occupation as an obstetrician and gynecologist, and Unum
Life began paying the maximum disability benefit to her.
4 The cost-of-living adjustment rider also included a
termination provision, which specified that the rider would
terminate on the earliest of (1) "the policy anniversary when
your age is 65 except with respect to a disability which exists
on that policy anniversary," (2) "the date we receive your
request to terminate this rider," or (3) "the date the policy
terminates." It is undisputed that the triggers for termination
have not occurred and that the cost-of-living adjustment rider
remains in effect.
5
Pursuant to the cost-of-living adjustment rider, Unum Life
increased the amount of the maximum disability benefit annually
but stopped doing so on the policy anniversary after Bombaugh
turned sixty-five years old. At that time, Bombaugh's monthly
maximum disability benefit was $14,421.03, which equaled the
original maximum disability benefit of $9,371 plus $5,050.03 in
increases. Since then, Unum Life has continued to pay Bombaugh
a monthly maximum disability benefit of $14,421.03, which
includes the $5,050.03 in increases that had accrued prior to
her sixty-fifth birthday.
Discussion. Unum Life argues that, under the terms of the
policy including all the riders, Bombaugh's maximum disability
benefit effectively froze on the policy anniversary after she
turned sixty-five years old. Unum Life does not dispute that
Bombaugh's maximum disability benefit continues to include the
cost-of-living adjustment increases that accrued prior to her
sixty-fifth birthday, only that Bombaugh's maximum disability
benefit is not subject to any additional increases. Bombaugh,
however, argues that Unum Life must continue to increase the
amount of her maximum disability benefit annually.
The question presented turns on the interpretation of the
policy, which is a question of law that we review de novo. See
Green Mountain Ins. Co. v. Wakelin, 484 Mass. 222, 226 (2020).
"[T]he rules governing the interpretation of insurance contracts
6
are the same as those governing the interpretation of any other
contract" (citation omitted). Sullivan v. Southland Life Ins.
Co., 67 Mass. App. Ct. 439, 442 (2006). Our "objective is to
construe the [insurance policy] as a whole, in a reasonable and
practical way, consistent with its language, background, and
purpose" (citation omitted). Id. If the language of an
insurance policy is unambiguous, then we construe the words
according to their plain meaning. See id. The language of an
insurance policy "is ambiguous only if it is susceptible of more
than one meaning and reasonably intelligent persons would differ
as to which meaning is the proper one" (citation omitted). Id.
at 443. Controversy between the parties does not alone create
an ambiguity, nor does difficulty in comprehension. See id.
Here, the focus of the parties' dispute is on the language
providing that, "[o]n each anniversary," Unum Life will increase
the maximum disability benefit if, among other things, "the
policy anniversary when your age is 65 has not occurred." This
provision sets forth a requirement that Bombaugh had to meet on
each anniversary for Unum Life to increase her maximum
disability benefit that year. On the policy anniversary after
Bombaugh turned sixty-five years old, she no longer met the
requirement. Accordingly, Unum Life stopped increasing
Bombaugh's maximum disability benefit in accordance with the
terms of the policy.
7
We are not persuaded by Bombaugh's argument that this
interpretation does not give full effect to the lifetime
sickness benefit rider. The lifetime sickness benefit rider
addresses the duration of the maximum benefit period, not the
amount of the maximum disability benefit. Consistent with the
lifetime sickness benefit rider, Unum Life continues to pay
Bombaugh the maximum disability benefit, as that benefit had
been adjusted under the cost-of-living adjustment rider.
Likewise, we are not persuaded by Bombaugh's argument that
the language requiring Unum Life to increase the maximum
disability benefit on each anniversary if certain criteria are
satisfied is ambiguous. Bombaugh argues that the provision
could be interpreted to set forth criteria that she had to
satisfy only at one point in time -- when she became unable to
perform the duties of her occupation. However, that is not what
the provision says.
First, we look to the grammatical structure of the
provision. See DeWolfe v. Hingham Ctr., Ltd., 464 Mass. 795,
803 (2013). The provision includes (1) an action (on each
anniversary, Unum Life will increase the amount of the maximum
disability benefit) and (2) a conditional clause that must be
satisfied for the action to occur. In ordinary usage, where a
sentence contemplates that an action may recur, the conditional
clause must be satisfied at each recurrence. Take, for example,
8
the following sentence: on the 15th of every month, you must
pay a $100 late fee if your balance has not been paid in full.
That sentence sets forth a test that must be satisfied on the
15th of every month, not a one-time test that must be satisfied
at an unspecified point in time. Likewise, here, the
conditional clause sets forth a test that must be satisfied on
each anniversary for the action to occur that year.
Second, Bombaugh's interpretation does not read the policy
as written. See Continental Cas. Co. v. Gilbane Bldg. Co., 391
Mass. 143, 147 (1984). To create a one-time test that Bombaugh
had to satisfy only when she became unable to perform the duties
of her occupation, Unum Life would have needed to include
additional language tying the conditional clause to that moment
in time. For example, the provision could have said that Unum
Life will increase the maximum disability benefit on each
anniversary if, at the time the disability begins, the policy
anniversary when the insured's age is sixty-five has not
occurred. Where no such language was included, the ordinary
interpretation, as discussed above, would be that Bombaugh had
to satisfy the conditional clause at each recurrence.
Third, Bombaugh's interpretation would render some of the
language of the provision superfluous. See Sherman v.
Employers' Liab. Assur. Corp., 343 Mass. 354, 357 (1961) ("An
interpretation which gives a reasonable meaning to all of the
9
provisions of a contract is to be preferred to one which leaves
a part useless or inexplicable"). The provision sets forth
three criteria that must be satisfied for Unum Life to increase
the maximum disability benefit: (1) "you are disabled," (2)
"the disability is caused by an injury that occurs, or by a
sickness that begins, after this rider became effective," and
(3) "the policy anniversary when your age is 65 has not
occurred." If Bombaugh's interpretation were correct, the first
requirement would redundantly read that Unum Life will adjust
the amount of the maximum disability benefit on each anniversary
if, at the time the disability begins, the insured is disabled.
Separately, Bombaugh's interpretation does not give effect
to all the language in the cost-of-living adjustment rider. See
Verveine Corp. v. Strathmore Ins. Co., 489 Mass. 534, 538-539
(2022). As indicated, the cost-of-living adjustment rider
includes the following additional language: "If you are
disabled on the policy anniversary when your age is 65, future
payments for that disability will be based on the Maximum
Disability Benefit in effect on that policy anniversary." This
language again frames the policy anniversary after an insured
has turned sixty-five years old as a point at which the maximum
disability benefit is calculated differently. When read in
conjunction with the language providing that Unum Life will
increase the amount of the maximum disability benefit if "the
10
policy anniversary when your age is 65 has not occurred," the
two provisions establish that the cost-of-living adjustment
increases stop on the policy anniversary after an insured has
turned sixty-five years old. Unum Life's interpretation -- that
the cost-of-living increases stop but that an insured continues
to receive the increases that previously accrued -- gives full
effect to both provisions. Bombaugh's interpretation -- that
she should continue to receive cost-of-living increases after
her sixty-fifth birthday -- does not.
We acknowledge that there are ways Unum Life could have
made it even clearer that it would stop increasing the amount of
the maximum disability benefit after Bombaugh turned sixty-five
years old. Bombaugh suggests, for example, that the cost-of-
living adjustment rider could have provided that increases to
the maximum disability benefit will freeze on the policy
anniversary after an insured has turned sixty-five years old.
However, the fact that different language could have been even
clearer does not render the language used ambiguous. Reading an
insurance policy is often a formidable task, and "difficulty in
comprehension does not equate with ambiguity."5 Massachusetts
5 Given our conclusion, we need not address additional
arguments raised by the parties, including Unum Group's argument
that it is not a proper party to this lawsuit.
11
Prop. Ins. Underwriting Ass'n v. Wynn, 60 Mass. App. Ct. 824,
827 (2004).
Conclusion. The judgment entered in favor of Bombaugh on
her breach of contract claim is reversed, and a new judgment
shall enter dismissing the complaint.
So ordered.
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