Augusta v. John Hancock Mutual Life Insurance

11 Misc. 2d 111, 170 N.Y.S.2d 908, 1958 N.Y. Misc. LEXIS 3798
CourtCity of New York Municipal Court
DecidedFebruary 27, 1958
StatusPublished
Cited by11 cases

This text of 11 Misc. 2d 111 (Augusta v. John Hancock Mutual Life Insurance) is published on Counsel Stack Legal Research, covering City of New York Municipal Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Augusta v. John Hancock Mutual Life Insurance, 11 Misc. 2d 111, 170 N.Y.S.2d 908, 1958 N.Y. Misc. LEXIS 3798 (N.Y. Super. Ct. 1958).

Opinion

J. Daniel Fink, J.

This controversy calls for the construction of a policy of group life insurance. There appears to be no authority in this jurisdiction directly in point.

The plaintiff, as widow and named beneficiary, seeks to recover the sum of $2,500, representing increased insurance benefits to which she claims she is entitled by virtue of an amendment to a policy of group life insurance covering her late husband.

Under an effective date of December 28, 1953 the ■ defendant issued its master group life insurance policy to Henry Spen & Co., Inc., of Brooklyn, N. Y., engaged in the business of manufacturing trailers and truck bodies, for civilian and Navy and Air Force use. Under the terms of the policy, one Samuel Augusta, an employee of Henry Spen & Co., Inc., since March, 1946, became insured under such policy on its effective date and received a certificate evidencing his coverage. The certificate named Elizabeth Augusta, described as wife, the plaintiff herein, as beneficiary.

[113]*113The master policy, insofar as pertinent to the question to be decided, provided:

Insurance Clause. Subject to the terms and conditions of this policy applicable to this coverage, upon receipt of due proof at the Home Office of the Company of the death of an employee insured for Life Insurance under this policy, the Company shall pay to the beneficiary the amount of Life Insurance in force under this Policy on the life of such employee at the date of death, in accordance with the provision entitled ‘ Amounts of Insurance ’ contained herein.
* • *
Amounts of Insurance. The amounts of insurance on any employee and any change in such amounts shall be based upon the following Schedule:
SCHEDULE OF INSURANCE FOR EMPLOYEE COVERAGE Classification of Employees Glass
All Employees under age 65................................... A
All Employees age 65 and over................................ B
Coverage Amount of Insurance
Class A Class B
Life Insurance ................................. $2500.00 $1000.00
Accidental Death and Dismemberment Insurance
(Full Amount) ............................. $2500.00 $1000.00
Employee’s Individual Certificate. The Company will issue to the Employer for delivery to each insured employee an individual certificate setting forth the benefits to which such employee is entitled under this policy, the name of the beneficiary, if any, designated by the employee, and the rights to which such employee is entitled in case of termination of his employment or termination of this Policy or of any Section hereof. Such certificate shall not constitute a part of this Policy.
* * *
Modification of Policy. This Policy may be amended or discontinued at any time by written agreement between the Company and the Employer.
* * *
Employer Not Company’s Agent. The Employer shall in no event be considered the agent of the Company for any purpose under this Policy.

On June 12, 1954 Samuel Augusta was taken to the Long Island College Hospital for what proved to be his terminal illness, where he remained until he died on June 30, 1954. He was admitted to the hospital suffering from, and complaining of, shortness of breath. The hospital records, received in evidence, indicate that the direct cause of death was heart failure due to rheumatic heart disease.

In the meantime, and on or about June 25, 1954, Henry Spen & Co., Inc., and the defendant, amended the master policy. The employer’s application for this amendment, bearing date June 7, 1954, indicated that the purpose of the amendment was to change the “ Schedule of Insurance ” so as to take into account [114]*114the length of service of various employees, and the pertinent provision of such application reads as follows:

It is agreed that no change requested herein shall become effective until this request shall have been approved by the Company at its Home Office; and it is further agreed that, subject to such approval, if any employee to whom such requested change is to be applicable is not actively at work on the effective date, such change shall not be applicable to such employee until the date of his return to active work. (Emphasis supplied.)

The actual amendment, as approved by the Company, was dated June 25, 1954, and reads, in part, as follows:

It is understood and agreed that effective as of June 28, 1954, said Policy is hereby amended as follows:
PART I
SCHEDULE OF INSURANCE
The Schedule of Insurance for Employee Coverage contained on Page T-2 of said Policy is cancelled and annulled. The amount of insurance as to each employee remaining insured and each employee becoming insured under said Policy on and after June 28, 1954, shall be determined in accordance with the following Schedule of Insurance for Employee Coverage, except that the amount of insurance for any employee who is not actually at work on said date shall not be increased until the date he returns to active work. (Emphasis supplied.)
SCHEDULE OF INSURANCE FOR EMPLOYEE COVERAGES Glassification of Employees Class
All Employees Length of Service
Less than 8 years ............................................ A
8 years and over ............................................. B
Coverage Amount of Inswanee
Glass A Class B
Life Insurance .................................. $2500 $5000
Accidental Death and Dismemberment Insurance
(Full Amount) .............................. $2500 $5000
The amount of insurance of an employee shall be reduced to $1000 by reason of attainment of age 65.
If the classification of an employee shall change, his amounts of insurance shall change accordingly on the date of such change in classification provided the employee is then actively at work, otherwise on the date he returns to active work. (Emphasis supplied.)

To summarize the foregoing provisions, the master policy provided that all employees under age 65 were deemed to be in Class A, and such Class A employees were entitled to life insurance in the amount of $2,500. The amendment to the master policy reclassified the employees, so that those with length of service of eight years or over, who had not attained age 65 at date of death, were deemed Class B employees entitled to life insurance in the sum of $5,000, provided such Class B employees were “ actively at work ” on June 28, 1954, [115]

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Bluebook (online)
11 Misc. 2d 111, 170 N.Y.S.2d 908, 1958 N.Y. Misc. LEXIS 3798, Counsel Stack Legal Research, https://law.counselstack.com/opinion/augusta-v-john-hancock-mutual-life-insurance-nynyccityct-1958.