D'Allessandro v. Durham Life Insurance

436 A.2d 669, 291 Pa. Super. 613, 1981 Pa. Super. LEXIS 3663
CourtSuperior Court of Pennsylvania
DecidedOctober 30, 1981
DocketNo. 100
StatusPublished
Cited by4 cases

This text of 436 A.2d 669 (D'Allessandro v. Durham Life Insurance) is published on Counsel Stack Legal Research, covering Superior Court of Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
D'Allessandro v. Durham Life Insurance, 436 A.2d 669, 291 Pa. Super. 613, 1981 Pa. Super. LEXIS 3663 (Pa. Ct. App. 1981).

Opinions

CAVANAUGH, Judge:

On or about March 21,1975, Charles D’Allessandro applied for group life insurance with the Durham Life Insurance Company and signed an application in which he stated that in the prior five years he had not consulted a physician. He also stated that he never had heart trouble, high bipod [615]*615pressure or chest pains.1 At that time he had a history of coronary and other heart problems, including coronary pain consistent with coronary disease and angina pectoris. During the period in question Mr. D’Allessandro had been hospitalized at St. Agnes Hospital in Philadelphia for recurrent coronary insufficiency pain and at Roxborough Memorial Hospital for kidney problems. He had also been treated by a Dr. Segal for renal cholic. On July 1, 1975, the appellant, Durham Life Insurance Company, issued a group life insurance policy in the amount of $50,000.00 to Mr. D’Allessandro and his wife, Barbara D’Allessandro, the appellee herein, was named the beneficiary. Mr. D’Allessandro died on October 14, 1975, as a result of coronary artery disease. Prior to his death he paid premiums in the amount of $400.65. A copy of the application containing the insured’s statements was furnished to the insured during his lifetime. Appellee claimed the proceeds of $50,000.00 under the insurance policy which the appellant refused to pay. Appellee then commenced an action in assumpsit. The matter was decided by Judge Garb on the basis of stipulated facts. Appellee’s motion for summary judgment was granted and appellant’s motion for summary judgment was denied. A verdict was entered for appellee and against appellant in the amount of $50,000.00 and Durham Insurance Company has appealed to this Court.

The sole issue for our determination is whether the application for insurance which was completed and signed by Mr. D’Allessandro may be used by the appellant to contest the claim of appellee, the named beneficiary under the policy. The court below determined that the application contained obviously false representations but that it could not be used [616]*616to contest the appellee’s claim. Appellee agrees that the misstatements of Mr. D’Allessandro in his application for insurance were of such a nature that she would be barred from claiming under the policy if the application could be used to contest the claim. The policy itself deals with contestability and states:

“INCONTESTABILITY—STATEMENTS BY INSURED PERSONS

The insurance of any person shall be incontestable after it has been in force for two years. All statements made by any of the persons insured hereunder shall be deemed representations and not warranties and no such statement shall be used in defense of a claim hereunder unless it is contained in a written instrument signed by him and unless a copy of the instrument containing the statement has been furnished to the person making the claim.” The insured died within two years after the issuance of

the policy so that it does not become incontestable because of the first sentence. Incontestability, if it exists, would be based on the second sentence. The court below found that the appellee was not furnished with a copy of the application signed by Mr. D’Allessandro until after his death and under the court’s interpretation of the policy it could not be used by the insurance company as a defense against appellee’s claim.

When interpreting a contract the intention of the parties must be determined. In a written contract the intent of the parties is manifested by the writing, and when the words are clear and unambiguous the intent is to be determined only from the express language of the agreement. Robert F. Felte, Inc. v. White, 451 Pa. 137, 302 A.2d 347 (1973). See also Chuy v. Philadelphia Eagles Football Club, 595 F.2d 1265 (3rd Cir. 1979). In this case, the words in the contestability clause are unambiguous as far as they go. The court below interpreted the contract as setting forth the intention of the parties that the statement must be furnished to the claimant prior to the insured’s death, and we agree with that interpretation. As stated in Blocker v. Aetna Casualty & [617]*617Surety Company, 232 Pa.Super. 111, 114, 332 A.2d 476, 477 8 (1975):

The single issue for our determination will of course be resolved by our analysis of the terms and conditions of the insurance policy issued by the appellant. This analysis of an insurance policy, like the interpretation of any other written contract, is a question of law for the court. Bole v. New Hampshire Fire Insurance Company, 159 Pa. 53, 28 A. 205 (1895). The policy must be read in its entirety; it should be construed according to the plain meaning of the words used, so as to avoid ambiguity while at the same time giving effect to all of its provisions. Masters v. Celina Mutual Insurance Company, 209 Pa.Super. 111, 224 A.2d 774 (1966); Galvin v. Occidental Life Insurance Company, 206 Pa.Super. 61, 64, 211 A.2d 120, 122 (1965). If it is determined that the language of a policy prepared by an insurer is either ambiguous, obscure, uncertain or susceptible to more than one construction, we must construe that language most strongly against the insurer and accept the construction most favorable to the insured. Patton v. Patton, 413 Pa. 566, 573, 198 A.2d 578, 582 (1964); Flynn v. Allstate Insurance Company, 50 Pa.D. & C.2d 195, 199-200 (1970).

The court below in reaching its conclusion that the person making the claim, in this case the beneficiary under the policy, must be furnished with a copy of the statement prior to the insured’s death, relied on Layman v. Continental Assurance Company, 430 Pa. 134, 242 A.2d 256 (1968). In that case the issue was whether an insurance carrier complied with the Act of May 11, 1949, P.L. 1210, § 6, as amended, 40 P.S. § 532.6(3)2 by sending a beneficiary a copy [618]*618of her husband’s application for insurance three months after his death. The court held that the statute required that a copy of the application be sent to the insured or beneficiary prior to the death of the insured.3 .

Words in an insurance policy are to be given their plain and popular meaning. Ranieli v. Mutual Life Insurance Co., 271 Pa.Super. 261, 413 A.2d 396 (1979). The policy in this case provided that the application for insurance may not be used to contest a claim unless a copy is given to the person making the claim. The contestability clause was inserted in the policy by the insurance company and was obviously placed there for the benefit of “the person making the claim” since it does not in any way benefit the insurer.

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Related

D'Allessandro v. Durham Life Insurance
467 A.2d 1303 (Supreme Court of Pennsylvania, 1983)
Saunders v. State Farm Insurance
440 A.2d 538 (Superior Court of Pennsylvania, 1982)
Commonwealth v. Sheridan
437 A.2d 44 (Superior Court of Pennsylvania, 1982)

Cite This Page — Counsel Stack

Bluebook (online)
436 A.2d 669, 291 Pa. Super. 613, 1981 Pa. Super. LEXIS 3663, Counsel Stack Legal Research, https://law.counselstack.com/opinion/dallessandro-v-durham-life-insurance-pasuperct-1981.