Introduction

In an amended summary order, the United States Court of Appeals for the Second Circuit affirmed the Western District of New York’s grant of summary judgment to Brighthouse Life Insurance Company in a coverage dispute arising out of home health care benefits attached to life insurance policies. The appeal—captioned Christopher Jackling, as Executor of the Estate of William T. Jackling v. Brighthouse Life Insurance Company, No. 23-7309 (2d Cir. Oct. 20, 2025)—centers on whether a policyholder can obtain reimbursement for services rendered by unlicensed or uncertified home health aides. The panel (Chief Judge Livingston, Judge Wesley, and Judge Wolford sitting by designation) held that under the policy’s plain language, the benefits do not extend to unlicensed or uncertified aides.

The case arrives against the backdrop of two related lawsuits stemming from denials of claims under separate policies issued to Mr. Jackling and his late wife. The district court previously granted summary judgment against the wife’s estate in Estate of Jackling, a decision the Second Circuit affirmed in 2024. In this companion matter concerning Mr. Jackling’s own policy, the district court again granted summary judgment to Brighthouse. On appeal, the appellant raised three principal issues:

• Whether, as a pro se litigant, he received the notice required by Vital v. Interfaith Medical Center regarding the nature and consequences of summary judgment;
• Whether collateral estoppel barred his present claims; and
• Whether the policy covers household or home health services provided by unlicensed and uncertified aides.

The Second Circuit resolved the case on contract interpretation grounds alone, concluding the policy unambiguously requires the use of either a licensed home health care agency (where the state requires agency licensure) or a licensed/certified home health aide. Because that construction foreclosed coverage, the court declined to decide the Vital notice and collateral estoppel arguments, though it flagged doubts about the adequacy of notice in this case.

Important procedural note: this is a “Summary Order.” By rule, it has no precedential effect, though it may be cited as persuasive authority under Federal Rule of Appellate Procedure 32.1 and the Second Circuit’s Local Rule 32.1.1.

Summary of the Opinion

The court affirmed summary judgment for Brighthouse, holding that the policy does not cover services rendered by unlicensed or uncertified home health aides. The decision rests on a plain-language reading of two adjacent provisions within the policy’s home health care reimbursement clause. Together, those provisions create two eligible pathways for coverage:

• Services provided through a licensed home health care agency (in states that require agency licensing), including home health aide, home hospice, and certain homemaker services prescribed in a plan of care; or
• Services provided by a licensed or certified home health aide who does not report through such an agency, provided the insured uses the policy’s care coordination benefit and the licensed health care practitioner develops and approves a written plan of care specifying the certified aide’s services.

The panel rejected the appellant’s grammatical reading that would have extended coverage to unlicensed aides, emphasizing that the structure and plain text instead require licensure or certification—either at the agency level (where required by state law) or at the individual aide level. The court noted this reading aligns with the policy’s immediately preceding subsections, each of which requires licensed providers (e.g., licensed nurse, licensed physical therapist).

Because the lack of coverage independently resolved the case, the court expressly declined to reach the appellant’s arguments regarding pro se summary judgment notice under Vital and collateral estoppel. In a pointed footnote, however, the court observed it was “hardly clear” the appellant had adequate Vital notice in the district court, signaling caution for future proceedings.

Key Policy Language at Issue

The court’s reasoning turns on two successive provisions within the home health care benefits section (subsection 7):

“Home Health Care Services include any one of the following: … 7. Services of a licensed home health care agency, if licensing is required by the state, to provide: (a) Home health aide services …; (b) Home hospice services; or (c) Homemaker services … provided that these services are prescribed in Your written Plan of care and are performed by any of the individuals described above. …”

“Services of a licensed or certified home health aide who does not report through a licensed or certified home health agency will be covered as long as the following conditions are met: (1) You must utilize the Care Coordination Benefit …; and (2) The Licensed Health Care Practitioner develops a written Plan of care … and arranges for and approves the necessary services of a certified home health aide.”

The appellant argued that the “if licensing is required by the state” clause diluted the aide-level licensure/certification requirement. The Second Circuit disagreed, reading the clause as limited to the agency pathway, not as a blanket dispensation for unlicensed aides.

Analysis

Precedents and Authorities Cited

• Village of Sylvan Beach v. Travelers Indemnity Co., 55 F.3d 114 (2d Cir. 1995).
  Used to anchor the interpretive approach: start with the policy’s clear language; construe ambiguity (especially in exclusions) in favor of the insured. The panel cited Sylvan Beach to frame the general rules but found the text here unambiguous, obviating insured-favorable construction.
• Newmont Mines Ltd. v. Hanover Insurance Co., 784 F.2d 127 (2d Cir. 1986).
  Cited for two core principles: give words their ordinary meaning and avoid absurd results. The court’s reading—requiring licensed agencies or certified/licensed aides—fits both principles and the policy’s broader structure.
• Duane Reade, Inc. v. St. Paul Fire & Marine Insurance Co., 600 F.3d 190 (2d Cir. 2010).
  Cited for the proposition that whether contract language is ambiguous is a question of law subject to de novo review. The Second Circuit exercised de novo review and held the provisions unambiguous.
• Vital v. Interfaith Medical Center, 168 F.3d 615 (2d Cir. 1999).
  Appellant relied on Vital to challenge the adequacy of pro se notice at summary judgment. Although the panel did not reach the issue, it flagged concern that adequate notice may not have been provided—an admonition to district courts in pro se cases.
• Estate of Jackling v. Brighthouse Life Ins. Co., 2022 WL 2669924 (W.D.N.Y. July 10, 2022), aff’d, No. 22-1703, 2024 WL 4100518 (2d Cir. Sept. 6, 2024).
  The related litigation involving the decedent’s spouse’s policy was resolved in Brighthouse’s favor and affirmed by the Second Circuit. While collateral estoppel was argued here, the panel did not need to reach it given the dispositive contract interpretation.

Legal Reasoning

The court’s reasoning is a straightforward application of contract interpretation under settled Second Circuit principles:

1. Start with the text. The panel read the two adjacent provisions together. The first provision secures coverage for services delivered through a licensed home health care agency “if licensing is required by the state.” The second provision covers services by an aide not reporting through an agency, but only if the aide is licensed or certified and other conditions (care coordination and a practitioner-approved plan of care) are met.
2. Constrain modifiers by structure. The court rejected the appellant’s attempt to carry the “if licensing is required by the state” qualifier beyond the agency clause to dilute aide-level requirements. Structurally and grammatically, the clause modifies “licensed home health care agency,” not “home health aide.” Functionally, this reflects the “last antecedent”/“series-qualifier” logic: a proviso positioned within the agency clause does not silently rewrite the separate aide-only clause that follows.
3. Context of surrounding subsections. The court noted that each of the six preceding subsections requires licensed professionals (e.g., licensed nurse, licensed physical therapist). Reading subsection 7 to require licensure/certification maintains consistency across the benefit categories and avoids the anomalous result that unlicensed aides would be uniquely covered when all other providers must be licensed.
4. No ambiguity, so no insured-favorable construction. Because the policy language was clear, the court declined to invoke contra proferentem (construing ambiguity against the insurer). The insured-favorable rule applies only after a genuine ambiguity is found; here, the court found none.
5. Affirm on any ground supported by the record. Having concluded the policy does not cover unlicensed/un-certified aides, the court affirmed without reaching the alternative arguments (pro se notice and collateral estoppel).

Impact and Practical Implications

While this ruling is a nonprecedential summary order, it carries several practical and persuasive implications for insurers, policyholders, and courts addressing similar policy language:

• Coverage gating by licensure/certification. Policies with similarly structured home health care benefits will likely be read to require either (i) services through a licensed agency (where state law requires agency licensing) or (ii) services by a licensed or certified home health aide (if not using an agency), subject to plan-of-care and care coordination prerequisites. Informal caregivers and unlicensed aides will typically fall outside coverage.
• Structural drafting matters. The opinion rewards careful drafting: qualifiers tied to specific subsections will be confined to those subsections. Attempts to broaden coverage by re-assigning modifiers across clauses are unlikely to succeed when the text and structure separate agency-based services from aide-only services.
• Consistency across benefit categories. Courts are sensitive to internal coherence. Where most listed services require licensed providers, an interpretation that would uniquely allow unlicensed providers in one category risks rejection as inconsistent or absurd.
• Pro se notice vigilance. Although not dispositive here, the court’s footnote suggests ongoing scrutiny of district court compliance with Vital. District courts should take care to provide clear, documented notice to pro se litigants facing summary judgment; counsel should be prepared to address harmlessness if notice is arguable.
• Long-term care and home care riders. The ruling will be persuasive in disputes involving life insurance riders or stand-alone long-term care policies with home health benefits, particularly those separating agency-based services from aide-based services and conditioning the latter on aide credentials and clinical oversight.

Complex Concepts Simplified

• Summary Order (Nonprecedential): A decision that resolves the dispute but, by rule, does not create binding precedent. It may still be cited as persuasive authority under FRAP 32.1 and the Second Circuit’s local rules.
• Summary Judgment: A procedural mechanism to resolve a case without trial when no genuine dispute of material fact exists and the movant is entitled to judgment as a matter of law.
• Vital Notice (Pro Se Summary Judgment Notice): In the Second Circuit, courts must ensure pro se litigants understand the nature and consequences of summary judgment and the need to adduce evidence to oppose it. Deficient notice can warrant reversal unless harmless.
• Collateral Estoppel (Issue Preclusion): Bars relitigation of an issue actually litigated and necessarily decided in a prior proceeding against a party (or its privy). The panel did not reach this question because the coverage issue independently disposed of the case.
• Plain Meaning Rule in Insurance Contracts: Courts give policy terms their ordinary meaning and avoid interpretations yielding absurd results. Only if language is genuinely ambiguous do courts construe it against the drafter (the insurer), especially as to exclusions.
• Licensed vs. Certified Aide: “Licensed” typically refers to formal authorization by a state licensing authority; “certified” refers to completion of specific training/competency standards recognized by a regulator or accreditor. The policy at issue conditions coverage for non-agency services on aides who hold such credentials.
• Care Coordination Benefit and Plan of Care: These policy mechanisms require coordination and approval by a licensed health care practitioner and a written plan specifying the needed services—additional safeguards that often accompany reimbursement for non-agency providers.

Observations on the Court’s Textual Approach

Beyond the cited authorities, the court’s method reflects familiar interpretive canons without naming them: modifiers are confined to their clauses (avoiding “spillover” across separately enumerated provisions), and terms are read harmoniously with surrounding subsections to preserve internal consistency. The court’s brief but decisive rejection of the appellant’s broader reading illustrates how placement, punctuation, and enumeration structure can carry significant legal consequences in insurance contracts.

The opinion also hints at a practical policy logic: when care is delivered outside the formal agency channel, the policy demands other proxies for quality and oversight—namely, the aide’s credential and a clinician-approved plan tied to care coordination. That logic would be undermined by reimbursing uncredentialed aides, and the court’s interpretation avoids that result.

Conclusion

The Second Circuit affirmed summary judgment for Brighthouse on the ground that the policy unambiguously excludes reimbursement for services rendered by unlicensed or uncertified home health aides. Although it left unresolved the appellant’s challenges under Vital and collateral estoppel, the court’s plain-language reading provides persuasive guidance for similar disputes: coverage for home health care services turns on either using a licensed home health care agency (where state law requires agency licensure) or employing a licensed/certified aide under a coordinated, clinician-approved plan of care.

For policyholders, the takeaway is clear: to preserve eligibility for reimbursement of home care, choose providers who satisfy the policy’s credentialing and structural requirements and document care through the policy’s coordination mechanisms. For insurers and drafters, the decision underscores the value of clear, enumerated structures that specify when licensure or certification is required and how state licensing regimes interact with aide-level credentials. And for courts, the footnote’s cautionary note on Vital serves as a reminder to vigilantly protect the procedural rights of pro se litigants even when the merits ultimately compel judgment as a matter of law.

Case Details

• Case: Jackling v. Brighthouse Life Insurance Company (Christopher Jackling, as Executor of the Estate of William T. Jackling, Plaintiff-Appellant)
• Court: United States Court of Appeals for the Second Circuit
• Docket No.: 23-7309
• Panel: Chief Judge Livingston, Circuit Judge Wesley, District Judge Wolford (by designation)
• Disposition: Affirmed (Summary Order, nonprecedential)
• Date: October 20, 2025
• Lower Court: W.D.N.Y. (Pedersen, M.J.), summary judgment for Brighthouse, Sept. 6, 2023