Alwes v. Hartford Life & Accident Insurance Co.

372 N.W.2d 376, 6 Employee Benefits Cas. (BNA) 2009, 1985 Minn. App. LEXIS 4928
CourtCourt of Appeals of Minnesota
DecidedAugust 6, 1985
DocketC9-84-2239
StatusPublished
Cited by14 cases

This text of 372 N.W.2d 376 (Alwes v. Hartford Life & Accident Insurance Co.) is published on Counsel Stack Legal Research, covering Court of Appeals of Minnesota primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Alwes v. Hartford Life & Accident Insurance Co., 372 N.W.2d 376, 6 Employee Benefits Cas. (BNA) 2009, 1985 Minn. App. LEXIS 4928 (Mich. Ct. App. 1985).

Opinion

OPINION

LESLIE, Judge.

The Hartford Life and Accident Insurance Co. appeals the judgment ordering it to pay the face amount of the life insurance policy for Fred Alwes, plus interest, costs, and disbursements. We affirm.

FACTS

Fred Alwes was an employee of Naegele Outdoor Advertising, Inc. In 1978 he took a medical leave of absence because he was suffering from a cancerous brain tumor. He considered himself an employee throughout his medical leave and believed he would return to active, full-time employment after the necessary treatment. Alwes never returned to full-time employment. He died in 1979.

In 1978, Naegele decided it would change its life insurance carrier. Until that time, Naegele had a group life insurance policy with Provident Mutual Insurance Co., and *378 Alwes was a covered employee under that policy.

One of the companies vying for Nae-gele’s business was The Hartford Life and Accident Insurance Company (Hartford). During negotiations, Naegele told Hartford that it wanted the new policy to cover all employees covered under the old Provident policy. Hartford was given census data so that it could determine a rate to submit in its bid for the Naegele account. Hartford did not tell Naegele that disabled employees affected the rate offered.

To verify the census data and secure a beneficiary designation, the Naegele employees signed Hartford’s “Group Insurance Enrollment Card.” The printed enrollment card contained a sentence in small print, “Am actively at work at least 30 hours per week.” Alwes signed this enrollment card, but wrote in large, legible print in the “occupation” block, “On disability at present.”

Hartford received Alwes’ enrollment card, but ignored the information he had printed on it. Apparently, Hartford routinely ignored all information in the “occupation” block.

During the negotiations, Hartford representative Charles Ambrosia said their policy would provide the same coverage as the Provident policy. A Naegele official testified that he thought Ambrosia meant that every individual employee covered by Provident would be covered by Hartford. However, respondents admitted Ambrosia made no false representations to them. No mention was made of Alwes or any other disabled employee during negotiations.

Hartford admits Alwes would have been accepted under their group policy if their representative knew about the situation, but with an upward rate adjustment. Nae-gele did not withhold information on Alwes to obtain a more favorable bid.

After Alwes died, Hartford refused coverage under the group life policy. Therefore, the Naegele Employee Health Plan (an unincorporated insurance trust which manages Naegele’s various insurance programs) made a $30,000 interest-free loan to Willie Alwes (Fred’s spouse) in exchange for a loan receipt agreement. Then, respondents Willie M. Alwes and the Naegele Employee Health Plan successfully sued Hartford under the terms of the group life insurance policy issued to Naegele.

ISSUES

1. Did the trial court err by ruling Hartford must pay the face value of the life insurance policy under the theory of equitable estoppel?

ANALYSIS

1. The appellate court need not defer to the trial court in reviewing questions of law. Van de Loo v. Van de Loo, 346 N.W.2d 173, 175 (Minn.Ct.App.1984). Therefore, this court may review de novo the application of equitable estoppel in this situation.

In its incorporated memo, the trial court applied equitable estoppel because Hartford’s representations led Fred Alwes and Naegele to believe that Alwes was a covered employee. The representations consisted of Hartford’s silence after Alwes submitted his enrollment card and Hartford’s acceptance of premiums for coverage on Alwes.

Appellant argues that the trial court improperly applied estoppel to enlarge coverage of the insurance policy, in opposition to the doctrine enunciated in Shannon v. Great American Insurance Co., 276 N.W.2d 77 (Minn.1979). In Shannon, the insured tried to “enlarge” the amount of coverage he could recover when his building was destroyed by fire. The policy had a $15,000 limit on recovery. However, the insurance agent offered $17,965 to settle the claim. The insured argued that the offer to settle constituted a waiver of the policy limits, and the insurer was therefore estopped from imposing those limitations. The Minnesota Supreme Court said estop-pel could not be used to enlarge the coverage amount. Id. at 78.

*379 The Shannon principle intends to prevent insured persons from “creating” coverage which does not exist. For example, the Wisconsin Supreme Court said estoppel could not “create” an insurance policy for the new owner of a farm to which the old insurance policy had not been assigned. Madgett v. Monroe County Mutual Tornado Insurance Co., 46 Wis.2d 708, 176 N.W.2d 314 (1970). However, the rule does not mean that estoppel cannot be applied in insurance cases where misrepresentation or material omission occurs.

Generally, five elements must be shown to prove equitable estoppel: (1) misrepresentation of a material fact; (2) the misrepresentation must be knowing; (3) there must be an intention that the misrepresentation be acted upon; (4) the party asserting estoppel must not have had knowledge of the true facts; and (5) the party asserting the estoppel must have relied upon the misrepresentation with detriment. Transamerica Insurance Group v. Paul, 267 N.W.2d 180, 183 (Minn.1978).

However, the conduct of the party to be estopped need not consist of affirmative acts or words. It may consist of silence or a failure to act when there is a duty to speak or act. Second, the party to be estopped need not actually know the facts, if the circumstances are such that knowledge is necessarily imputed to that party. Third, the party to be estopped need not have acted with fraudulent intention to deceive, if that person should have known it was natural and probable the plaintiff would rely on those actions. Browning v. Browning, 246 Minn. 327, 331, 76 N.W.2d 100, 103 (1956). (Cite omitted.) That is, negligence takes the place of intent to deceive, where there is a duty to disclose. See 31 C.J.S. Estoppel, § 102 (1964).

The issue concerns what duties may be imposed on insurance companies. In particular, did Hartford have a duty to inspect the employees’ enrollment cards and give notice that disabled employees could not be covered without an increased rate?

Appellant argues that there was no duty of notice, citing Tollefson v. American Family Insurance Co., 302 Minn.

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

Related

UnitedHealth Group Inc. v. Columbia Casualty Co.
836 F. Supp. 2d 912 (D. Minnesota, 2011)
EEP Workers' Compensation Fund v. Fun & Sun, Inc.
794 N.W.2d 126 (Court of Appeals of Minnesota, 2011)
Christensen v. Metropolitan Life Insurance
542 F. Supp. 2d 935 (D. Minnesota, 2008)
State v. Holmberg
545 N.W.2d 65 (Court of Appeals of Minnesota, 1996)
In Re the Liquidation of Excalibur Insurance Co.
519 N.W.2d 494 (Court of Appeals of Minnesota, 1994)
Southern Development Land & Golf Co. v. South Carolina Public Service Authority
426 S.E.2d 748 (Supreme Court of South Carolina, 1993)
Saeger v. ITT Financial Services (In Re Saeger)
119 B.R. 184 (D. Minnesota, 1990)
In re the Amended Administrative Penalty Order to Westling Manufacturing, Inc.
442 N.W.2d 328 (Court of Appeals of Minnesota, 1989)
Matter of Westling Mfg., Inc.
442 N.W.2d 328 (Court of Appeals of Minnesota, 1989)
Fitger Brewing Co. v. State
416 N.W.2d 200 (Court of Appeals of Minnesota, 1987)
Kiecker v. Estate of Kiecker
404 N.W.2d 881 (Court of Appeals of Minnesota, 1987)
State, City of Eden Prairie v. Liepke
403 N.W.2d 252 (Court of Appeals of Minnesota, 1987)

Cite This Page — Counsel Stack

Bluebook (online)
372 N.W.2d 376, 6 Employee Benefits Cas. (BNA) 2009, 1985 Minn. App. LEXIS 4928, Counsel Stack Legal Research, https://law.counselstack.com/opinion/alwes-v-hartford-life-accident-insurance-co-minnctapp-1985.