Annette M. Riner Suzette Marriott v. Allstate Life Insurance Company

131 F.3d 530
CourtCourt of Appeals for the Fifth Circuit
DecidedJanuary 14, 1998
Docket96-20953
StatusPublished
Cited by7 cases

This text of 131 F.3d 530 (Annette M. Riner Suzette Marriott v. Allstate Life Insurance Company) is published on Counsel Stack Legal Research, covering Court of Appeals for the Fifth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Annette M. Riner Suzette Marriott v. Allstate Life Insurance Company, 131 F.3d 530 (5th Cir. 1998).

Opinion

DeMOSS, Circuit Judge:

Annette Riner (Riner) and Suzette Marriott (Marriott) sued Allstate Life Insurance *532 Company (Allstate) after Allstate refused to pay benefits under a temporary insurance agreement on the life of their father, Robert Marriott (Mr. Marriott). Allstate defended on the theory that alleged misrepresentations in the insurance application absolved it of liability. The district court granted summary judgment in favor of Allstate, and Riner and Marriott appealed. We reverse the district court’s judgment in favor of Allstate and render judgment in favor of Riner and Marriott on the issue of coverage. We remand the cause to the district court for further development of the remaining liability issues and for a determination of damages.

MATERIAL FACTS

Prior to 1994, Mr. Marriott had five back surgeries, which left him with chronic back pain. That back pain became aggravated and was joined by a feeling of loneliness and sadness after his wife of more than thirty years left him. Following his divorce in June 1994, Mr. Marriott wanted to replace his life insurance policy, which named his ex-wife as beneficiary, with a new policy naming his daughters as beneficiaries.

Riner referred Mr. Marriott to an Allstate agent. On June 29, 1994, Allstate sent an agent to Mr. Marriott’s home to take his application information. Allstate’s lengthy standardized application contained a list of medical questions. The applicant responded to those questions by checking boxes marked “yes” or “no.”. When a box was marked “yes,” the application contained additional space for further explanation by the applicant. Mr. Marriott disclosed that he had chronic back problems and certain other medical problems. Mr. Marriott’s application is marked “no,” however, with respect to whether he had ever received treatment for the use of alcohol or received treatment for depression within the past three years.

Mr. Marriott explained to the agent that he was “groggy” from medication he was taking for back pain. After completing the application, the agent requested an initial premium check in the amount of $276.23. The record reflects that Mr. Marriott was too affected by the painkillers he was taking to complete the check. For that reason, the agent completed the premium check, which was then signed by Mr. Marriott. 1 In return, the agent issued a “Receipt and Temporary Insurance Agreement” to Mr. Marriott. Although the agent left a copy of the agreement, the agent did not leave a copy of Mr. Marriott’s application with Mr. Marriott. The temporary insurance agreement provided that Mr. Marriott’s premium was received as “payment for life insurance” in the amount of $100,000. The agreement further provided that temporary coverage would start when Mr. Marriott’s medical exam was completed. Mr. Marriott completed the medical exam on July 26,1994.

Six days after the exam, Mr. Marriott died suddenly of either an aneurism or heart disease. Thereafter, his daughters made a claim under the temporary insurance agreement. On the claim form, Suzette Marriott indicated that Mr. Marriott was seeing a doctor for “depression/chronic pain.” Allstate requested Mr. Marriott’s medical records and began an ■ investigation to determine whether it would pay benefits under the temporary insurance agreement. Three months later, Allstate denied liability under the temporary ■ insurance agreement. Allstate denied liability because it concluded that, contrary to Mr. Marriott’s answers in the application, he had received treatment for his use of alcohol and for depression.

PROCEEDINGS IN THE DISTRICT COURT

Mr. Marriott’s beneficiaries, Riner and Marriott, sued Allstate in Texas state court. Allstate properly removed the matter to federal court. In federal court, Riner and Marriott amended their complaint, alleging that Allstate’s refusal to pay violated certain provisions of the Texas Insurance Code and the Texas Deceptive Trade Practices Act. Riner and Marriott also contended that Allstate’s *533 actions constituted a breach of contract and a breach of Allstate’s duty of good faith and fair dealing. Allstate answered that Mr. Marriott’s misrepresentations in the application absolved it of all liability.

Riner and Marriott moved for summary judgment on the issue of Allstate’s liability, arguing that Allstate could not rely upon any misrepresentations in the application to deny coverage because Allstate failed to attach a copy of Mr. Marriott’s application to the temporary insurance agreement, as required by article 21.35 of the Texas Insurance Code. 2

Allstate responded that it was not required to attach the application because the temporary insurance agreement was not a “contract-or policy of insurance” within the meaning of article 21.35. Alternatively, Allstate maintained that its delivery of the application and temporary insurance agreement to Mr. Marriott’s beneficiaries ‘after the death claim was filed satisfied the requirements of article 21.35. Allstate did not file its own motion for summary judgment.

The district court, acting sua sponte and without notice to the parties, granted summary judgment in favor of Allstate. The district court held that the temporary insurance agreement was not a “contract or policy of insurance” within the meaning of article 21.35. Instead, the district court reasoned that the temporary insurance agreement was merely a promise to provide insurance relating back to the date of application, if and when Mr. Marriott was determined to be an acceptable risk. Alternatively, the district court held that Allstate did not breach its statutory obligation to attach the application to the temporary insurance agreement because Part 2 of the application, which recorded Mr. Marriott’s medical examination, was not completed until he was examined on July 26,1994.

Riner and Marriott moved for reconsideration of the district court’s denial of their motion for summary judgment and the district court’s sua sponte entry of summary judgment in favor of Allstate. The motion was. denied, and Riner and Marriott appealed both the final judgment and the district court’s denial of their motion for reconsideration.

DISCUSSION

I.

. Allstate Issued an Enforceable Contract for Temporary Insurance

To resolve this appeal, we must first determine whether the temporary insurance agreement provided to Mr. Marriott was a “contract of insurance,”, as Riner and Marriott claim, or instead a conditional offer to provide coverage, as Allstate claims and the district court held.

Texas law governs our interpretation of the temporary insurance agreement. We review thp district court’s interpretation of Allstate’s temporary insurance agreement de novo. Gladney v. Paul Revere Life Ins. Co., 895 F.2d 238, 241 (5th Cir.1990) (reviewing the district court’s interpretation of Mississippi insurance law).

Allstate argues that a receipt and temporary insurance agreement is a novel creature that can never be a “contract or policy of insurance” as contemplated by article 21.35. See Tex.Ins.Code art.

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131 F.3d 530, Counsel Stack Legal Research, https://law.counselstack.com/opinion/annette-m-riner-suzette-marriott-v-allstate-life-insurance-company-ca5-1998.