Caswell v. Reserve National Insurance Company

272 So. 2d 37, 1973 La. App. LEXIS 5799
CourtLouisiana Court of Appeal
DecidedJanuary 15, 1973
Docket5061
StatusPublished
Cited by4 cases

This text of 272 So. 2d 37 (Caswell v. Reserve National Insurance Company) is published on Counsel Stack Legal Research, covering Louisiana Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Caswell v. Reserve National Insurance Company, 272 So. 2d 37, 1973 La. App. LEXIS 5799 (La. Ct. App. 1973).

Opinion

272 So.2d 37 (1973)

John J. CASWELL
v.
RESERVE NATIONAL INSURANCE COMPANY.

No. 5061.

Court of Appeal of Louisiana, Fourth Circuit.

January 15, 1973.

*38 Thomas Barr, III, New Orleans, for plaintiff-appellee.

*39 Adams & Reese and Robert A. Vosbein, New Orleans, for defendant-appellant.

Before LEMMON, GULOTTA and SCHOTT, JJ.

SCHOTT, Judge.

This action was brought by plaintiff against defendant insurer for benefits allegedly due him under a health and accident insurance policy as well as damages, penalties and attorneys' fees.

The policy sued upon was originally issued by American Physicians Insurance Company to the plaintiff on February 22, 1960. In November, 1964, defendant, Reserve National Life Insurance Company, assumed all liability under the contract of insurance owned by the plaintiff. On April 8, 1965, plaintiff suffered a heart attack and in due course after making claim under the policy he received the benefits to which he was entitled. On February 9, 1966, defendant advised plaintiff that it would renew plaintiff's policy provided he accepted a rider which would eliminate all benefits for heart and circulatory system disease.

Plaintiff then tendered his premium to defendant and insisted that this policy be renewed as it was originally written. Plaintiff's premium was returned and after a series of correspondence between the parties he filed this suit claiming benefits under the policy for illnesses suffered by him and in the amounts specified in the policy as though it were in full force and effect, notwithstanding defendant's refusal to renew the policy in its original form.

It is, and at all times since February, 1966, has been the position of the defendant that the policy was renewable at the option of the company, and therefore the company had the legal right to offer a renewal with the elimination rider. Plaintiff has contended that this option was not available to defendant for the reason that the language providing for the option is not in such place in the policy and in such form so as to comply with LSA-R.S. 22:212(8) which provides:

"(8) In any case where the policy is subject to cancellation or renewal at the option of the insurer, there shall be prominently printed on the first page of such policy a statement so informing the policyholder."

Defendant has insisted that the language was on the first page of the policy and in other respects was in compliance with the insurance code.

The policy in question is a booklet consisting of a cover, 12 printed pages and some special forms stapled to the back cover. The printed pages are numbered with the first page designated as Page 1. This page begins with the words "This is your policy" and after some five printed paragraphs contains the following:

"Insured: JOHN J. CASWELL Policy No. E-F-D-V2-60-2-571 Premium: 1 Mo. 8.80 3 Mos. 25.34 6 Mos. 50.60 12 Mos. 99.00 Issue Date 2-22-60"

Page 2 of the policy contains questions and answers which provide information concerning the company and the policy to the policy holder.

Page 3 of the policy begins with the words "FORM E—PHYSICIANS PREFERRED HOSPITAL POLICY. This policy provides payment for expense incurred due to surgical operations and hospital confinement resulting from accidental bodily injury, sickness or childbirth, as herein limited and provided. American Physicians Insurance Company of Baton Rouge, Louisiana."

There follows "Part One" of the policy which begins with a long insuring paragraph and which is followed on the bottom of Page 3 with the sentence "This policy is renewable at the option of the Insured and the Company."

*40 The case was tried to a jury on six interrogatories which are as follows together with the jury's verdict as to each:

"1.

Did the Defendant, Reserve National Insurance Company, have the right to refuse to renew Plaintiff's policy considering whether the statuary (sic.) language was or was not printed on the first page of the policy?

Yes _______ No x (If the answer to No. 1 is yes, No. 2, 3, 4, 5 and 6 need not be answered)

2.

If the Insurance Company did not have the right to refuse to renew the policy, did the Plaintiff, John J. Caswell, suffer any damages?

Yes x No _______

3.

If answer to No. 2 is `yes'—How much damages, $1,000.00

4.

If the Insurance Company did not have the right to refuse to renew the policy, how much is the amount of the health and accident benefits which are due under the terms of the policy

$500.00

5.

If the Insurance Company did not have the right to refuse to renew the policy, do you find that they had just and reasonable grounds, such as would put a reasonable and prudent business man on his guard for such action; that is, did they act reasonable?

Yes _______ No x (If the answer to No. 5 is `yes'—No. 6 need not be answered)

6.

If the answer to No. 5 is `No'—Is the plaintiff entitled to attorney fees?

Yes x No _______"

From this judgment the defendant has appealed, specifying seven errors for this Court's consideration.

The first two specifications of error are related and can be considered together in the formulation of this opinion. Appellant maintains that the jury verdict, finding that the defendant did not have the right to refuse to renew the policy, was contrary to the law and evidence and that the trial court erred in refusing to direct the jury that the policy conformed to Louisiana law as a matter of law. At the trial of the case there was made available to the jury the booklet which formed the policy sued upon and which had already been described herein. Likewise, there was made available to the jury the plain wording of LSA-R.S. 22:212(8) quoted above.

The question of whether page 3 of the policy is really the first page for purposes of compliance with the quoted statute was treated by the trial judge as a question of fact to be resolved by the jury. This was done in favor of the plaintiff. While we do not believe that this was properly handled as a fact question for the jury to decide, nevertheless the result is the same whether treated as a question of law or fact.

Appellant urges that neither pages 1 nor 2 of the policy qualifies as the first page because they contain nothing more than advertising or promotional information with the substance of the policy actually beginning on page 3, by means of pages 3 through 10 being inserted into the covers and the sheets which form pages 1 and 2 and 11 and 12. Appellee correctly points out, however, that there are contained on page 1 elements which are required to be included in an insurance policy by LSA-R.S. 22:624, including the name of the insured, the policy number, the premium schedule, and the issue date, elements which do not appear anywhere else in the policy. The presence of this information on page 1 would certainly compel a conclusion that this is indeed the first page of the policy within the meaning of R.S. 22:212(8). Furthermore, the purpose of the statute is to alert and adequately inform persons purchasing the policy that the issuer has the option to refuse to renew the policy. The required language printed in the body of another paragraph at the bottom of the third page in ordinary print does not fulfill this purpose.

Therefore, we hold that as a matter of law the requirements of the statute were not complied with in that the page on *41

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Cite This Page — Counsel Stack

Bluebook (online)
272 So. 2d 37, 1973 La. App. LEXIS 5799, Counsel Stack Legal Research, https://law.counselstack.com/opinion/caswell-v-reserve-national-insurance-company-lactapp-1973.