Anderson v. Country Life Insurance

886 P.2d 1381, 180 Ariz. 625, 178 Ariz. Adv. Rep. 18, 1994 Ariz. App. LEXIS 240
CourtCourt of Appeals of Arizona
DecidedNovember 17, 1994
Docket1 CA-CV 93-0181
StatusPublished
Cited by29 cases

This text of 886 P.2d 1381 (Anderson v. Country Life Insurance) is published on Counsel Stack Legal Research, covering Court of Appeals of Arizona primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Anderson v. Country Life Insurance, 886 P.2d 1381, 180 Ariz. 625, 178 Ariz. Adv. Rep. 18, 1994 Ariz. App. LEXIS 240 (Ark. Ct. App. 1994).

Opinion

OPINION

TOCI, Judge.

Anna Mae Anderson, individually and as personal representative of the estate of her husband, Roger Anderson, appeals the trial court’s grant of summary judgment in favor of Country Life Insurance Company (“Country Life”).

This appeal presents the following issue: may an insurer who accepts advance premiums and issues a written receipt for health insurance coverage effective immediately, conditioned upon the later issuance of a policy of insurance, defeat interim coverage by refusing to issue the policy after a loss occurs?

The answer is no. We conclude that a conditional receipt of this nature is illusory, unconscionable, and against public policy. An insurer may not collect a premium for a period during which it had no risk. Consequently, when Country Life accepted a premium from the Andersons for immediate coverage, a contract for interim insurance was created notwithstanding the condition in the receipt giving Country Life the power to defeat such coverage by not issuing a policy of insurance. Thus, we reverse the summary judgment in favor of Country Life and remand with directions that judgment be entered in favor of the Andersons on this issue.

We also dispose of two additional issues. First, we conclude that the Andersons’ failure to submit a claim does not preclude recovery where the insurer indicated that no coverage existed. Second, we conclude that, because the Andersons’ policy was not an “insurable risk” type of policy, Country Life did not condition insurance on Mr. Anderson’s health at the time of application. *628 Country Life was, therefore, under no duty to continue processing Mr. Anderson’s application once Country Life determined that it would not issue a policy. We therefore affirm summary judgment for Country Life on Mrs. Anderson’s claim of insurance bad faith.

I. FACTS AND PROCEDURAL HISTORY

[1,-23 In reviewing the ruling on a motion for summary judgment, we are not bound by any issues of law decided by the trial court and will determine such issues anew. See Gary Outdoor Advertising Co. v. Sun Lodge, Inc., 133 Ariz. 240, 242, 650 P.2d 1222, 1224 (1982). Furthermore, where the issues can be decided as a matter of law, we have the authority both to vacate the trial court’s grant of summary judgment in favor of one party and to enter summary judgment for the other party if appropriate. McCallister Co. v. Kastella, 170 Ariz. 455, 457, 825 P.2d 980, 982 (App.1982); Roosevelt Sav. Bank of New York v. State Farm Fire & Casualty Co., 27 Ariz.App. 522, 526, 556 P.2d 823, 827 (1976); see also Trimmer v. Ludtke, 105 Ariz. 260, 263, 462 P.2d 809, 812 (1969). In exercising our authority to enter summary judgment in favor of the nonmoving party, the Andersons, on the issue of interim health benefits, we view the following facts and all inferences therefrom in a light most favorable to Country Life. Cf. Cecil Lawter Real Estate Sch., Inc. v. Town & Country Shopping Ctr. Co., 143 Ariz. 527, 533, 694 P.2d 815, 821 (App.1984).

On November 26, 1990, Country Life’s agent, Donald Fitzgerald, met with the Andersons at their home to obtain their application for health insurance. The Andersons filled out an application, and Mrs. Anderson wrote a personal check in the amount of $1,616.93 to Country Life for a six-month premium for both the Andersons. Fitzgerald accepted the check and completed the application. During the meeting, Fitzgerald gave the Andersons a “conditional receipt for medical policy,” which he dated that same day. 1 Fitzgerald specifically pointed out to Mr. Anderson that the policy would not become effective until all conditions were met and the company approved the issuance of a policy. 2 Fitzgerald said that after reading the conditional receipt, Mr. Anderson indicated that he understood the significance of the document and considered its use standard procedure for issuance of the policies.

After the meeting, Country Life proceeded with the Andersons’ application. Country Life cashed the Andersons’ premium check on or about December 4, 1990, and the Andersons received a copy of the canceled check. On December 7, 1990, Country Life notified Fitzgerald that the company required additional information. Country Life wanted medical examinations of both Mr. and Mrs. Anderson. It also requested some additional medical history for Mr. Anderson. Finally, it indicated that, even without a medical examination, Mrs. Anderson would require a 75 percent rate increase because of her stated height and weight. Fitzgerald relayed this information to the Andersons on December 14,1990, and asked them to schedule the medical examinations.

The very next morning, on December 15, 1990, Mr. Anderson suffered a heart attack and was hospitalized. Mrs. Anderson contacted Fitzgerald the following day to notify him of these events and to obtain assurance that they would have health coverage for his medical bills. Fitzgerald told her he could *629 not confirm coverage and would need to contact the home office.

Before the home office responded, local processing of the application continued. Shortly after December 15, 1990, Mrs. Anderson was visited by Dr. Potoch, a medical examiner, who took urine samples and provided certain paperwork for Mrs. Anderson’s signature. On December 20, 1990, Fitzgerald visited the Andersons in Mr. Anderson’s hospital room. Fitzgerald had Mr. Anderson complete and sign a form regarding additional medical history.

In the evening of December 20, 1990, Mr. Anderson died from an aneurysm. The following day, before County Life learned of his death, it sent a letter addressed to Mr. Anderson refunding his portion of the advance premium on the policy. The letter stated that Mr. Anderson’s heart attack prevented normal processing procedures on his behalf. The letter also stated, however, that processing of the application could continue on behalf of Mrs. Anderson if she had the required medical examination and paid the 75 percent rate increase previously mentioned.

Several months later, Fitzgerald visited Mrs. Anderson at her home. He brought with him three application amendments requiring her signature to secure her policy. Mrs. Anderson signed amendments increasing her premium rates because of her weight and clarifying her answer to a question on the original application. A third proposed amendment provided for the exclusion of Mr. Anderson from the original policy application. Mrs. Anderson refused to sign this amendment, telling Fitzgerald that her husband “was never on the policy, so why should I sign?” Country Life then discontinued processing Mrs. Anderson’s application and refunded the balance of the premiums paid.

Mrs. Anderson filed suit against Country Life.

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Bluebook (online)
886 P.2d 1381, 180 Ariz. 625, 178 Ariz. Adv. Rep. 18, 1994 Ariz. App. LEXIS 240, Counsel Stack Legal Research, https://law.counselstack.com/opinion/anderson-v-country-life-insurance-arizctapp-1994.