American General Life Insurance Company v. Pike

CourtDistrict Court, N.D. Alabama
DecidedOctober 26, 2020
Docket1:20-cv-00607
StatusUnknown

This text of American General Life Insurance Company v. Pike (American General Life Insurance Company v. Pike) is published on Counsel Stack Legal Research, covering District Court, N.D. Alabama primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
American General Life Insurance Company v. Pike, (N.D. Ala. 2020).

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF ALABAMA SOUTHERN DIVISION

AMERICAN GENERAL LIFE ] INSURANCE COMPANY, ] ] Plaintiff, ] ] v. ] Case No.: 1:20-cv-00607-ACA ] AIMEE PIKE, ] ] Defendant. ]

MEMORANDUM OPINION

Before the court is Plaintiff American General Life Insurance Company’s (“American General”) motion for default judgment. (Doc. 12). After the Clerk entered default against Defendant Aimee Pike (doc. 8), American General moved under Federal Rule of Civil Procedure 55(b) for a default judgment, seeking a declaratory judgment that a life insurance policy it issued to Ms. Pike’s fiancée is due to be rescinded pursuant to Alabama Code § 27-14-7. (Doc. 12 at 12). Because American General’s well-pleaded allegations and other evidence of record support its request for a declaration that the life insurance policy at issue is due to be rescinded, the court WILL GRANT the motion for default judgment. I. BACKGROUND A defaulting defendant “admits the plaintiff’s well-pleaded allegations of

fact” for purposes of liability. Buchanan v. Bowman, 820 F.2d 359, 361 (11th Cir. 1987) (quotation marks omitted)). In resolving a motion for default judgment, the court also may consider evidence presented in the form of an affidavit or

declaration. Frazier v. Absolute Collection Serv., Inc., 767 F. Supp. 2d 1354, 1362 (N.D. Ga. 2011). On January 4, 2019, Randy Lee Webb applied for a $100,000 life insurance policy with American General. (Doc. 1 at ¶ 7; Doc. 12-1; Doc. 12-2). As part of

the application, Mr. Webb answered a series of question about his medical history. He answered “no” when asked if he had ever been diagnosed with, treated for, or consulted a physician for cancer or masses. (Doc. 12-2 at 3). Mr. Webb answered

“yes” when asked if—other than previously stated on the application—he had “taken any medications, had treatment or therapy or been under medical observation within the past 12 months.” (Id. at 4). He explained that he was taking medication for wrist pain after falling off a ladder. (Id. at 6).

Mr. Webb answered “no” when asked whether, in the past five years, he had “been hospitalized, consulted a member of the medical profession or had any illness, injury, or surgery.” (Doc. 12-2 at 4). He also answered “no” when asked

whether he had “been advised by a member of the medical profession concerning any abnormal diagnostic test results, been advised to see a specialist, or been advised to have any diagnostic test, hospitalization, surgery, or treatment that was

NOT completed” or whether he had any pending test results. (Id.). Mr. Webb answered “no” when asked if, within the past five years, he had “been treated for or been diagnosed by a member of the medical profession for any other medical,

physical, or psychological condition” not previously disclosed. (Id. at 5). Mr. Webb signed the application under the “Agreement and Signatures” section which stated that “[m]y answers to the questions in this application are true and complete to the best of my knowledge and belief,” and that “I understand that

any misrepresentation contained in this application and relied on by [American General] may be used to reduce or deny a claim or void the policy if: (1) such misrepresentation materially affects the acceptance of the risk; and (2) the policy is

within its contestable period.” (Doc. 12-2 at 6). American General issued Policy No. 4199590241 (“the policy” or “life insurance policy”) on February 4, 2019, insuring Mr. Webb’s life for $100,000. (Doc. 1 at ¶ 8; Doc. 1-1 at 3–60). Defendant Aimee Pike, Mr. Webb’s fiancée, is

the named beneficiary of the policy. (Doc. 1 at ¶ 8; Doc. 12-1 at 2). On December 2, 2019, Ms. Pike notified American General that Mr. Webb passed away on November 6, 2019. (Doc. 12-4 at 2). Ms. Pike filed a claim for

the policy’s death benefits. (Doc. 12-4 at 2–11). Because Mr. Webb’s death occurred within two years of issuance of the policy, American General conducted a contestable claim investigation. (Doc. 1 at ¶ 13; see also Doc. 1-1 at 19–20; Doc.

12-7 at 2). During its investigation, American General obtained medical records for Mr. Webb indicating that he had misrepresented his health and medical history on the

insurance application. (Doc. 1 at ¶ 13; see Docs. 12-8, 12-9, 12-10). These records reveal that Mr. Webb had received treatment for liver disease and colon cancer in the months before he submitted his life insurance application, but he did not disclose this information when he applied for the life insurance policy.

(Compare Doc. 12-2 at 3–5, 7 with Docs. 12-8, 12-9, 12-10).1 After reviewing these medical records, an American General underwriting specialist issued a memorandum stating that if Mr. Webb had disclosed this treatment and medical

history in his application, then “the application would have been declined.” (Doc. 12-11). American General sent Ms. Pike a letter explaining that American General considered the life insurance policy void due to Mr. Webb’s material

misrepresentations on the application. (Doc. 12-12 at 1–4). American General

1 The court has thoroughly reviewed the medical records that American General submitted. (Docs. 12-8, 12-9, 12-10). To avoid unnecessary publication about the details of Mr. Webb’s medical history in the months before his death, the court does not elaborate on every diagnosis, test, and treatment that Mr. Webb received but did not disclose on his insurance application. advised Ms. Pike that it would send a premium refund check to Ms. Pike under separate cover. (Id. at 3).

II. DISCUSSION Federal Rule of Civil Procedure 55 establishes a two-step procedure for obtaining a default judgment. First, when a defendant fails to plead or otherwise

defend a lawsuit, the Clerk of Court must enter the party’s default. Fed. R. Civ. P. 55(a). Second, if the defendant is not an infant or an incompetent person, the court may enter a default judgment against the defendant as long as the well-pleaded allegations in the complaint state a claim for relief.

Fed. R. Civ. P. 55(b); Eagle Hosp. Physicians, LLC v. SRG Consulting, Inc., 561 F.3d 1298, 1307 (11th Cir. 2009). Here, the Clerk has already entered Ms. Pike’s default, so the court must

determine whether the well-pleaded factual allegations and other evidence of record support American General’s claim for a declaration that the policy is due to be rescinded and that Ms. Pike is not entitled to the policy benefits. Under Alabama law, any misrepresentations, omissions, concealment of

facts, or incorrect statements do not prevent recovery under an insurance policy unless they are “material [] to the acceptance of the risk,” or “[t]he insurer in good faith would either not have issued the policy or contract, or would not have issued

a policy or contract at the premium rate as applied for or would not have issued a policy or contract in as large an amount or would not have provided coverage with respect to the hazard resulting in the loss if the true facts had been made known to

the insurer. . . .” Ala. Code. § 27-14-7(a)(2)-(3).

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American General Life Insurance Company v. Pike, Counsel Stack Legal Research, https://law.counselstack.com/opinion/american-general-life-insurance-company-v-pike-alnd-2020.