Blumberg v. Paul Revere Life Insurance

177 Misc. 2d 680, 677 N.Y.S.2d 412, 1998 N.Y. Misc. LEXIS 354
CourtNew York Supreme Court
DecidedMarch 10, 1998
StatusPublished
Cited by3 cases

This text of 177 Misc. 2d 680 (Blumberg v. Paul Revere Life Insurance) is published on Counsel Stack Legal Research, covering New York Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Blumberg v. Paul Revere Life Insurance, 177 Misc. 2d 680, 677 N.Y.S.2d 412, 1998 N.Y. Misc. LEXIS 354 (N.Y. Super. Ct. 1998).

Opinion

OPINION OF THE COURT

Jerome C. Gorski, J.

This matter comes before this court by way of plaintiff’s motion for summary judgment, as well as the motions of each defendant for summary judgment.

Plaintiff received a solicitation, on or about December 23, 1988, from defendant Charles J. Sellers & Company, Inc. (hereinafter, Sellers) to purchase disability income insurance through its agency with Paul Revere Life Insurance Company (hereinafter, Paul Revere). According to the solicitation, enrollment was available to the membership of defendant N. Y. Criminal & Civil Courts Bar Association (hereinafter, NYCCCBA). Plaintiff responded to the solicitation, and completed the application for disability insurance. Along with the application, plaintiff sent a premium check for the amount specified in the application. He also tendered his check for membership dues in the NYCCCBA. Plaintiffs application was denied, the check for the premium was returned, and no policy was ever formally issued to the plaintiff.

Plaintiff seeks to enforce the provisions of the policy, however, based on the statements made in the solicitation from Sellers which stated “guaranteed issue — underwriting waived”; “coverage will be offered during the charter enrollment regardless of past medical history”. It is the position of the defendant, Paul Revere, that the guaranteed enrollment did not apply to plaintiff, who was a new enrollee to the organization, and moreover, that the solicitation was merely that, and did not form the basis of a contract. Said defendant refers to the specific language of the application itself which states: “Applicants will be informed whether or not their application has been accepted within 60 days or be given a reason for any further delay” and “No agent or broker has the authority to waive the answer to any question, to determine insurability, to waive any of the company’s rights or requirements, or to make or alter any contract or policy”. Defendant Sellers takes the position that it was authorized to extend the offer of guaranteed insurance to plaintiff, and that defendant Paul Revere should be bound by the terms of the solicitation it authorized. Defendant Siller [682]*682avers that it is not liable as it was not a party to the offering, only a marketing vehicle for the plan.

Under these factual circumstances, the court must decide whether the submission of a signed application for disability insurance by plaintiff, along with payment of the initial premium, constituted the formation of a contract, giving rise to a cause of action for breach of said contract. The general rule is that an insurance application constitutes nothing more than an offer to the insurer, which it may accept or reject after determining whether an applicant is a desirable risk. (Prudential Ins. Co. v Snyder, 142 Misc 150 [1928], affd 229 App Div 852 [1930].) An application in no way binds an insurer to issue a policy. (Bullis v Metropolitan Life Ins. Co., 85 Misc 2d 209 [1976].)

There are, however, situations under which it has been held that the solicitation itself formed an offer and the application with premium constitutes an acceptance. Such a situation arises where the soliciting literature spelled out the terms of the insurance, the scope of the insurance coverage, the intention of the insurer to accept applicants irrespective of their age or health, and nothing was left open to negotiations. (Klos v Mobil Oil Co., 55 NJ 117, 259 A2d 889 [1969].) In Klos, plaintiff was the holder of a Mobil Oil credit card and as a member of that group was solicited to purchase an accident insurance policy from American Home Assurance Co. The solicitation provided the available coverages which applicant could check. Plaintiff checked a certain box, which provided that for $9 per quarter, his beneficiary would receive $25,000 if he met with accidental death. Attached to the solicitation was an application, and the solicitation stated that Mobil “ ‘takes pride in Offering you’ its policy” (55 NJ, at 122, 259 A2d, at 892). The court held that the solicitation with application constituted an offer which the cardholder was free to accept or reject, and the only question for the court was the effective date. In that case, however, there was a policy that was delivered to the plaintiff prior to a claim for enforcement.

Similarly, in the case of Fritz v Old Am. Ins. Co. (354 F Supp 514 [SD Tex 1973]), the United States District Court, relying on Klos (supra), held that a life insurance policy was effective upon the mailing of the application wherein the solicitation had no underwriting requirements nor physical examination requirement, and a reasonable person would expect that if he correctly filled out the application form and mailed it, coverage would be effecuated. In that case, even though there were state[683]*683ments in the application that stated that the insurance application is subject to acceptance by the insurer, the “reasonable expectation” of the applicant was controlling. In that instance, the reasonable expectation, as derived from the solicitation, was that insurance could only be rejected in the remotest of circumstances, and therefore, coverage was in effect upon the mailing of the application.

This line of reasoning was adopted in the matter of Riordan v Automobile Club (100 Misc 2d 638 [1979]). In that case, plaintiff purchased travel accident insurance from a solicitation in a mailing from the American Automobile Association. The solicitation stated, “ ‘Your Club membership automatically qualifies you to enroll’ ” (at 640). Plaintiffs mailed the enrollment form with accompanying premium, and the court found them to be insured as of the date of mailing. The court applied what it called the “reasonable expectation” doctrine, in that the solicitation gave those targeted by same the reasonable expectation that their application would be immediately effective and that unless they were untruthful in the application, there was no reasonable expectation that they could be rejected. The court, in Riordan, analogized the situation to that presented in Lachs v Fidelity & Cas. Co. (306 NY 357), wherein the purchaser of machine-solicited flight insurance was held to be in effect as of the date purchased.

In the case at bar, the plaintiff had a reasonable expectation that the policy would be approved since it was *a “guaranteed issue” and the solicitation promised “underwriting waived”. Although some qualifying language was contained in the application itself, it was directly contradicted by the solicitation. The circumstances, considered as a whole, gave plaintiff a reasonable expectation that the policy would be issued and said would conform to the promised coverage set forth in the solicitation. In fact, the defendant, Paul Revere, confirmed that this issuance of its disability policy was to be a guaranteed issue, and that plaintiff, had he been a member of the NYCCCBA prior to the solicitation, would have been afforded coverage. (Charles D. Havens letter of Feb. 17, 1989.) Therefore, it can be reasonably concluded that the underwriting had indeed been waived for those eligible to respond to the solicitation. This court must then examine the details of the program to determine whether plaintiff was within the group of persons intended to be part of the “guaranteed” program.

The subject disability insurance program was developed through the collaboration between Paul Revere and Sellers, [684]*684which began approximately February 1987.

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Bluebook (online)
177 Misc. 2d 680, 677 N.Y.S.2d 412, 1998 N.Y. Misc. LEXIS 354, Counsel Stack Legal Research, https://law.counselstack.com/opinion/blumberg-v-paul-revere-life-insurance-nysupct-1998.