Home Life Insurance v. Chandler

402 So. 2d 356, 1981 Miss. LEXIS 2142
CourtMississippi Supreme Court
DecidedAugust 19, 1981
DocketNo. 52634
StatusPublished
Cited by1 cases

This text of 402 So. 2d 356 (Home Life Insurance v. Chandler) is published on Counsel Stack Legal Research, covering Mississippi Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Home Life Insurance v. Chandler, 402 So. 2d 356, 1981 Miss. LEXIS 2142 (Mich. 1981).

Opinion

BOWLING, Justice, for the Court:

Appellant Home Life Insurance Company brings this appeal from the Circuit Court of [357]*357Leake County where a jury verdict and judgment thereon was entered for appellee Mary Joyce Chandler (plaintiff below) in the sum of $9,999.00.

Appellee’s alleged claim was for benefits due because of the death of her husband, Clyde C. Chandler. The deceased at the time of his death and prior thereto was an employee of Olen Burrage Trucking, Inc., whose home office was in Philadelphia, Mississippi. The principal business of this company was operating transportation trucks with Chandler being one of the drivers. As of May 31,1972, appellant Home Life issued to Chandler’s employer, Olen Burrage Trucking, Inc., a policy of insurance to cover hospital, medical, death and other incidental benefits by employees of Burrage.

Chandler died on June 23,1978. Appellee filed a claim for death benefits allegedly due under the group policy. Appellant denied that appellee’s claim was within the terms of the group policy and affirmatively alleged that the claim was specifically excluded for reasons hereinafter set out. The death benefit, if owed, was in the sum of $10,000. Appellee filed her suit in the Circuit Court of Leake County for $9,999. The jury returned a verdict in the latter amount and a judgment was entered thereon.

Appellant assigns a number of alleged errors on appeal. It is necessary to consider only one assignment, as it disposes of the appeal. This contention is that at the conclusion of all the evidence the lower court should have granted a peremptory instruction. We are forced to agree with this contention and to reverse and render judgment here for appellant.

The affirmative defense of appellant was that the application of Chandler to come under the group policy was made more than thirty-one days after his employment with Burrage and that he could not have been eligible for coverage under the policy without furnishing evidence of insurability. This required evidence would have been in the form of a medical examination and a form completed by a physician of Chandler’s choice.

Witness Mrs. Beverly Durant was the employee of Burrage who handled the group insurance coverage for her employer. She had been doing this for approximately two years and the insurance work consumed approximately one day each week. Prior to Mrs. Durant handling the insurance matters, it was done by Mrs. Olen Burrage. Mrs. Durant testified that she did not know about the so-called “late entrant” requirements and she thought that the only requirement was a waiting period of thirty days after an employee applied, regardless of the length of prior employment.

Chandler came to the office on April 15, 1978, and completed a “group insurance enrollment card” with the assistance of Mrs. Durant. Under the information requested as to “date of permanent full-time employment” there was inserted the date of “4/15/78.” Mrs. Durant testified that she informed Chandler on that date that he would have to wait thirty days. The enrollment card reveals that it was signed on May 15, 1978, and it was Mrs. Durant’s opinion that she was then obligated to forward the card to the appellant who would then include Chandler as a covered employee. This was done and a certificate was returned to be attached to policy coverage information and delivered to Chandler. Pursuant to the information on the enrollment card, appellant enrolled Chandler as a covered employee and Chandler admittedly received the coverage information booklet.

The group policy, in describing Burrage’s employees who could elect to be covered under the policy, provided that any employee could be covered but that:

(c) If such request is made by the employee more than thirty-one days after he becomes eligible or is made after previous termination of his insurance because of failure to make a required contribution, the employee must furnish, at his own expense, evidence of his insurability. If such evidence is submitted, his insurance for which he is then eligible shall become effective on the date Home Life approves the employee’s evidence of insurability.

[358]*358The coverage information given to the employee who applied for such coverage, including Chandler, expressly set out the above requirement. It was stipulated that Chandler had been employed more than thirty-one days prior to April 15, 1978. In fact, the proof shows that he had worked continuously since August 1976 and for various periods of time prior to that date.

Chandler’s physical condition at the time the enrollment card was executed is undisputed. For many years he had had a serious heart condition and had had a bout with malignancy and operations for that ailment. His health, unfortunately, was extremely bad. He had been plagued by high blood pressure for a long period of time. On April 7, 1978, shortly prior to completing the enrollment card, there was a growth removed from Chandler’s back which proved to be malignant.

We think it appropriate to state that had Chandler started to work and begun his employment with Burrage on April 15, 1978, the date placed on the enrollment card, he would have received full coverage and full benefits under the group policy regardless of his physical condition. The sole question as hereinbefore stated is that due to the fact he had been employed more than thirty-one days, he could not be covered without evidence of insurability under the terms of the policy.

Appellee contended below and contends here that Mrs. Durant [the employer’s representative] was acting as agent of appellant Home Life and that the action of Bur-rage through Mrs. Durant was binding on appellant. Appellant contends that Bur-rage was not its agent, but on the other hand Burrage was required to follow the instructions and directives of appellant in regard to enrolling employees under the group plan.

The threshold question therefore appears to be whether or not as a legal proposition the employer under the group plan, such as the one involved here, is an agent of the insurance company and can waive or alter coverage requirements, as the one involved in this appeal. Research reveals that there is a diversity among jurisdictions on this agency question. The majority of jurisdictions appear to hold that the employer is not the “agent” of the company. There are a number of jurisdictions in the minority that hold the employer is the agent of the company and any action of the employer binds the company. It appears that this Court has never spoken directly to this legal question, although several cases have touched on the subject. We find that it is not necessary to reach a definite decision on this question on the appeal before us. As is usually the case, such questions are considered on a case by case basis because of the wide divergence of facts in each case. In our opinion the evidence in the record before us is sufficient to require a holding that Chandler did not become a covered employee and it was against the overwhelming weight of the evidence for the lower court to fail to grant appellant a peremptory instruction.

As hereinbefore stated, Mrs. Durant denied any knowledge of Burrage Trucking Company through her of the late entrant requirement. Appellant introduced the testimony of witness Michael Duran. He was a senior group underwriter for appellant and testified in detail regarding the type of policy in question and the manner in which it operated through the various covered employers and their employees.

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605 F. Supp. 179 (S.D. Mississippi, 1985)

Cite This Page — Counsel Stack

Bluebook (online)
402 So. 2d 356, 1981 Miss. LEXIS 2142, Counsel Stack Legal Research, https://law.counselstack.com/opinion/home-life-insurance-v-chandler-miss-1981.