Hartford Accident & Indemnity Insurance v. Washington National Insurance

638 F. Supp. 78, 1986 U.S. Dist. LEXIS 25842
CourtDistrict Court, N.D. Illinois
DecidedMay 6, 1986
DocketNo. 85 C 06462
StatusPublished
Cited by17 cases

This text of 638 F. Supp. 78 (Hartford Accident & Indemnity Insurance v. Washington National Insurance) is published on Counsel Stack Legal Research, covering District Court, N.D. Illinois primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Hartford Accident & Indemnity Insurance v. Washington National Insurance, 638 F. Supp. 78, 1986 U.S. Dist. LEXIS 25842 (N.D. Ill. 1986).

Opinion

[79]*79MEMORANDUM OPINION AND ORDER

GETZENDANNER, District Judge:

This diversity action, before the court on cross-motions for summary judgment, requires this court to interpret a critical clause of an insurance contract. Defendant Washington National Insurance Company (“WNIC”) is the holder of a fidelity bond, issued by plaintiff Hartford Accident and Indemnity Company (“Hartford”). The bond indemnifies WNIC for losses arising from the fraudulent and dishonest acts of its employees and agents, as those acts are defined in the contract of indemnity. Beginning in 1982, two WNIC agents, Kevin Masteller and Errol Phillips, engaged in schemes whereby they were able to acquire monies to which they were not entitled from WNIC. These schemes caused WNIC substantial economic loss. Those losses prompted WNIC to file “proof of loss” documents with Hartford and demand indemnification. Hartford now seeks a declaration, under 28 U.S.C. § 2201, that it is not required under the terms of the fidelity bond to cover the type of loss that occurred here. For the reasons herein, the court substantially agrees but nevertheless must deny both motions for summary judgment.

Background of the Case

WNIC is in the business of selling life insurance policies. To maximize the incentive for agents to sell policies, WNIC paid its salespeople a disproportionate percentage of the expected receipt of a life insurance policy’s premiums during the first few years that the policy was in effect. Although all premium payments for the policy would not be fully made for several years, and might be discontinued entirely if the policy were cancelled, a very large commission was paid in the first year to reward the salesperson. According to Hartford, the commissions received by the agent in the first year frequently equaled or exceeded 100% of the total premiums actually paid by the buying policyholder in that first year.

Apparently driven by the inducement of receiving such high commissions in the early years of the policies, Masteller and Phillips concocted schemes whereby insurance policies would be sold to private individuals, but Masteller or Phillips would themselves finance or assist in the financing of the premium payments. Since Masteller and Phillips would receive more from WNIC in commission payments than they would have to pay in premiums during the first year, it became profitable for them to personally pay the premiums or assist in financing the premium payments in the first year of the policy. Although there are certain similarities between their schemes, there is no claim that Masteller and Phillips worked together to defraud WNIC.

Masteller’s scheme involved the creation of two charitable donation programs ostensibly for the purpose of enabling charitable donors to contribute toward life insurance policies written on the lives of key executives of Gonzaga University and Seattle University. The charitable donors were employees of the Burlington Northern Railroad. Burlington Northern employees were eligible for matching charitable donations from the Burlington Northern Foundation, which provided $2.00 in donations for every $1.00 of charitable gift given by a Burlington Northern employee. Masteller’s plan had him purchase a cashier’s check with his own funds in the name of the Burlington Northern employee who would then execute the Burlington Northern Foundation matching gift form as if said employee were making a contribution to a university. Masteller would then send the cashier’s check and the matching gift form to the university, the proceeds of which would then be used to buy life insurance policies on key university personnel. The policies then generated commissions for Masteller to which, the parties agree, he was not entitled. Burlington Northern employees were told they would receive tax deductions as a result of the scheme.

The Phillips scheme is similar to Masteller’s in all material respects, though the details are substantially more complex. [80]*80Accordingly, his scheme will only be outlined here. Phillips, like Masteller, created a charitable gift program for colleges and universities in Utah. Phillips represented that anonymous donors were encouraged to donate monies to pay premiums on policies owned by universities. In reality, there were no donors contributing significant amounts to the Phillips program. The premiums were funded, essentially, by use of the commission payments made by Phillips or one of his associates. Initially, the premiums were paid with funds supplied by associate Kenlon Reeve, in the form of a loan to Phillips which he repaid. Some of the premium payments were financed by taking loans against the built up cash values of the policies, or by taking loans out from established lending institutions. The purpose and net result of the plan was to induce WNIC “to pay commissions which Phillips had not earned to which he was not entitled.” WNIC Ans. ¶ 32.

In sum, the Masteller scheme cost WNIC $360,465.93 in the form of commissions and subsidies. The Phillips scheme caused WNIC (and its affiliated business) to incur losses of $8,525,426.35 in commissions and other compensation payments, $2,970,-601.78 in policy loans, $400,000 in death claims, and $1,900,000 in settlement of claims by North American Life and Casualty Company. WNIC also has incurred related losses of $38,698.50, as a result of settlements entered into with the educational institutions and employers.

Legal Issue Presented

WNIC has put in two claims for much of the above-recited losses on the grounds that those losses are the direct result of Masteller’s and Phillips’ fraudulent acts. In a letter dated July 15, 1985, Hartford denied both of these claims. Hartford’s denial is based on its argument that the losses are not within the scope of the coverage provided by the fidelity bond because the two schemes do not meet the definition of “dishonest and fraudulent acts” as set forth in the rider to the fidelity bond contract.

In order for a loss to be covered by the fidelity bond, it must be the “direct result” of a “dishonest or fraudulent act.” Such acts are explicitly defined in the rider to the Hartford indemnity agreement:

Dishonest or fraudulent acts as used in this insuring Clause shall mean only dishonest or fraudulent acts committed by such Employee or Agent with the manifest intent:
(a) to cause the insured to sustain such loss; and
(b) to obtain financial benefit for the Employee or the Agent, or for any other person or organization intended by the Employee or the Agent to receive such benefit, other than salaries, commissions, fees, bonuses, promotions, awards, profit sharing, pensions, or other employee benefits earned in the normal course of employment.

The dispute in this case is whether part (b) of this definition has been satisfied. For purposes of the pending cross-motions, it may be assumed that Masteller’s and Phillips’ acts were committed with the intent to injure WNIC, thus satisfying part (a). The question presented is whether Masteller and Phillips also intended that they (or perhaps others) should receive some financial benefit from their actions other than salaries, commissions, or some other employee benefit earned in the normal course of employment.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

3BC Properties, LLC v. State Farm Fire & Casualty Co.
2020 IL App (2d) 190501 (Appellate Court of Illinois, 2020)
Amerisure Insurance v. DeBruyn Produce Co.
825 N.W.2d 666 (Michigan Court of Appeals, 2012)
Patrick Schaumburg Automobiles, Inc. v. Hanover Insurance
452 F. Supp. 2d 857 (N.D. Illinois, 2006)
Cincinnati Ins. Company v. Tuscaloosa Parking Auth.
827 So. 2d 765 (Supreme Court of Alabama, 2002)
VanKirk v. Boyer (In re Barnes)
258 B.R. 712 (N.D. Indiana, 2000)
Susquehanna Bancshares, Inc. v. National Union Fire Insurance
659 A.2d 991 (Superior Court of Pennsylvania, 1995)
Heller International Corporation v. Alec Sharp
974 F.2d 850 (Seventh Circuit, 1992)
Heller International Corp. v. Sharp
974 F.2d 850 (Seventh Circuit, 1992)
Hanson PLC v. National Union Fire Insurance
794 P.2d 66 (Court of Appeals of Washington, 1990)
Judge v. Burnhope (In Re Leedy Mortgage Co.)
76 B.R. 440 (E.D. Pennsylvania, 1987)
HARTFORD ACC. & INDEM. INS. v. Wash. Nat. Ins.
638 F. Supp. 78 (N.D. Illinois, 1986)

Cite This Page — Counsel Stack

Bluebook (online)
638 F. Supp. 78, 1986 U.S. Dist. LEXIS 25842, Counsel Stack Legal Research, https://law.counselstack.com/opinion/hartford-accident-indemnity-insurance-v-washington-national-insurance-ilnd-1986.