Brown v. Phoenix Life Ins

CourtCourt of Appeals for the Fifth Circuit
DecidedJanuary 12, 2021
Docket20-30225
StatusUnpublished

This text of Brown v. Phoenix Life Ins (Brown v. Phoenix Life Ins) 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
Brown v. Phoenix Life Ins, (5th Cir. 2021).

Opinion

Case: 20-30225 Document: 00515703807 Page: 1 Date Filed: 01/12/2021

United States Court of Appeals for the Fifth Circuit United States Court of Appeals Fifth Circuit

FILED January 12, 2021 No. 20-30225 Lyle W. Cayce Clerk

William Edward Brown,

Plaintiff—Appellant,

versus

Phoenix Life Insurance Company,

Defendant—Appellee.

Appeal from the United States District Court for the Middle District of Louisiana USDC No. 3:18-CV-478

Before Haynes, Higginson, and Oldham, Circuit Judges. Stephen A. Higginson, Circuit Judge:* This case concerns a contract dispute involving a life insurance policy purchased by Plaintiff-Appellant William Edward Brown from Defendant- Appellee Phoenix Life Insurance Company. Brown appeals the district court’s dismissal of his Second Amended Complaint with prejudice pursuant

* Pursuant to 5th Circuit Rule 47.5, the court has determined that this opinion should not be published and is not precedent except under the limited circumstances set forth in 5th Circuit Rule 47.5.4. Case: 20-30225 Document: 00515703807 Page: 2 Date Filed: 01/12/2021

No. 20-30225

to Federal Rule of Civil Procedure 12(b)(6). We AFFIRM in part, REVERSE in part, and REMAND for further proceedings. 1 I. Factual Background As alleged in Brown’s Second Amended Complaint, in December 1986 Phoenix 2 sold Brown a “universal life insurance policy” (“the Policy”) with a $150,000 death benefit and a $1,200 annual premium. At the time of the sale, an insurance agent working for Phoenix allegedly represented to Brown that the Policy charged higher premiums, which—in addition to covering the immediate costs of the insurance—would be used to create and build an investment fund that would earn interest and be available to pay premiums later in life in order to provide “coverage for life.” The agent described the investment fund model as differentiating the Policy from term life insurance. To help demonstrate how the Policy would function, the agent provided Brown with a “Sales Illustration.” 3 The Sales Illustration shows two different projections of the investment fund’s accumulated value over time, with the variable inputs being the cost of insurance and the interest rate, and with an assumption of a steady $1,200 annual premium payment. One of the projections is based on a “guaranteed” interest rate of 4.5% along with a guaranteed cost of insurance. The other projection is based on an “assumed”

1 Judge Haynes concurs in the opinion and judgment except as to Count Three. She would certify that question to the Louisiana Supreme Court. 2 Phoenix assumed responsibility for the insurance policy at issue; the original parties to the transaction were Brown and Home Life Financial Assurance Corporation, Phoenix’s predecessor-in-interest. For simplicity, we refer only to Phoenix when describing the involvement of either Home Life or Phoenix. 3 While Brown did not attach the Sales Illustration to his Second Amended Complaint, Phoenix attached it to its motion to dismiss and the magistrate judge held that it could be considered because it was incorporated by reference into the complaint.

2 Case: 20-30225 Document: 00515703807 Page: 3 Date Filed: 01/12/2021

interest rate of 9.75% and the “current” cost of insurance. The projection based on the assumed 9.75% interest rate shows the value of the investment fund steadily growing through the end of year 30, where the table ends. The projection based on the guaranteed 4.5% interest rate shows that the value of the fund initially grows before it begins to decrease and eventually reaches zero in year 19. Accompanying the table is a note that reads: “[A]dditional premium will be required in month 7 of year 19 or policy will lapse, based on guaranteed factors.” The Sales Illustration also contains handwritten notes which allegedly “reflect what [Phoenix’s] agent told Brown at the time of the sale.” These markings include a note that states “can reduce premiums w/ cash value interest.” Brown alleges that this note “records [Phoenix’s] agent’s representation that the investment fund (cash value) will be sufficient to reduce premiums in the future.” Other notes state: “1200[,] 150 k,” “50 whole + 100 term,” and “5 yrs[,] 50 k.” Brown alleges that the “1200” note records the agent’s representation “that the annual premium will remain level at $1,200 per year” because the investment fund will pay additional or increased premiums later in life. He also alleges that the “50 whole” and “5 yrs[,] 50k” reflect the agent’s representations that $50,000 of the $150,000 death benefit is whole life insurance which would be “paid up” after five years. To finalize the purchase, Brown completed an “Application for Insurance,” which described the “planned” monthly premium to be $100 and stated that the Policy would take effect “when the [P]olicy is delivered to the owner and the full first premium is paid.” Brown paid the full first premium; however, he alleges that Phoenix failed to deliver the Policy. In the decades following the purchase of the Policy, Brown continued to make $100 monthly premium payments. He also repeatedly reached out

3 Case: 20-30225 Document: 00515703807 Page: 4 Date Filed: 01/12/2021

to Phoenix to request a written copy of the original Policy. In total, he alleges that he made six written requests (along with multiple phone inquiries) for the Policy. For example, in a November 23, 1988 letter, Brown wrote: “This is my third request to [Phoenix] headquarters for my insurance policy. . . . I have not been able to obtain the policy from the agent or the company. Please send me the policy immediately.” In August 2006, in response to another of Brown’s requests for a copy of the Policy, Phoenix sent Brown a “Lost Policy Certificate.” On January 12, 2009, Brown sent another letter to Phoenix that stated: “Please send a copy of the agreement that authorizes Phoenix to increase the premiums and a copy of the premium schedule for past and future years. . . . As your files will show, I have never received a copy of the policy. All I have is a Lost Policy Certificate.” Phoenix responded in a letter dated February 6, 2009. The letter states that Brown’s Policy “is a type of Universal Life Insurance . . . [that] is a combination of permanent insurance and an investment fund that provides coverage for the insured’s entire life.” It describes that the value of the investment fund “is determined by the accumulated premiums and interest earned, less the cost of insurance (at the insured’s attained age), and administrative costs.” The letter also states that the interest rate was 9.75% at the time the Policy was issued in December 1986, but that the current interest rate is 4.5% and the guaranteed interest rate is also 4.5%. It then advises: “It is important for you to remember that your policy is a premium paying contract and has reached a point where it required more than $100.00 monthly to support the death benefit. UL polices are flexible premium policies . . . and depend on prevailing interest rates to keep the accumulation account large enough to support the death benefit.”

4 Case: 20-30225 Document: 00515703807 Page: 5 Date Filed: 01/12/2021

On August 3, 2015, Brown sent Phoenix another letter requesting, among other things, the policy provisions and standards Phoenix uses to determine premium increases, and the projected premiums for Brown’s Policy over the next 10 years. Brown also noted, again, that he had never received the original Policy from Phoenix. Phoenix replied in a letter dated August 17, 2015. The letter encloses an attachment, which is described as a “representative copy of the contract form” that shows the “current benefits and features” of Brown’s Policy.

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Brown v. Phoenix Life Ins, Counsel Stack Legal Research, https://law.counselstack.com/opinion/brown-v-phoenix-life-ins-ca5-2021.