Hodgson v. Banner Life Insurance

21 Cal. Rptr. 3d 907, 124 Cal. App. 4th 1358
CourtCalifornia Court of Appeal
DecidedJanuary 12, 2005
DocketC041384
StatusPublished

This text of 21 Cal. Rptr. 3d 907 (Hodgson v. Banner Life Insurance) is published on Counsel Stack Legal Research, covering California Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Hodgson v. Banner Life Insurance, 21 Cal. Rptr. 3d 907, 124 Cal. App. 4th 1358 (Cal. Ct. App. 2005).

Opinions

Opinion

RAYE, Acting P. J.

Purchasers of life insurance are sometimes provided interim coverage while the application for insurance is being considered by the insurer. The terms of the interim coverage are set forth in a “conditional receipt,” sometimes referred to as a “ ‘binder.’ ” (Smith v. Westland Life Ins. Co. (1975) 15 Cal.3d 111, 113 [123 Cal.Rptr. 649, 539 P.2d 433].) In the present matter, Michael Hodgson, father of plaintiffs Kara and Mikayla Hodgson and husband of plaintiff Carrie Hodgson, completed an application for life insurance with defendant Banner Life Insurance Company (Banner) and paid an initial premium.1 The application included a conditional receipt. Defendants Poage Center Insurance Services and its successor, BISYS Insurance Services, (Poage) served as general agent for Banner. Within days, Banner returned the check for the initial premium and declared the conditional receipt ineffective, explaining that the company did not [1362]*1362provide interim coverage for the policy amount sought by Michael. The company continued to process Michael’s application for permanent coverage. Approximately two weeks later, Michael suffered mortal injuries in a motor vehicle accident. Banner considered the policy terminated prior to Michael’s accident.

Hodgson filed a complaint against Banner alleging breach of contract, bad faith, conversion, and negligence, and requesting an accounting and imposition of a constructive trust. The complaint also alleged negligence against Poage. All parties filed motions for summary judgment. The trial court granted summary judgment in favor of Banner and Poage, finding that Michael had no insurance coverage with Banner and that Poage satisfied all its obligations to Michael. Hodgson appeals, contending Michael was covered by the Banner policy at the time of his death. We shall reverse the judgment in favor of Banner. We affirm the judgment in favor of Poage.

FACTUAL AND PROCEDURAL BACKGROUND

Michael, a licensed life and disability insurance agent with Banner, submitted a Banner life insurance application requesting $500,000 in insurance on his life. Michael submitted an initial premium check in the amount of $210, payable to Banner.

The Banner application form submitted by Michael contained the following language: “WHEN INSURANCE TAKES EFFECT: Except as provided in the Conditional Receipt bearing the same number as this application, no insurance applied for will take effect until the full first premium is paid and such policy is delivered to the owner while all proposed insureds are living and their health remains as described in this application. If all of these take place, insurance will take effect on the policy date.”

The Banner application also contained a conditional receipt form. The conditional receipt provides temporary or interim insurance coverage while Banner is underwriting the application. Banner issued a conditional receipt after Michael paid the initial premium.

Banner sets certain limitations on interim insurance coverage. When Michael applied for his policy, Banner limited interim insurance to applicants who applied for face amounts of life insurance of $250,000 or less. The company issued a memorandum to all of its general agents announcing the conditional receipt limits. Poage, a general agent of Banner, knew of the conditional receipt limitations. However, Poage used an older application package for Michael’s application, in which the conditional receipt form referred to a limit of $500,000.

[1363]*1363Banner’s application package also included an “Authorization to Draw Checks in Payment of Life Insurance Premiums” (PAC form). The PAC form authorized Banner to draw directly from an insured’s bank account for payment of monthly premiums. The process would begin after Michael’s policy was approved. Banner never withdrew funds from Michael’s account.

Michael submitted the application and initial premium check to Poage. Poage forwarded the application and premium to BI US, Inc. (BI US), who provided underwriting services for Banner. After reviewing the application, BI US prepared an audit sheet. The audit sheet contained the notation “Return ck” and a line item stating “Do not accept money on polic[i]es ... (In Calif, over $250,000).” BI US forwarded the audit sheet and application to Banner’s home office.

Banner assigned Michael’s application a number and began the process of underwriting the application. Several days later, Banner returned the original premium check to Michael. The accompanying correspondence stated: “We are returning your payment of $210.00 received in connection with the above referenced application, since it is our practice not to accept a deposit on applications that exceed the limits under which a conditional receipt can be given. However, we will continue to underwrite this application. . . . [f] Please return the conditional receipt to us for our file, since any coverage that may have been provided under the conditional receipt is no longer effective.”

After Michael received the returned check, a Poage employee spoke with him. The employee’s notes of the conversation state: “Agent called to see why his premium check was returned. Advised him because it was over the binding limit of $250,000 for California. Advised him that Banner (Life Insurance Co.) applications are incorrect as far as the conditional receipt information on them.”

Following the return of Michael’s check, Banner continued to underwrite his application. Banner’s underwriter tentatively approved issuance of a standard life insurance policy subject to Michael’s completion and submission of an alcohol questionnaire. Banner received the questionnaire and final underwriting approval was given for a policy with a face amount of $500,000. Banner notified Poage of the approval and policy issuance on June 1, 1999.

However, five days prior to this notification, on May 27, 1999, Michael suffered injuries in a motor vehicle collision that left him in a coma. He never recovered from his injuries and died in early 2000.

Poage received Michael’s life insurance policy on June 7, 1999. Under Banner’s procedures and policy terms, Michael’s coverage could not be [1364]*1364effective unless (1) the policy was delivered to him while he was in the same health as described in his application; (2) he paid the first monthly premium; (3) he signed an amendment reflecting a change in the policy as issued (“non-tobacco”) versus as applied for (“preferred non-tobacco”); and (4) he signed a delivery receipt.

Banner contended Michael’s injuries and continuing coma were a material change in his health from the application and prevented him from completing the necessary requirements. Under this rationale, the policy did not become effective and was not delivered by Poage. Banner advised Poage to return the policy. Banner terminated the policy.

Hodgson filed suit against Banner, alleging breach of contract, bad faith, conversion, and negligence. The complaint also requested an accounting and formation of a constructive trust, and included a claim for punitive and exemplary damages. Against Poage, Hodgson alleged a cause of action for negligence.

Banner, Hodgson, and Poage each filed a motion for summary judgment.

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Bluebook (online)
21 Cal. Rptr. 3d 907, 124 Cal. App. 4th 1358, Counsel Stack Legal Research, https://law.counselstack.com/opinion/hodgson-v-banner-life-insurance-calctapp-2005.