Crawley v. American Public Life Ins. Co.

603 So. 2d 835, 1992 Miss. LEXIS 283, 1992 WL 118660
CourtMississippi Supreme Court
DecidedJune 3, 1992
Docket07-CA 59513
StatusPublished
Cited by6 cases

This text of 603 So. 2d 835 (Crawley v. American Public Life Ins. Co.) is published on Counsel Stack Legal Research, covering Mississippi Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Crawley v. American Public Life Ins. Co., 603 So. 2d 835, 1992 Miss. LEXIS 283, 1992 WL 118660 (Mich. 1992).

Opinion

603 So.2d 835 (1992)

Gary CRAWLEY
v.
AMERICAN PUBLIC LIFE INSURANCE COMPANY.

No. 07-CA 59513.

Supreme Court of Mississippi.

June 3, 1992.

Robert P. Shepard, Murphy & Shepard, A.M. Murphy, Lucedale, for appellant.

Thomas L. Kirkland, Jr., Kirkland Barfield & Panter, Jackson, for appellee.

En Banc.

ON PETITION FOR REHEARING

HAWKINS, Presiding Justice, for the Court:

The petition for rehearing of the appellee American Public Life Insurance Company is denied. The petition for rehearing of the *836 appellant Gary Crawley is granted, the original opinion withdrawn, and the following is the opinion of the Court.

FACTS

This appeal being from an order sustaining a motion for summary judgment on behalf of the defendant American Public Life Insurance Company (American Public) and dismissing Crawley's complaint, we relate the facts favorable to Crawley.

Crawley and Betty Crawley married July 17, 1971. Three children were born of their marriage, namely: Gary Thomas, born in 1975; David Travis, born in March, 1976; and Kenneth Dwayne, born in 1978. Crawley was employed as a game warden with the Department of Wildlife Conservation. Betty was granted a divorce from Crawley in 1982, following which the couple became reconciled and remarried in 1983. The second marriage lasted only about a month, and Betty was again granted a divorce from Crawley July 15, 1983, in the chancery court of George County.

Pertinent provisions of the divorce decree state:

2.
That paramount custody and control of the minor children born of the marriage, namely; Gary Thomas Crawley, David Travis Crawley and Kenneth Dwayne Crawley, is vested with Betty Crawley, with Gary Crawley having the following reasonable rights of visitation:
a. Alternate weekends from 5:00 p.m. on Fridays until 5:00 p.m. on Sundays.
b. Christmas visitation from 2:00 p.m. on Christmas Day until 5:00 p.m. the 31st day of December of each year.
c. Alternate Thanksgivings and Easters with Gary Crawley having Thanksgiving visitation during the odd numbered years and Easter visitation during the even numbered years.
d. Summer visitation for the first and second week of June and the first and second week of August of each year.
e. Or as is mutually agreeable among the parties.
3.
That Gary Crawley shall pay unto Betty Crawley the sum of $408.00 per month child support beginning on August 1, 1983, and alike [sic] payment each and every month thereafter until further order of this Court
4.
That Gary Crawley is hereby ordered to pay all reasonable medical, dental and hospitalization expenses of the minor children not otherwise covered by insurance.

As a state employee Crawley and his dependents were insured under the medical and hospital coverage authorized by the State to all state employees. On May 1, 1984, Jennifer Hughes, an insurance agent salesman for American Public, a Mississippi insurance corporation, solicited Crawley along with other state employees to take out a supplemental policy covering cancer and other specified dread diseases. When Hughes was questioning Crawley in filling in the application, she asked him his wife's name and he told her that he was single. She then asked his children's names, and whether they lived with him or not. He told her their names, and also told her that they did not live with him, but lived with their mother.

Crawley then asked her if there was any problem with coverage with the children living with their mother. According to him, she told him it made no difference as long as he had their names on the policy and kept the premiums up. Crawley then signed the application.[1] According to Crawley, later in the year 1984 there was another meeting between agents of American Public and state employees, and he was again told by an agent that his children were covered under his policy, even though they lived with their mother.

*837 In the first paragraph of the application, there is a line on which is printed "Spouse's Name and Date of Birth (if family coverage)." Following this there is handwritten: "single w/children."

Under paragraph 2 the application reads:

COVERAGE            Policy                           Daily
APPLIED FOR:        Form             Fam. Ind.       benefit/Unit
Cancer &            SCSD1 (in        X               60.00 (in
specified           handwriting)     (checked        handwriting)
disease                              in ink)

A copy of the application is attached as an appendix.

On May 18, 1984, American Public issued policy number A77541 to Crawley, effective June 1 of that year. The monthly premium was $9.60, and the policy schedule states "FAMILY COVERAGE." A higher monthly premium was charged for family coverage than an individual. Had Crawley been issued a policy restricted to individual coverage, his monthly premium would have been $5.30. The policy authorized $125.00 per day hospitalization benefits to an insured. The policy provided coverage by the following paragraph:

Company, Our, We, Us means the American Public Life Insurance Company.
You, Your means the Insured. If this is an individual policy, it will mean only the person named as Insured in the Policy schedule. If this is a family policy, it will mean the person named in the Policy Schedule, their named spouse, and all dependent children as stated below.
Dependent Child refers to Your unmarried natural born children, stepchildren, or legally adopted children living with you and under the age of 21 (25 if a full time student), including newborn children from the moment of birth. An unmarried, mentally retarded or physically handicapped child insured under this policy and unable to provide self support shall be considered a dependent child regardless of age. (Underscoring added)

In February, 1986, Crawley's son Kenneth was hospitalized for six days in Mobile, Alabama, with viral meningoencephalitis. (R. 254) Crawley was unaware that this was a disease covered under the policy and made no claim.

In July, 1987, there was another meeting between representatives of American Public and state employees about their insurance policies. When Crawley was interviewed, he told the agent he had no wife. She then asked his children's names and dates of birth, and he told her. She asked him if they lived with him, and he told her they did not, but lived with their mother. He did get them periodically under the divorce decree, and whenever else he wanted them, however. He also told her that he was responsible for the medical bills and had to pay child support.

During this interview the agent asked him if his children had certain diseases which she named. He told her they had not, but that his youngest son Kenneth had encephalitis the previous year. The agent asked him if he had made a claim, and he told her he had not, because he did not think this disease was covered by his policy. The agent checked the file and told him the disease was covered, that he was entitled to $150 a day while Kenneth was in the hospital. The agent left to make a telephone call, returned and told Crawley he would receive a claim form in the mail, and for him to fill it out and mail it in.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Stubbs v. MISS. FARM BUREAU CASUALTY INSURANCE COMPANY
825 So. 2d 8 (Mississippi Supreme Court, 2002)
Ross-King-Walker, Inc. v. Henson
672 So. 2d 1188 (Mississippi Supreme Court, 1996)
Celtic Life Insurance Co. v. Coats
885 S.W.2d 96 (Texas Supreme Court, 1994)
Ross-King-Walker Inc v. Helen Henson
Mississippi Supreme Court, 1992

Cite This Page — Counsel Stack

Bluebook (online)
603 So. 2d 835, 1992 Miss. LEXIS 283, 1992 WL 118660, Counsel Stack Legal Research, https://law.counselstack.com/opinion/crawley-v-american-public-life-ins-co-miss-1992.