Duncan v. Primerica Life Ins. Co.

CourtDistrict Court, E.D. California
DecidedFebruary 13, 2023
Docket2:21-cv-01106
StatusUnknown

This text of Duncan v. Primerica Life Ins. Co. (Duncan v. Primerica Life Ins. Co.) is published on Counsel Stack Legal Research, covering District Court, E.D. California primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Duncan v. Primerica Life Ins. Co., (E.D. Cal. 2023).

Opinion

1 2 3 4 5 6 7 8 UNITED STATES DISTRICT COURT 9 EASTERN DISTRICT OF CALIFORNIA 10 11 SHIRLEY DUNCAN, No. 2:21-cv-01106-JAM-DMC 12 Plaintiff, ORDER GRANTING IN PART AND DENYING IN PART PLAINTIFF’S 13 v. MOTION FOR SUMMARY JUDGMENT AND GRANTING IN PART AND DENYING IN 14 PRIMERICA LIFE INSURANCE PART DEFENDANT’S MOTION FOR COMPANY, SUMMARY JUDGMENT 15 Defendant. 16 17 This case concerns the sole beneficiary of a life insurance 18 policy, Shirley Duncan (“Plaintiff”) and the issue of whether she 19 is entitled to the proceeds of her decedent husband’s policy with 20 Primerica Life Insurance Company (“Defendant”). As discussed 21 below, this case also involves a legal issue of first impression 22 involving statutory interpretation and unique circumstances and 23 facts regarding a life insurance policy that had lapsed due to 24 one non premium payment over nearly 25 years and a life insurance 25 company that did not notify Plaintiff, as the sole beneficiary 26 under the policy, of the payment lapse. 27 The parties have filed cross motions for summary judgment on 28 Plaintiff’s complaint. See Mot. for Partial Summary Judgment 1 (“Duncan Mot.”), ECF No. 38; Mot. for Summary Judgment 2 (“Primerica Mot.”), ECF No. 39. Plaintiff asserts two claims for 3 breach of contract and one claim for breach of the implied duty 4 of good faith and fair dealing against Defendant for its denial 5 of life insurance benefits following the death of her husband 6 Larry Duncan (“Decedent”). See Compl., ECF. No. 1. 7 For the reasons set forth below, this Court GRANTS 8 Plaintiff’s motion on her breach of contract claim concerning the 9 life insurance policy’s death benefit and GRANTS Defendant’s 10 cross motion on Plaintiff’s breach of contract claim concerning 11 the insurance policy’s Terminal Illness Accelerated Benefit 12 (“TIAB”) and Plaintiff’s claim for breach of the implied duty of 13 good faith and fair dealing. 14 I. FACTUAL ALLEGATIONS AND PROCEDURAL BACKGROUND 15 Plaintiff’s late husband, Larry Duncan (“Decedent”) obtained 16 a life insurance policy with Defendant in 1995 and was the 17 policy’s sole owner. Statement of Undisputed Material Facts 18 (“Primerica UMF”) No. 1-2, ECF No. 39. The policy provided 19 $300,000 in coverage for Decedent’s life and a $100,000 rider to 20 the policy for Plaintiff’s life. Id. No. 3. The policy also 21 included a TIAB Rider that would have advanced Decedent or his 22 designee with 40% of the face value of the policy in the event 23 Decedent applied for the TIAB in writing and submitted a 24 physician statement diagnosing him with a terminal illness that 25 would result in death in less than six months from the date of 26 the physician statement. Id. No. 56. 27 Plaintiff is, and at all times was, the sole beneficiary of 28 Decedent’s life insurance policy. Statement of Undisputed Facts 1 (“Duncan UMF”) No. 6, ECF No. 38. Decedent’s policy required the 2 quarterly payment of premiums by Decedent. Primerica UMF No. 8. 3 Prior to 2020, Decedent never missed a premium payment. On 4 May 4, 2020, Defendant mailed Decedent a premium due notice for 5 $4,637.24 covering the period of May 25, 2020 to August 25, 2020, 6 due by May 25, 2020. Id. No. 30. About one month later, 7 Primerica mailed Decedent a Notice of Potential Lapsed Policy 8 (“lapse notice”), notifying him that the $4,637.24 payment was 9 due by July 24, 2020 or else the policy would lapse. Id. No. 33. 10 A couple of weeks later, Decedent paid the amount due ahead of 11 the July 24, 2020 deadline. Id. No. 37. Defendant claims that 12 it mailed Decedent a premium due notice for $5,747.06 covering 13 the period of August 25, 2020 to November 25, 2020, due by 14 August 25 and then sent Decedent a lapse notice on September 23, 15 2020 after Decedent failed to submit payment; Defendant informed 16 Decedent payment was due by October 24, 2020 or his policy would 17 lapse. Id. No. 38-40. Plaintiff contends that Defendant has 18 failed to prove that this lapse notice was sent to Decedent. 19 Response to Primerica UMF (“Duncan Response”) No. 38-39, Opp’n, 20 ECF No. 40. The Court disagrees. 21 No payment was made on the policy after Decedent’s July 2020 22 payment of $4,637.42. Primerica UMF No. 45. Decedent was 23 hospitalized on or about November 9, 2020 and died on 24 December 20, 2020 of renal cancer. Id. No. 41, 47; Duncan UMF 25 No. 17. At no time did Decedent make a claim for the TIAB; the 26 claim for the TIAB was made for the first time by Plaintiff in 27 this action. Duncan Response No. 57. Defendant has not been 28 provided with a physician statement diagnosing Decedent with a 1 medical condition that would result in Decedent’s death within 2 six months. Primerica UMF No. 58. Defendant denied Plaintiff’s 3 claim for benefits from Decedent’s policy due to the policy’s 4 lapse in October 2020. Id. No. 54. Defendant alleges that from 5 2013 to 2020, Defendant mailed Decedent notices of his right to 6 designate a third party to receive a copy of lapse notices or to 7 change any prior designation. Id. No. 51. Plaintiff claims that 8 she never received these communications. Duncan Response No. 51- 9 52. 10 Decedent did not designate any third-party to receive copies 11 of lapse notices. Primerica UMF No. 53. Plaintiff did not open 12 Decedent’s mail or pay the family’s bills at all for their entire 13 marriage, including up to Decedent’s death. Duncan UMF No. 17. 14 Plaintiff filed her complaint on June 22, 2021 asserting two 15 claims for breach of contract and one claim for breach of the 16 implied duty of good faith and fair dealing against Defendant. 17 See Compl. A couple of months later, Defendant filed its answer. 18 See Answer, ECF No. 7. On October 13, 2022, Plaintiff filed her 19 motion for partial summary judgment seeking judgment on her two 20 breach of contract claims. See Duncan Mot. Defendant filed a 21 cross motion for summary judgment a couple of weeks later seeking 22 judgment on all three claims. See Primerica Mot. 23 24 II. OPINION 25 A. Legal Standard 26 Summary judgment is proper “if the pleadings, depositions, 27 answers to interrogatories, and admissions on file, together with 28 affidavits, if any, show that there is no genuine issue of 1 material fact and that the moving party is entitled to judgment 2 as a matter of law.” Fed. R. Civ. P. 56(c). The moving party 3 bears the initial burden of demonstrating the absence of a 4 genuine issue of material fact for trial. Anderson v. Liberty 5 Lobby, Inc., 447 U.S. 242, 248–49 (1986). If the moving party 6 meets its burden, the burden of production then shifts so that 7 “the non-moving party must set forth, by affidavit or as 8 otherwise provided in Rule 56, ‘specific facts showing that there 9 is a genuine issue for trial.’” T.W. Elec. Serv., Inc. v. 10 Pacific Elec. Contractors Ass'n, 809 F.2d 626, 630 (9th 11 Cir.1987). The Court must view the facts and draw inferences in 12 the manner most favorable to the non-moving party. United States 13 v. Diebold, Inc., 369 U.S. 654, 655 (1962). 14 B. Analysis 15 1. Claim One: Breach of Contract (Terminal Illness 16 Accelerated Benefit) 17 Plaintiff contends that she is at least entitled to 18 Decedent’s Terminal Illness Accelerated Benefit (TIAB), amounting 19 to 40% of the face value of Decedent’s life insurance policy 20 ($120,000), on two grounds: (1) Decedent had a terminal illness 21 while his life insurance policy was still in effect and Defendant 22 cannot show that it was prejudiced by its lack of notice of his 23 terminal illness; and (2) the TIAB coverage did not lapse because 24 Defendant’s policy form did not offer waiver of premium payments, 25 in violation of California Insurance Code § 10295.14. Duncan 26 Mot. at 17–20.

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Bluebook (online)
Duncan v. Primerica Life Ins. Co., Counsel Stack Legal Research, https://law.counselstack.com/opinion/duncan-v-primerica-life-ins-co-caed-2023.