Holmes v. JEFFERSON PILOT FINANC. INS. CO.

907 So. 2d 185, 2005 WL 1522724
CourtLouisiana Court of Appeal
DecidedJune 29, 2005
Docket39,721-CA
StatusPublished
Cited by4 cases

This text of 907 So. 2d 185 (Holmes v. JEFFERSON PILOT FINANC. INS. CO.) is published on Counsel Stack Legal Research, covering Louisiana Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Holmes v. JEFFERSON PILOT FINANC. INS. CO., 907 So. 2d 185, 2005 WL 1522724 (La. Ct. App. 2005).

Opinion

907 So.2d 185 (2005)

Alisa Armstrong HOLMES, Plaintiff-Appellant
v.
JEFFERSON PILOT FINANCIAL INSURANCE COMPANY, et al., Defendant-Appellee.

No. 39,721-CA.

Court of Appeal of Louisiana, Second Circuit.

June 29, 2005.

*186 Dale G. Cox, Shreveport, for Appellant.

James A. Mijalis, Shreveport, for Appellee.

Before WILLIAMS, STEWART and PEATROSS, JJ.

WILLIAMS, Judge.

The plaintiff, Alisa Holmes, appeals a judgment in favor of the defendants, Jefferson Pilot Financial Insurance Company and Jefferson Pilot Life Insurance Company ("Jefferson Pilot"). The trial court found that plaintiff's husband did not have life insurance coverage in effect on the date of his death. For the following reasons, we affirm.

FACTS

In May 2001, Alisa Holmes and Dennis Holmes met with Marcia Moss, an agent with Liberty Mutual, to discuss a life insurance policy for Dennis. While completing the application, Dennis informed Moss that he was diabetic. He paid the initial projected monthly premium of $47 and received a conditional receipt from Moss. A short time later, Dennis Holmes completed a required medical examination. When the test results indicated that his diabetes was in "poor control," Liberty Mutual declined to provide coverage. However, Moss told Holmes that a reinsurer was willing to provide life insurance at a much higher premium of $141.58 per month.

At that point, in an attempt to get a lower premium, Dennis Holmes contacted Clay Eaves, an agent for Jefferson Pilot and a customer of Holmes' auto body repair shop. On May 23, 2001, Dennis Holmes completed an application for $200,000 in life insurance benefits, with a rider providing $100,000 of coverage for Alisa. Dennis Holmes paid Eaves $200 for the first month's policy premium and signed a conditional receipt, which provided for the following conditions:

*187 • A minimum advance payment equal to one month premium for the insurance applied for must be made.
• Any check given in payment must be honored when first presented to the bank.
• All medical examinations and tests required by the company's initial underwriting requirements must be completed and received at its home office/service office within 60 days from the completion of Part I of the application.
• If any person proposed for insurance dies by suicide or if the application or this receipt contains any material misrepresentations, then the company's liability under this receipt is limited to a refund of the premium paid.
• Each person proposed for insurance must be a risk insurable on the insurability date in accordance with the company's rules, limits and standards for the plan and the amount applied for without modification either as to plan, amount, riders, supplemental agreements and/or the rate of premium paid.

The receipt further provided that if "all conditions in this receipt have been fulfilled exactly, coverage under the policy applied for, subject to the amount limitations may begin on the insurability date, which is the latest of (a) the date of completion of Part I of the application, or (b) the date of completion of all medical examinations, tests and other evidence required by the company, or (c) the policy date, if any, requested in the application." Above the signature line for the "proposed insured," the receipt also stated that "I have read the terms of this conditional receipt. I understand that the insurance applied for will not be effective unless and until all conditions of this conditional receipt are met."

A scheduled medical examination was cancelled by Dennis Holmes, who wanted to try to improve his blood sugar level. On June 16, 2001, the decedent, Dennis Holmes, was seriously injured in a motorcycle accident. He died on June 20, 2001. The decedent had not undergone the medical examination at the time of his death. Jefferson Pilot later returned the $200 payment to Alisa Holmes.

Subsequently, Alisa Holmes submitted a demand for payment of life insurance benefits to Jefferson Pilot, which declined coverage on the grounds that the decedent had not satisfied all of the requirements of the conditional receipt. In addition, Jefferson Pilot reviewed decedent's medical records, which were received after his death, and concluded that he was not an insurable risk because his diabetes was "uncontrolled." The plaintiff, Alisa Holmes, filed this action against the defendants, Jefferson Pilot Financial Insurance Company and Jefferson Pilot Life Insurance Company, asserting a claim for life insurance proceeds.

After a trial, the district court issued written reasons for judgment finding that the conditional receipt was a contract subject to a suspensive condition, which could never be fulfilled due to the decedent's death prior to completion of the medical examination. The trial court rendered judgment in favor of the defendants. The plaintiff appeals the judgment.

DISCUSSION

In a number of assignments of error, the plaintiff contends the trial court erred in finding that she was not entitled to recover life insurance benefits from defendants upon the death of her husband. These assignments of error relate to the interpretation of the conditional receipt and *188 whether it provided any life insurance coverage for the decedent.

Contracts have the effect of law between the parties. LSA-C.C. art. 1983. Interpretation of a contract is the determination of the common intent of the parties. LSA-C.C. art. 2045. When the words of a contract are clear and unambiguous, no further interpretation may be made in search of the parties' intent. LSA-C.C. art. 2046. Words in a contract must be given their generally prevailing meaning. Technical terms must be given their technical meaning when the contract involves a technical matter. LSA-C.C. art. 2047.

In the present case, Clay Eaves testified that he met with decedent and his wife in May 2001 to discuss a variable life insurance policy, which allowed premium payments to be invested for a potential increase in policy proceeds. Eaves stated that he gave them both a chance to read the application documents before they signed, he accepted a $200 check for the projected monthly premium and gave them a conditional receipt. Eaves did not recall explaining the conditional receipt to decedent or plaintiff and did not know if they had read the documents in detail. Eaves testified that the policy illustration was generated by defendants as a projection of the rate of return available for investing a certain premium amount. He explained that questions about decedent's finances were meant to guard against a person seeking an inordinate amount of insurance coverage. Eaves stated that he told decedent about the need to take a medical exam, which included a blood test and urinalysis.

Henry Edmonston, the vice-president for underwriting at Jefferson Pilot, testified that he was involved with evaluating insurance applications and classifying risks. Edmonston stated that when an application was completed and an agent collected money, a conditional receipt was used to inform the applicant when he might be considered to have coverage. Edmonston testified that because the decedent did not undergo a medical examination he did not complete the condition requiring him to submit test results to defendants. Edmonston stated that another condition was that the applicant must be an insurable risk as determined by defendants' guidelines.

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Bluebook (online)
907 So. 2d 185, 2005 WL 1522724, Counsel Stack Legal Research, https://law.counselstack.com/opinion/holmes-v-jefferson-pilot-financ-ins-co-lactapp-2005.