Life Insurer Took Advantage of Plaintiff But Damages not Proved

Post 5187

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In Malcolm Wiener v. AXA Equitable Life Insurance Company, No. 24-1316, United States Court of Appeals, Fourth Circuit (September 3, 2025) the Fourth Circuit’s opinion addressed the sufficiency of evidence for a jury’s damages award in a negligence case involving AXA Equitable Life Insurance and Malcolm Wiener. AXA was found liable for negligence yet the court affirmed the trial court’s conclusion that the jury lacked sufficient evidence to reasonably calculate Wiener’s damages beyond minimal damages.

AXA liable for negligence but damages unsupported:

The court affirmed AXA’s negligence liability but ruled the jury’s $16 million damages award was unsupported due to insufficient evidence on Wiener’s expected remaining lifespan.

Damages require reasonable certainty under North Carolina law:

Under North Carolina law, damages must be proved with reasonable certainty, requiring specific and complete evidence to allow a jury to reasonably conclude the amount. Speculative damages are not permitted.

Two key data points needed for damages calculation:

To calculate damages for increased insurance premiums, the jury needed evidence of (1) additional annual premiums Wiener would pay, and (2) his expected remaining lifespan after 2014. Wiener provided evidence only for the first.

Insufficient evidence on Wiener’s expected lifespan:

The jury lacked adequate medical or actuarial evidence to determine Wiener’s remaining lifespan, with only general health remarks and a video call observation offered, which the court found speculative.

Nominal damages awarded due to lack of damage proof:

Since Wiener established causation and injury but failed to prove damages with reasonable certainty, the court held nominal damages of $1 were appropriate.

Jury’s use of death benefit as damages measure rejected:

Wiener’s argument that the $16 million death benefit of a hoped-for replacement policy could serve as damages was rejected as it confused the injury type; the injury was increased cost, not loss of policy termination.

Prior rulings and procedural posture:

The case had prior appeals affirming negligence liability but remanding for damages evaluation. The district court granted AXA’s Rule 50(b) motion to reduce damages, which the appellate court affirmed, declining to address a conditional new trial motion.

In the second time the case come before the Fourth Circuit on appeal. The first time, the parties disputed, among other things, whether there was sufficient evidence for a jury to find AXA liable for causing Malcolm Wiener’s inability to find a life insurance policy. The Fourth Circuit held that there was but remanded to have the district court determine whether the jury had sufficient evidence to calculate the amount of Wiener’s damages. The district court found the evidence lacking.

DISCUSSION

With AXA’s liability settled, the sole question on appeal is whether the jury had sufficient evidence to determine that Wiener suffered $16 million in damages.

The Jury Lacked Sufficient Evidence To Calculate Damages

Taking the evidence in the most favorable light to the party opposing the motion the Fourth Circuit asked whether a reasonable jury could have arrived at its conclusion. Under North Carolina law, proof of damages must be made with reasonable certainty. Although absolute certainty is not required, damages may not be awarded where the evidence permits no more than speculation.

The evidence fell short. The injury is that Wiener could not obtain insurance at a reasonable price because AXA’s erroneous MIB codes prevented carriers from issuing a policy at the standard rate. In other words, Wiener would have had to pay increased premiums over the rest of his life to receive the same permanent life insurance coverage through death.

AXA argued that we cannot assume that Wiener could have obtained a policy at the standard rate in the absence of erroneous MIB codes. Wiener’s expected remaining lifespan in 2014. North Carolina courts have rejected damages awards from juries that had more medical information than the jury did here. Wiener needed to put forth evidence directly establishing his expected remaining lifespan. Because he did not, the jury should not be permitted to speculate how long, in their opinion, they think Wiener’s life will continue in the future.

The jury was not given sufficient evidence to determine Wiener’s expected remaining lifespan. And without that data point, the jury could not calculate Wiener’s damages with reasonable certainty. That leaves Wiener to recover nominal damages of $1.

ZALMA OPINION

Although the District Court and the Fourth Circuit agreed that AXA took advantage of the plaintiff in how it calculated its premium, since they did not prove Wiener’s life expectancy the calculation of damages failed and he was only entitled, after two appeals, to $1 in damages. The lawyers, if on a contingency, earned $0.40 to $0.45 cents of the damages. This case establishes that even if an insurance company does wrong does not mean that the plaintiff will get rich with large compensatory damages and punitive damages.

(c) 2025 Barry Zalma & ClaimSchool, Inc.

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