Frank v. SENTRY LIFE INSURANCE COMPANY

1974 OK 108, 526 P.2d 1146, 1974 Okla. LEXIS 398
CourtSupreme Court of Oklahoma
DecidedSeptember 17, 1974
Docket46357
StatusPublished
Cited by3 cases

This text of 1974 OK 108 (Frank v. SENTRY LIFE INSURANCE COMPANY) is published on Counsel Stack Legal Research, covering Supreme Court of Oklahoma primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Frank v. SENTRY LIFE INSURANCE COMPANY, 1974 OK 108, 526 P.2d 1146, 1974 Okla. LEXIS 398 (Okla. 1974).

Opinion

IRWIN, Justice.

This is an action to recover under a group life insurance policy where the in *1147 sured-employee died after terminating his employment. Both parties filed motions for summary judgment. Judgment was rendered in favor of Appellee (plaintiff), the insured’s surviving spouse. Appellant, the insurance carrier (defendant), appealed.

Lawton H. Frank (insured) was employed by Barbour and Short, Inc., and insured under defendant’s group life insurance policy. On April 15th, in preparation for termination of his employment, the insured met with his employer and defendant’s agent to discuss the options available to insured for converting the group policy to an individual policy. The insured terminated his employment on April 30th and died on June 27th, without having exercised any option for conversion.

The issue presented is the correctness of the trial court’s judgment determining that plaintiff was entitled to benefits under the group policy.

Article 41 of the Insurance Code [36 O. S.1971 §§ 4101-4111] relates to Group Life Insurance and Group Annuity Contracts. Secs. 4103 — 1104 set forth certain provisions that group life insurance policies must contain. Although defendant’s group policy does not follow verbatim the statutory language, it does contain the provisions required by statute that are pertinent here. Therefore, for clarification, we will determine the rights of the parties under the terms of the group policy as those rights are statutorily prescribed.

Sec. 4103(8) provides that if insurance on a person covered under a group life insurance policy ceases because of termination of employment, such person “shall be entitled to have issued to him by the insurer, without evidence of insurability, an individual policy of life insurance without disability or other supplementary benefits, provided an application for the individual policy shall be made, and the first premium paid to the insurer, within thirty-one (31) days after such termination, * *

Sec. 4103(10) provides that if a person insured under a group policy dies during the period within which he would have been entitled to have an individual policy issued to him in accordance with § 4103(8), supra, and other provisions not here pertinent, “ * * * and before such an individual policy shall have become effective, the amount of life insurance which he would have been entitled to have issued to him under such individual policy shall be payable as a claim under the group policy, whether or not application for the individual policy or the payment of the first premium therefor has been made.”

Since insured did not make application or pay the first premium for an individual policy within the thirty-one (31) days period following termination of employment, or at a subsequent time, we must determine whether coverage under the group policy continued beyond the thirty-one (31) day period.

36 O.S.1971, § 4104, relates to the right of an insured under a group policy to convert to an individual policy; notice of the right to convert; and time for exercising such right. It provides:

“If any individual insured under a group life insurance policy hereafter delivered in this state becomes entitled under the terms of such policy to have an individual policy of life insurance issued to him without evidence of insurability, subject to making of application and payment of the first premium within the period specified in such policy, and if such individual is not given notice of the existence of such right at least fifteen (15) days prior to the expiration date of such period, then, in such event the individual shall have an additional period within which to exercise such right, hut nothing herein contained shall be construed to continue any insurance beyond the period provided in such policy. This additional period shall expire fifteen (15) days next after the individual is given such notice but in no event shall such additional period extend beyond sixty (60) days next after the expiration date of the period provided in such policy. *1148 Written notice presented to the individual or mailed by the policyholder to the last known address of the individual or mailed by the insurer to the last known address of the individual as furnished by the policyholder shall constitute notice for the purpose of this paragraph.”

In addition to the meeting with the insured on April 15th, to discuss the options available for conversion to an individual policy, at insured’s request, the agent went to insured’s home on May 18th, to renew discussion of the conversion options. Both times the agent discussed the conversion options with insured, he brought a copy of the conversion application and urged the insured to sign. No copies of the conversion application were left with the insured. On June 11th, defendant mailed written notice and a copy of the conversion application form to the insured who received them on June 14th. The insured died thirteen (13) days later on June 27th without making application for the individual policy or paying the first premium.

Defendant contends that the group coverage expired at the end of the thirty-one (31) day period following employment termination. Plaintiff contends that coverage under the group policy continued until the insured was given the opportunity to convert to an individual policy and the time for conversion had not expired at the time of his death.

The trial court found, inter alia, that:

“ * * * the 31-day conversion period cannot ‘run’ until it ‘starts’, and it cannot start until an assured has actual unqualified and uninhibited opportunity to exercise it. Notice without opportunity to act is a due process nullity. The assured (decedent) could not convert until he filed the application form. He was entitled to 15 days to consider conversion. The period had to be uninterrupted. Defendant could not dangle the form before the assured, start the time clock running, then conceal the form so he could not act upon it. * * * defendant had to give decedent a reason-
able time to exercise his conversion right without forcing him to lapse life cover-

The trial court concluded that “decedent was without ‘notice’ until he was provided ‘opportunity’ to convert his group life to individual life coverage; that he first received such uninterrupted and unencumbered opportunity on or after June 14th, when he received and could at his leisure determine if he wanted to exercise his conversion option; that his interim group coverage continued, notwithstanding language of the policy or Oklahoma Statutes, until he had at least 15 consecutive uninterrupted days to exercise his conversion option; that death interrupted his conversion time, and consequently, his beneficiary (plaintiff) is entitled to claim under the group life provisions.”

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Related

Reinisch v. Metropolitan Life Insurance
97 A.D.2d 135 (Appellate Division of the Supreme Court of New York, 1983)

Cite This Page — Counsel Stack

Bluebook (online)
1974 OK 108, 526 P.2d 1146, 1974 Okla. LEXIS 398, Counsel Stack Legal Research, https://law.counselstack.com/opinion/frank-v-sentry-life-insurance-company-okla-1974.