Farley v. Metropolitan Life Insurance

127 A.D.2d 99, 513 N.Y.S.2d 712, 1987 N.Y. App. Div. LEXIS 41348
CourtAppellate Division of the Supreme Court of the State of New York
DecidedMarch 30, 1987
StatusPublished
Cited by8 cases

This text of 127 A.D.2d 99 (Farley v. Metropolitan Life Insurance) is published on Counsel Stack Legal Research, covering Appellate Division of the Supreme Court of the State of New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Farley v. Metropolitan Life Insurance, 127 A.D.2d 99, 513 N.Y.S.2d 712, 1987 N.Y. App. Div. LEXIS 41348 (N.Y. Ct. App. 1987).

Opinion

OPINION OF THE COURT

Sullivan, J.

On February 6, 1964, Robert T. Farley, a 38-year-old margin clerk, was issued a Metropolitan Life Insurance Company (hereinafter Metlife) family policy, number 646 201 504 M. This single document provided insurance coverage for Robert, his wife Anna and each of their three sons Michael, Dennis and Brian. The insurance on Robert was endowment insurance which would pay $3,000 to his widow in the event of his death or to him if he was still living on February 6, 2011. The insurance on his wife Anna was a combination term insurance and endowment insurance which would pay $1,080 to her husband in the event of her death before February 6, 2011, and $500 to her if she were alive on that date. The insurance on the children, including any afterborn children, was term insurance which would pay $1,000 to the parents upon the death of each child, if death occurred before the child’s twenty-fifth birthday.

This policy became incontestable, except for nonpayment of premiums, two years after its date of issue. The annual premiums were $126.87 for the first five years and $149.25 thereafter. It appears that Robert Farley paid the premiums on this policy for at least 16 years and the policy was incontestable.

Sometime in September 1979 a Metlife representative Jonathan Bolos, sold Robert Farley a new joint life policy number 791 065 217 A, which was issued on October 11, 1979. This policy, in the face amount of $10,000, was on the lives of Robert and Anna and was payable upon the death of the first [101]*101of them, i.e., if Robert died first, it would pay $10,000 to Anna and if Anna died first, it would pay $10,000 to Robert. The survivor would have temporary insurance for three months, but would have no coverage thereafter. Robert and Anna signed separate applications. This policy also contained a provision for incontestability two years after the date of issue. The annual premiums on this policy were $652.90 for 18 years and $636.80 for the next 21 years.

On June 18, 1981, Robert Farley died and Anna submitted proof of death to Metlife under the joint-life policy. Since the death occurred within the two-year period of contestability, Metlife conducted an investigation, including obtaining authorizations for any medical records pertaining to Robert and Anna Farley, and they were furnished. By letter dated December 16, 1981, Metlife denied liability and declared the joint-life policy void because Anna Farley did not disclose in her application that she had been treated for hypertension and diabetes.

This law suit ensued in the Civil Court of the City of New York, Kings County. In the first cause of action, Anna Farley sought to recover $10,000 under joint-life policy number 791 065 217 A. Metlife’s answer stated in effect that the joint-life policy was void because of alleged misrepresentations by Anna Farley and that the family policy had been surrendered for its cash value.

This case presents a number of questions that, in combination, seem to be without precedent. Is a joint-life insurance policy severable? Do misrepresentations of health conditions by the surviving insured under a joint-life policy void the policy on the death of the nonmisrepresenting insured? Do violations of the Insurance Department’s regulations concerning the replacement of life insurance policies (11 NYCRR part 51) estop the insurance company from asserting any defenses to the claim under the joint-life policy? If the company is so estopped, is there a counterestoppel against the plaintiff from asserting a claim under the joint-life policy by reason of her misrepresentations, thereby relegating her to a claim under the family policy?

At this stage in the litigation, the record before us is inadequate to make a final determination. Metlife appears to concede some violation of the replacement regulations, without specifying the violation. It would appear, however, from this concession, that the joint-life policy was issued as a [102]*102replacement for the family-plan policy. 11 NYCRR 51.2 (b) (5) states that a policy is a replacement policy:

"(b) When new life insurance is to be purchased which is to be delivered or issued for delivery in New York and it is known to the department licensee that, as part of the transaction existing life insurance has been or is likely to be * * *

"(5) Assigned as collateral for a loan or subject to substantial borrowing of the loan value whether in a single loan or under a schedule or series of borrowing over a period of time ('substantial borrowing’ includes all transactions wherein an amount in excess of 50 percent of the tabular cash value is to be borrowed on one or more existing policies)”.

Robert Farley obtained a loan of $653 against his family-plan policy on October 25, 1979, which coincided with the initial premium payment of $652.90 on the joint-life policy. A second loan of $637.01 was taken against the family-plan policy on October 24, 1980, which became the primary source of the second annual premium which was paid on November 3, 1980. This supports the statements in the affidavit of Anna Farley that Metlife’s agent told them that the values of the family-plan policy would cover the cost of the additional insurance. Such a procedure would indicate that the joint-life policy was in fact a replacement for the family-plan policy and subject to the requirements of 11 NYCRR part 51.

The purpose of the Insurance Department in adopting these regulations is set forth in 11 NYCRR 51.1 (b): "To protect the interests of the life insurance public by establishing minimum standards of conduct to be observed in the replacement * * * of life insurance policies, by making available full and clear information on which an applicant for life insurance can make a decision in his own best interest, by reducing the opportunity for misrepresentation and incomplete comparison in replacement situations, and by precluding unfair methods of competition and unfair practices” (emphasis added).

Where replacement insurance is being offered, the agent of the insurer is required to provide the applicant with a notice setting forth certain pitfalls in replacing existing life insurance (11 NYCRR Appendix 11) and also a complete disclosure statement (11 NYCRR Appendix 10) setting forth a detailed comparison of the existing and proposed policies and the relative advantages and disadvantages of each. This disclosure statement must be given to the applicant and signed by the applicant, and a copy must be left with the applicant, before [103]*103the taking of the new application (11 NYCRR 51.4 [d] [3]). The agent must submit signed copies of this disclosure statement along with any sales material used to the insurer with the application (11 NYCRR 51.4 [d] [4]) and the insurer must retain this material (11 NYCRR 51.5 [a] [5]). No disclosure statements signed by the Farleys have been submitted by Metlife.

The fact that question 12 of part A of the applications for the joint-life policy indicates that it was not to be a replacement policy is not controlling. The failure of the agent to inquire as to replacement, the incorrect recording of the answer by the agent, or the counselling of the applicant by the agent to answer this question in the negative in order to avoid the regulations is expressly prohibited (11 NYCRR 51.6).

It is apparent that there must be a full exploration of the facts and circumstances surrounding the issuance of the joint-life policy in this case.

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Cite This Page — Counsel Stack

Bluebook (online)
127 A.D.2d 99, 513 N.Y.S.2d 712, 1987 N.Y. App. Div. LEXIS 41348, Counsel Stack Legal Research, https://law.counselstack.com/opinion/farley-v-metropolitan-life-insurance-nyappdiv-1987.