Amica Life Insurance Company v. Wertz

2020 CO 29, 462 P.3d 51
Supreme Court of Colorado·Decided April 27, 2020·No. 19SA143·Published·Cited by 5 cases

Opinion

Opinions of the Colorado Supreme Court are available to the public and can be accessed through the Judicial Branch’s homepage at http://www.courts.state.co.us. Opinions are also posted on the Colorado Bar Association’s homepage at http://www.cobar.org.

ADVANCE SHEET HEADNOTE

April 27, 2020

2020 CO 29

No. 19SA143 Amica Life Insurance Company v. Wertz—Non-Delegation Doctrine— Interstate Compacts—Suicide Exclusion Policies.

This case requires the supreme court to answer the following certified question from the Tenth Circuit Court of Appeals:

May the Colorado General Assembly delegate power to an interstate administrative commission to approve insurance policies sold in Colorado under a standard that differs from Colorado statute?

Answering the certified question narrowly, the supreme court now concludes that the General Assembly did not have the authority to delegate to the Interstate Insurance Product Regulation Commission the power to issue a standard authorizing the sale of life insurance policies in Colorado containing a two-year suicide exclusion when a Colorado statute prohibits insurers doing business in Colorado from asserting suicide as a defense against payment on a life insurance policy after the first year of that policy.

The Supreme Court of the State of Colorado 2 East 14th Avenue • Denver, Colorado 80203

2020 CO 29

Supreme Court Case No. 19SA143 Certification of Question of Law United States Court of Appeals for the Tenth Circuit Case No. 18-1455

Plaintiff Counter Defendant-Appellee:

Amica Life Insurance Company, v.

Defendant Counterclaimant-Appellant:

Michael P. Wertz.

Certified Question Answered en banc

April 27, 2020

Attorneys for Plaintiff-Appellee: Cozen O’Connor Christopher S. Clemenson Denver, Colorado

Cozen O’Connor Lisa D. Stern West Conshohocken, Pennsylvania

Attorneys for Defendant-Appellant: The Law Office of Ruth Summers, LLC Ruth Summers Boulder, Colorado

Attorneys for Amicus Curiae Colorado Trial Lawyers Association: McDermott Law, LLC Timothy M. Garvey Denver, Colorado

Attorneys for Amici Curiae National Association of Insurance Commissioners and Interstate Insurance Product Regulation Commission: Holland & Hart LLP Marcy G. Glenn Melissa Y. Lou Denver, Colorado

JUSTICE GABRIEL delivered the Opinion of the Court.

¶1 This case requires us to answer the following certified question from the Tenth Circuit Court of Appeals:

May the Colorado General Assembly delegate power to an interstate administrative commission to approve insurance policies sold in Colorado under a standard that differs from Colorado statute?

¶2 The certified question arises from a dispute in which plaintiff Amica Life Insurance Company seeks a declaratory judgment that it is not required to pay defendant Michael P. Wertz benefits under a life insurance policy naming Wertz as the beneficiary. The policy, which was issued in compliance with a standard enacted by the Interstate Insurance Product Regulation Commission (the “Commission”), contained a two-year suicide exclusion, and the insured committed suicide more than one year but less than two years after Amica had issued the life insurance policy to him. Wertz contends, however, that the policy’s two-year suicide exclusion is unenforceable because it conflicts with a Colorado statute, section 10-7-109, C.R.S. (2019), which provides:

The suicide of a policyholder after the first policy year of any life insurance policy issued by any life insurance company doing business in this state shall not be a defense against the payment of a life insurance policy, whether said suicide was voluntary or involuntary, and whether said policyholder was sane or insane.

Wertz asserts that the Colorado General Assembly could not properly delegate to the Commission the authority to enact a standard that would effectively override this statute.

¶3 We agree with Wertz. Accordingly, answering the certified question narrowly, we conclude that the General Assembly did not have the authority to delegate to the Commission the power to issue a standard authorizing the sale of life insurance policies in Colorado containing a two-year suicide exclusion when a Colorado statute prohibits insurers doing business in Colorado from asserting suicide as a defense against payment on a life insurance policy after the first year of that policy.

I. Facts and Procedural History

¶4 In 2004, the Colorado General Assembly passed legislation to join with other states to establish the Interstate Insurance Product Regulation Compact, section 24-60-3001, C.R.S. (2019) (the “Compact”). The Compact’s purpose is, among other things, to create the Commission and to “develop uniform standards for insurance products covered under the Compact.” Id. at art. I, §§ 2, 6.

¶5 As pertinent here, the Compact authorized the Commission to promulgate rules, to establish uniform standards governing the form of insurance policies covered under the Compact, and to review and approve such insurance policies. Id. at art. IV, §§ 1–3. Under the Compact, such rules, standards, and complying policies are given “the force and effect of law and shall be binding in the Compacting States.” Id.

¶6 In accordance with the foregoing authority, the Commission established certain Individual Term Life Insurance Policy Standards, IIPRC-L-04-I (2016) (“Standards”). As pertinent here, one of these Standards provides, “The suicide exclusion period shall not exceed two years from the date of issue of the policy.” Id. at § 3(Y)(3).

¶7 Pursuant to this Standard, the Commission authorized the sale of life insurance policies containing a two-year suicide exclusion in Compacting States like Colorado. Id. In Colorado, however, by statute, insurers doing business in this state may not assert suicide as a defense against payment of a life insurance policy after the first year of that policy. See § 10-7-109. Thus, this case presents a scenario in which the policy at issue complied with the Commission’s suicide-exclusion Standard but in which enforcement of that Standard amounts to the assertion of a defense that is precluded under Colorado statutory law.

¶8 Specifically, on January 28, 2014, Amica issued a ten-year convertible level term life insurance policy (with an annual renewable term provision) to Martin Fisher. The policy was in the face amount of $500,000 and named Wertz as the beneficiary. Pursuant to the Commission’s Standards, the policy included a suicide-exclusion section that provided, “Suicide of the Insured, while sane or insane, within two (2) years from the Date of Issue is not covered under this policy.”

¶9 Thereafter, on March 12, 2015—that is, more than one year but less than two years after the policy was issued—Fisher committed suicide. Wertz then submitted a claim for the death benefit under the policy, but Amica denied that claim, relying on the policy’s two-year suicide exclusion. Amica Life Ins. Co. v. Wertz, 272 F. Supp. 3d 1239, 1244 (D. Colo. 2017).

¶10 Recognizing the imminent dispute between the parties, Amica filed suit in the United States District Court for the District of Colorado, seeking a declaratory judgment that it had properly denied Wertz’s claim. Id. Wertz responded that the two-year suicide exclusion in the policy violated Colorado state law and should be declared unenforceable. Id. In addition, he filed counterclaims for reformation of the policy, breach of contract, and common-law bad faith breach of insurance contract. Id. Amica then moved for summary judgment, asserting that, as a matter of law, the Standards control over section 10-7-109. Id. at 1245.

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Amica Life Insurance Company v. Wertz, 2020 CO 29, 462 P.3d 51 (Colo. 2020).

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