Fishel v. American Security Life Insurance

660 F. Supp. 45, 1986 U.S. Dist. LEXIS 21833
CourtDistrict Court, S.D. Mississippi
DecidedAugust 6, 1986
DocketCiv. A. No. S85-0960(NG)
StatusPublished
Cited by1 cases

This text of 660 F. Supp. 45 (Fishel v. American Security Life Insurance) is published on Counsel Stack Legal Research, covering District Court, S.D. Mississippi primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Fishel v. American Security Life Insurance, 660 F. Supp. 45, 1986 U.S. Dist. LEXIS 21833 (S.D. Miss. 1986).

Opinion

MEMORANDUM OPINION

GEX, District Judge.

This matter is before the Court on (1) the parties’ cross motions for summary judgment on the question of coverage under the subject policies, and (2) Defendant’s motion for partial summary judgment on the issue of punitive damages. For the reasons stated below, the Court is of the opinion that the cross motions should be denied and that Defendant’s motion for partial summary judgment on the issue of punitive damages should be granted.

[46]*46I. STATEMENT OF FACTS

Prior to August, 1983, Stephen Timothy Fishel, Plaintiff’s decedent, was employed as corporate legal counsel for Malone Properties, Inc. During this time, Fishel was covered under two policies of group insurance issued by Defendant to Malone Properties as policyholder. One policy (# GL7733) provided $50,000.00 life insurance coverage and the other policy (# G-D7733) provided $50,000.00 accidental death benefits.

In August or September of 1983, Fishel left the full time employment of Malone Properties and opened an office where he engaged in the private practice of law until his death on December 2, 1983. Although Fishel represented a number of clients in private practice, he continued to represent and perform legal services for Malone Properties. After August of 1983, Malone Properties continued to remit a premium on behalf of Fishel until his death on December 2, 1983. Malone Properties never notified Defendant that it should terminate insurance coverage for Fishel after the change in his employment status.

On September 13, 1984, counsel for the Plaintiff—in response to efforts by Defendant to obtain documentation relative to Plaintiff’s alleged coverage under the two aforementioned policies—advised Betty Stark, Defendant’s Vice President of Policy Benefits, by letter1 that "... Jim Fishel terminated his employment with Malone Properties several months before his death and you indicated that he would probably not be covered. Nevertheless, I look forward to receiving a copy of the policy together with your views as to coverage.” Also as a follow-up to that same telephone conversation, Ms. Stark, by letter dated September 11, 1984, informed counsel for the Plaintiff as follows:

We appreciated your phone call last week explaining what Mr. Fishel’s employment status with Malone Properties was on the date of his death.
The policy covers active full-time employees who work regularly at the principal place of business of the employer for a least 30 hours per week. A copy of the policy is enclosed for your perusal. Based on the information you furnished us it doesn’t appear Mr. Fishel was covered under the policy as his coverage terminated on the same date his employement with Malone Properties terminated. If you concur with this decision please let us know as Malone Properties will be entitled to a refund of premiums from the date of his termination.

No further action concerning Fishel’s alleged coverage under the two group policies appears to have been taken until Plaintiff’s counsel’s letter dated March 4, 1985, addressed to Ms. Stark, advised her that “[a]fter having ... further investigated the circumstances of Mr. Fishel’s coverage, we have decided that it is appropriate for the Estate to make a claim under Malone’s group policy.” Plaintiff’s counsel explained his client’s position, and indicated further that her correspondence dated September 11, 1984, contained only a copy of the schedule of insurance and not the “full copy of the Group Policy of Malone Properties.” Plaintiff’s formal claim for benefits was referred to counsel which, by letter dated July 9, 1985, explained to Plaintiff’s counsel its position that no coverage on behalf of the decedent was in effect at the time of his death. This lawsuit followed.

II. LAW AND ANALYSIS

The criteria to be employed by this Court in considering the merits of a motion for summary judgment are well established. A grant of summary judgment is appropriate only when it appears from the pleadings, depositions, admissions, answers to interrogatories and affidavits that there is no genuine issue as to any material fact and that the moving party is entitled to judgment as a matter of law. Rule 56(c), Federal Rules of Civil Procedure; Galindo v. Precision American Corp., 754 F.2d 1212, 1216 (5th Cir.1985); Rayborn v. Mississippi state Board of Dental Examiners, 776 F.2d 530 (5th Cir.1985). The purpose of the motion for summary judgment is to [47]*47test the intrinsic merits of the case and to determine prior to trial whether any factual controversy is presented. Gossett v. DU-RA-KEL Corporation, 569 F.2d 869 (5th Cir.1978). Summary judgment is permitted only when “the underlying facts are undisputed, and the record reveals no evidence from which reasonable persons might draw conflicting inferences about these facts”. Prinzi v. Keydril Company, 738 F.2d 707 (5th Cir.1984).

A. Coverage under the Subject Policies

Each of the policies here under consideration contains this pertinent language:

The term “employee” means a person directly employed in the regular business of and compensated for services by the Employer.
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The terms “actively at work” and “active work” mean the active expenditure of time and energy in the service of the Employer, except that an employee shal be deemed actively at work on each day of a regular paid vacation, or on a regular non-working day, on which he is not disabled provided he was actively at work on the last preceding regular working day.
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The classes of employees eligible for insurance hereunder (herein called eligible classes) shall be as follows: An active full-time employee is defined as an employee who works regularly at the principal place of business of the employer for at least 30 hours per week.
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Except as provided for in the “Extended Insurance” provision hereof, the insurance of an employee shall automatically terminate immediately upon the earliest of the following dates:
(a) the date of his termination of employement with the Employer or of his termination of membership within the eligible classes;
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Cite This Page — Counsel Stack

Bluebook (online)
660 F. Supp. 45, 1986 U.S. Dist. LEXIS 21833, Counsel Stack Legal Research, https://law.counselstack.com/opinion/fishel-v-american-security-life-insurance-mssd-1986.