Clyde Anglin v. Gulf Guaranty Life Insurance Company

Mississippi Supreme Court·Decided October 14, 2005·No. 2005-CA-02082-SCT·Published

Opinion

IN THE SUPREME COURT OF MISSISSIPPI NO. 2005-CA-02082-SCT

CLYDE ANGLIN v. GULF GUARANTY LIFE INSURANCE COMPANY

DATE OF JUDGMENT: 10/14/2005 TRIAL JUDGE: HON. PAUL S. FUNDERBURK COURT FROM WHICH APPEALED: LEE COUNTY CIRCUIT COURT ATTORNEYS FOR APPELLANT: DANA GAIL DEATON CHRIS H. DEATON

GRANT M. FOX

SARA MARTIN FOX

ATTORNEY FOR APPELLEE: THOMAS WICKER NATURE OF THE CASE: CIVIL - INSURANCE DISPOSITION: REVERSED AND REMANDED - 04/19/2007 MOTION FOR REHEARING FILED: MANDATE ISSUED:

BEFORE SMITH, C.J., CARLSON AND RANDOLPH, JJ.

RANDOLPH, JUSTICE, FOR THE COURT:

¶1. In conjunction with two separate loans, Clyde Anglin purchased credit life insurance coverage and monthly disability insurance coverage underwritten by Gulf Guaranty Life Insurance Company (“Gulf Guaranty”). The certificates of insurance were issued to Anglin without a request to answer any health questions preprinted on the application or otherwise. The certificates of insurance reserved the right for Gulf Guaranty to decline coverage within ninety days of each loan. Because of information acquired in conjunction with a third loan and purchase of credit life and monthly disability insurance coverage, and within ninety days

of the first two purchases, Gulf Guaranty declined Anglin’s monthly disability insurance coverage (but only on the second certificate of insurance), and cancelled his credit life insurance coverage on all certificates of insurance, including the third policy, which is not at issue in this appeal. Subsequent to his receipt of the certificates of insurance, but before the declination of one policy and cancellation of three others, Anglin was diagnosed with an incurable, fast-progressing disease, amyotrophic lateral schlerosis (“ALS” or “Lou Gehrig’s disease”). Prior to his death in May 2000, Anglin filed suit against Gulf Guaranty.

¶2. On September 13, 2005, Gulf Guaranty filed a motion for summary judgment asserting it properly “cancelled and/or declined coverage within ninety (90) days of the date of the loans in question . . . .” In response, Anglin’s estate argued that Gulf Guaranty had only the right to decline coverage, not cancel coverage. The Circuit Court of Lee County granted Gulf Guaranty’s motion for summary judgment. From that ruling comes this appeal.

FACTS

¶3. On July 31, 1998, Anglin refinanced two loans and purchased credit life and monthly disability insurance coverage underwritten by Gulf Guaranty. The certificate of insurance pertaining to the first loan provided $15,051.72 in credit life insurance coverage and $418.11 in monthly disability insurance coverage (Certificate Number 1746754)1 . The second certificate of insurance provided $21,500.72 in credit life insurance coverage and $449.19

1 This same certificate encompasses Certificate Number 17467540, which is the credit life insurance coverage and Certificate Number 17467547, which is the monthly disability insurance coverage.

in monthly disability insurance coverage (Certificate Number 1746755) 2. Each certificate of insurance clearly and unambiguously states that “[Gulf Guaranty] agrees to insure the Insured Debtor(s)[3] as specified in this Certificate, subject to the provisions contained in the Group Credit Insurance policy.” Each certificate of insurance further provided that “[i]f [Gulf Guaranty] finds the Insured Debtor is not an insurable risk, it reserves the right to decline the Insurance within 90 days of the Date of Loan by mailing notice of declination directly to the Creditor Beneficiary and returning all premiums collected for this Certificate.” (Emphasis added).4 The deposition testimony of Ellen Methvin, vice president and office manager of Gulf Guaranty, revealed that agents such as loan officer Brian Porter receive no training or guidelines as to underwriting criteria in processing applications for insurance.5 While the preprinted application for insurance form contained health questions, Gulf Guaranty did not require those questions to be asked or answered. Furthermore, the parties agree that Porter asked him no health questions. Porter furnished Anglin a copy of

2 This same certificate encompasses Certificate Number 17467550, which is the credit life insurance coverage and Certificate Number 17467557, which is the monthly disability insurance coverage. The combined monthly disability insurance coverage purportedly provided to Anglin via Certificates Number 17467547 and 17467557 was $867.30. Note, however, that each certificate of insurance specifically states that “[t]he maximum aggregate Total Disability benefit payable to any Insured Debtor under this and all other certificates is . . . $300.00 per month for ages 51-65.”

3 On both applications, Anglin was listed as the “insured debtor” and People’s Bank was listed as the “creditor beneficiary.”

4 This provision was contained on the back of the certificate of insurance. Note that each certificate of insurance was on the same document as the application for insurance. For reasons unexplained in the record, Gulf Guaranty claims it did not receive these applications for insurance/certificates of insurance until September 9, 1998.

5 This was corroborated by Porter.

the certificates of insurance. Anglin further asserted that Porter told him as he left the office that “you’re covered.” Porter denied telling Anglin that he was “covered” or otherwise implying that Anglin’s coverage was guaranteed. By contrast, Porter claimed that he informed Anglin that “[b]ecause the loan amounts were over $10,000 . . . he could probably expect a . . . health questionnaire [from] Gulf Guaranty.”

¶4. On August 25, 1998, Anglin borrowed an additional $60,000.00 for the purpose of buying an excavating machine. Anglin purchased credit life and monthly disability insurance. The certificate of insurance pertaining to the August 25, 1998, loan purported on its face to provide $80,010.64 in credit life insurance coverage and $1,666.89 in monthly disability insurance coverage (Certificate Number 1746759).6 The certificate of insurance stated that “[Gulf Guaranty] agrees to insure the Insured Debtor(s) as specified in this Certificate, subject to the provisions contained in the Group Credit Insurance policy.” For reasons unexplained in the record, Gulf Guaranty claims it did not receive this certificate of insurance until October 14, 1998. After receipt, and prior to cancelling, Methvin testified that Gulf Guaranty reduced the credit life insurance coverage to $64,311.00 “because it was so much over the maximum allowed for [Anglin’s] age . . . .” This testimony is contrary to the policy language, which stated in a limitation provision that for insureds between the age of 50-61, “[t]he aggregate amount of life insurance . . . under this and all other [c]ertificates shall not exceed” $50,000.00. Accordingly, this coverage which Anglin purchased was of

6 The monthly disability insurance coverage of Certificate Number 1746759 was of no value. See footnote 2 supra.

limited value, although the premium was based on stated coverage, since he already held certificates of insurance totaling in excess of $36,000.00 of credit life insurance coverage.

¶5. On October 20, 1998, both credit life insurance coverage and monthly disability insurance coverage were cancelled on Certificate Number 1746759 and the premiums were returned to the bank. However, this suit involves only the two July 31, 1998, certificates of insurance.

¶6. On September 14, 1998, Anglin was admitted to Baptist Memorial Hospital complaining of muscle weakness. The office notes of The Neurology Clinic from that same day indicate that “[Anglin] has probable diagnosis of [ALS].” 7 By October 6, 1998, the outpatient record of Anglin at North Mississippi Medical Center definitively diagnosed Anglin as suffering from “ALS with increasing shoulder and arm pain.”

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