Halstead Consultants, Inc. v. Continental Casualty Co.

891 P.2d 926, 181 Ariz. 459, 175 Ariz. Adv. Rep. 26, 1994 Ariz. App. LEXIS 217
CourtCourt of Appeals of Arizona
DecidedOctober 6, 1994
Docket1 92-0395
StatusPublished
Cited by2 cases

This text of 891 P.2d 926 (Halstead Consultants, Inc. v. Continental Casualty Co.) is published on Counsel Stack Legal Research, covering Court of Appeals of Arizona primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Halstead Consultants, Inc. v. Continental Casualty Co., 891 P.2d 926, 181 Ariz. 459, 175 Ariz. Adv. Rep. 26, 1994 Ariz. App. LEXIS 217 (Ark. Ct. App. 1994).

Opinion

OPINION

TOCI, Judge.

Halstead Consultants, Inc. (“Halstead”) 1 purchased a one-year term, renewable group accidental death and dismemberment insurance policy from Continental Casualty Company (“Continental”). The policy insured “active full-time consultants [of Halstead] under age 70.” Although Ann Halstead (“decedent”) was not a Halstead employee, she was listed as an active, full-time consultant when the policy was first issued and each time the policy was renewed. Continental denied Halstead’s claim for accidental death benefits, claiming that because decedent was not an active, full-time consultant of Halstead when the policy was issued, she was not eligible for coverage.

Halstead sued Continental, alleging that Continental breached the insurance contract by failing to pay the accidental death benefit. 2 Halstead then moved for summary judgment, arguing that the policy’s incontestability clause precluded Continental from denying Halstead’s claim for benefits. The trial court granted Halstead’s motion and entered judgment in its favor for $450,000, plus costs and attorneys’ fees.

The following issues are presented: (1) is the incontestable clause applicable to this policy; (2) does the contestable period of a group insurance policy run from the inception of the policy, or is it extended each time the policy is renewed; and (3) does the incontestable clause bar the insurer from defending against a claim on the ground that the insured was never eligible for insurance under the terms of the policy?

We resolve the above issues as follows. We hold that the incontestable clause is applicable to this policy and that it begins to run when the policy is issued. In other words, the contestable period is not extended by each policy renewal. We also hold that, because decedent’s eligibility for insurance was ascertainable by Continental when the policy was issued, such eligibility is not a limitation of the risk Continental contracted to insure. Consequently, the incontestable clause bars Continental from raising it as a defense. We, therefore, affirm the judgment of the trial court.

I. FACTS AND PROCEDURAL HISTORY

Continental sold Halstead group accidental death and dismemberment coverage for its employees. Although the original policy term was from June 10, 1986 to June 10, *461 1987, the policy permitted Halstead to renew coverage after June 10, 1987, with Continental’s consent. Halstead renewed the policy for successive one-year terms in 1987, 1988, and 1989.

The policy contains the following relevant terms and conditions. It insures “all persons specified in the Policy Schedule.” The policy schedule describes insured persons as “ALL ACTIVE FULL-TIME CONSULTANTS UNDER AGE 70 OF [HALSTEAD] FOR WHOM APPLICATION IS MADE AS A CLASS I INSURED PERSON BY [HAL-STEAD].” The policy further provides that individual insurance is terminated on “the date the insured person ceases to be associated with [Halstead] in a capacity that makes him eligible” for coverage.

The policy also contains the following incontestability clause:

This policy constitutes the entire contract between the parties. Any statement made by [Halstead] or by any Insured Person shall be deemed a representation and not a warranty. No such statement shall void the insurance or reduce the benefits under this policy or be used in defense to a claim hereunder unless it is contained in a written instrument, a copy of which has been furnished [to Halstead] or the Insured Person. No such statement of [Halstead] shall be used at all to void this policy after it has been in force for two years from the date of its issue.

At the inception of the policy, Halstead gave written notice to Continental of the names of those active, full-time consultants for whom Halstead had applied for coverage. Thereafter, at the time of renewal of the policy, and from time to time as events warranted, Halstead gave notice to Continental of such consultants whose coverage was to be added or terminated. Continental sent acknowledgments of the applications and effective dates for such persons, and premiums were calculated on the basis of the information received from Halstead.

Decedent made her initial application for coverage in June of 1986, and was listed by Continental at that time as a Class I insured person. She was also listed as an insured person at the time of each of the three policy renewals. It is, however, undisputed that when the policy was underwritten and issued and at the time of her death, decedent was not an active, full-time consultant of Hal-stead.

In September 1989, after decedent’s death by accidental drowning, Halstead timely submitted a notice of death and proof of loss to defendant. Following an investigation, Continental denied the claim because decedent was not eligible for coverage as an active, full-time consultant. Continental returned the full amount of all premiums Halstead paid on decedent’s behalf.

Halstead sued Continental for breach of contract, claiming that Continental violated the policy by denying Halstead’s claim. Hal-stead moved for summary judgment, arguing that the two-year contestable period had expired. According to Halstead, Continental was precluded from denying Halstead’s claim on the ground that decedent was not eligible for coverage. The trial court granted Hal-stead’s motion, finding:

The incontestability clause ... precluded Continental from voiding coverage based on the alleged misrepresentation of [decedent’s] employment status two years after the date the policy was issued. The facts demonstrate that this policy was issued more than two years before [decedent’s] death.

Continental appeals from the trial court’s judgment in favor of Halstead in the amount of $450,000, plus costs and attorneys’ fees.

II. DISCUSSION

A. Does the Incontestable Clause Apply at All?

In reviewing a trial court’s order granting summary judgment where no disputed issues of material fact exist, we will determine only whether the trial court correctly applied the substantive law to the undisputed facts. Norquip Rental Corp. v. Sky Steel Erectors, Inc., 175 Ariz. 199, 202, 854 P.2d 1185, 1188 (App.1993).

Continental argues that because decedent was eligible for insurance but shortly *462 before her death became ineligible, the termination provisions of the policy control rather than the incontestable clause. See Crawford v. Equitable Life Assurance Soc’y of the United States, 56 Ill.2d 41, 805 N.E.2d 144, 151 (1973) (incontestability clause does not apply when employee was eligible and later terminates employment).

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Cite This Page — Counsel Stack

Bluebook (online)
891 P.2d 926, 181 Ariz. 459, 175 Ariz. Adv. Rep. 26, 1994 Ariz. App. LEXIS 217, Counsel Stack Legal Research, https://law.counselstack.com/opinion/halstead-consultants-inc-v-continental-casualty-co-arizctapp-1994.