Alleman v. State Farm Life Insurance

334 F. App'x 470
CourtCourt of Appeals for the Third Circuit
DecidedJune 26, 2009
Docket07-4283
StatusUnpublished
Cited by6 cases

This text of 334 F. App'x 470 (Alleman v. State Farm Life Insurance) is published on Counsel Stack Legal Research, covering Court of Appeals for the Third Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Alleman v. State Farm Life Insurance, 334 F. App'x 470 (3d Cir. 2009).

Opinion

OPINION

POLLAK, District Judge.

Appellant Dr. Mary L. Alleman (“Alle-man”) filed this putative nationwide class action in the Western District of Pennsylvania, alleging four counts against State Farm Life Insurance Company (“State Farm”): (1) breach of contract; (2) breach *471 of fiduciary duty; (3) constructive fraud; and (4) unjust enrichment. On August 2, 2006, in an unpublished Memorandum and Order addressing a motion to dismiss filed by State Farm, the District Court dismissed Alleman’s breach of fiduciary duty claim but sustained her breach of contract, constructive fraud, and unjust enrichment claims.

On September 11, 2007, 508 F.Supp.2d 452, the District Court granted State Farm’s motion for summary judgment as to the breach of contract claim, but denied State Farm’s motions for summary judgment as to the constructive fraud and unjust enrichment claims, and also denied Alleman’s motion for class certification. On November 4, 2007, the District Court entered an order granting the parties’ stipulated dismissal of Alleman’s unjust enrichment and constructive fraud claims.

Alleman argues on appeal that the District Court erred in denying her breach of contract claim and her motion for class certification. The nub of Alleman’s claim is that State Farm breached its insurance contract by charging the same insurance premiums to juvenile insureds who do not smoke tobacco as it did to juvenile insureds who do. The District Court had diversity jurisdiction over this case pursuant to 28 U.S.C. § 1332. We have appellate jurisdiction under 28 U.S.C. § 1291. Because the District Court properly granted summary judgment for State Farm on Alleman’s breach of contract claim, we will affirm.

I.

Alleman is the owner of two life insurance policies issued by State Farm: (1) a whole life insurance policy insuring the life of her son, Samuel J. Doctor, and (2) a whole life insurance policy insuring the life of her son, Nathan Doctor. Both policies were issued on June 26, 2002, for face amounts of $15,000 each. Alleman’s policies were purchased by her late husband, Dr. John S. Doctor. At the time the policies were purchased, Samuel was sixteen years old and Nathan was ten years old.

Each of the policies is identified as “Policy Class 1,” which is explained in the policy as the “underwriting classification of the Basic Plan.” Policy Class 1 is State Farm’s standard classification for policies insuring juveniles, and in policies for juveniles State Farm does not distinguish between insured individuals on the basis of their tobacco use. The policies are virtually identical, with one notable exception: Samuel’s policy provides that the “Annual Premium” is $139.80, payable for life, whereas Nathan’s policy provides that the “Annual Premium” is $259.35, payable until 2012. State Farm has at all times charged Alleman the amounts for coverage indicated in the policies.

Both policies, which were signed by Alleman’s late husband, state on their covers: “Read this policy with care. This is a legal contract between the Owner and State Farm Life Insurance Company.” The policies also state: “The policy contains the Basic Plan, any amendments, endorsements, and riders, and a copy of the application. The policy is the entire contract.” Further, both policy contracts provide that the statements contained in the application “are representations and not warranties.”

The standardized application forms, which State Farm uses for both adult and juvenile applicants, asked Alleman’s late husband whether, inter alia, each child smoked or used tobacco products. Alle-man’s late husband designated both children to be non-smokers/non-tobacco users in these application forms.

Although State Farm has offered tobacco-distinct premiums for adults, State Farm has never offered tobacco-distinct premiums for insureds age twenty and un *472 der. Rather, it offers an aggregate juvenile premium rate that takes into account the mortality experience of all juveniles (both those who use tobacco and those who do not). Accordingly, for Samuel and Nathan’s premiums, State Farm offered the “aggregate” or “blend” received by most of its insureds under the age of twenty. 1

II.

We review the District Court’s grant of summary judgment de novo. TKR Cable Co. v. Cable City Corp., 267 F.3d 196, 199 (3d Cir.2001). Summary judgment is appropriate where “the pleadings, the discovery and disclosure materials on file, and any affidavits show that there is no genuine issue as to any material fact and that the movant is entitled to judgment as a matter of law.” Fed.R.Civ.R 56(c); IFC Interconsult, AG v. Safeguard Int’l Partners, L.L.C., 438 F.3d 298, 317 (3d Cir.2006).

Because subject-matter jurisdiction is based on the diversity of citizenship of the parties, because the parties agree that Pennsylvania law governs this dispute, and because the policies in question were purchased in Pennsylvania, we look to the substantive law of Pennsylvania to determine the rights and obligations of the parties.

III.

In the absence of an affirmative misrepresentation by the insurer or its agent about the contents of a policy, the plain and unambiguous terms of that policy demonstrate the parties’ intent, and they control the rights and obligations of the insurer and the insured. West v. Lincoln Benefit Life Co., 509 F.3d 160, 168-69 (3d Cir.2007) (citations omitted). When a provision of the policy is clear and unambiguous, it must be enforced. West, 509 F.3d at 169 (citing Madison Constr. Co. v. Harleysville Mut. Ins. Co., 557 Pa. 595, 735 A.2d 100, 106 (1999)). By contrast, an unclear, ambiguous provision will be construed against the insurer and in favor of the insured. Id. (citing Madison Constr. Co., 735 A.2d at 106).

Contractual language is ambiguous if it is reasonably susceptible to different constructions and capable of being understood in more than one sense. Madison Constr. Co., 735 A.2d at 106. In determining whether a contract term is ambiguous, a court must consider the actual words of the agreements themselves, as well as any alternative meanings offered by counsel. St. Paul Fire & Marine Ins. Co. v. Lewis, 935 F.2d 1428, 1431 (3d Cir.1991).

As the District Court properly held, the terms of the policies at issue here are unambiguous.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Cite This Page — Counsel Stack

Bluebook (online)
334 F. App'x 470, Counsel Stack Legal Research, https://law.counselstack.com/opinion/alleman-v-state-farm-life-insurance-ca3-2009.