Jackson v. Continental Cas. Co.

412 So. 2d 1364, 1982 La. LEXIS 10762
CourtSupreme Court of Louisiana
DecidedApril 5, 1982
Docket81-C-1759
StatusPublished
Cited by12 cases

This text of 412 So. 2d 1364 (Jackson v. Continental Cas. Co.) is published on Counsel Stack Legal Research, covering Supreme Court of Louisiana primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Jackson v. Continental Cas. Co., 412 So. 2d 1364, 1982 La. LEXIS 10762 (La. 1982).

Opinion

412 So.2d 1364 (1982)

Phillip JACKSON
v.
CONTINENTAL CASUALTY COMPANY.

No. 81-C-1759.

Supreme Court of Louisiana.

April 5, 1982.
Rehearing Denied May 14, 1982.

Leo J. Berggreen, Baton Rouge, for plaintiff-applicant.

Paul H. Spaht, of Kantrow, Spaht, Weaver & Walter, Baton Rouge, for defendant-respondent.

WATSON, Justice.

ISSUE

Is a person who pays group insurance premiums for almost six years to insure the life of his "spouse" barred from collecting benefits for her death by the fact that their thirty-five year union was not a legal marriage?

FACTS

Plaintiff, Phillip Jackson, an illiterate Louisiana State University employee, was insured under a group policy with Continental Assurance Company. Beulah Jackson was enrolled for life insurance coverage as his spouse on September 8, 1973. Premiums for that coverage were deducted from Jackson's pay checks. After living with Phillip Jackson for thirty-five years, Beulah Jackson died on July 9, 1979. The two were never legally married, but Beulah Jackson was economically dependent on Phillip.

Continental Assurance Company contested liability because it was unaware the parties were not legally married until after Beulah's death. The trial court dismissed plaintiff's suit. The Court of Appeal affirmed because Beulah Jackson was not a "legal spouse" and therefore was ineligible for coverage. Jackson v. Continental Cas. Co., 402 So.2d 175 (La.App. 1 Cir. 1981). A writ was granted to review the judgment. 405 So.2d 532 (La.1981).

LAW

LSA-R.S. 22:176(2) requires that all group life insurance policies issued in the State of Louisiana have the following or an equivalent provision:

"(2) Incontestability: A provision that the validity of the policy shall not be *1365 contested, except for nonpayment of premiums, after it has been in force for two years from its date of issue and that no statement made by an individual insured under the policy relating to his insurability shall be used in contesting the validity of the insurance with respect to which such statement was made after such insurance has been in force prior to the contest for a period of two years during such individual's lifetime nor unless it is contained in a written instrument signed by him."

CONCLUSION

The Court of Appeal relied on Crawford v. Equitable Life Assurance Society of the United States, 56 Ill.2d 41, 305 N.E.2d 144 (1973), which held that a defense of ineligibility was not barred by an incontestability clause. Crawford reasoned that the question of eligibility for group coverage is not foreclosed because the insurer's risk and premium is affected by whether the insured was, as represented, an employee. "[E]mployment or active or full-time employment may protect the insurer against adverse selection." 305 N.E.2d at 150. Even on that point, the various jurisdictions "are not uniform in result." 305 N.E.2d at 149. See, for example, Simpson v. Phoenix Mutual Life Insurance Co., 24 N.Y.2d 262, 299 N.Y.S.2d 835, 247 N.E.2d 655 (1969).[1] The result in Crawford is also contrary to past Louisiana jurisprudence. See Michel v. Washington National Insurance Co., 315 So.2d 863 (La.App. 3 Cir. 1975); Allison v. Aetna Life Ins. Co., 158 So. 389 (La.App. 2 Cir. 1935); and Garrell v. Good Citizens Mut. Ben. Ass'n, 204 La. 871, 16 So.2d 463 (1943). Irrespective of its merits, Crawford's rationale is inapplicable here. The adverse selection factor is not present. Eligibility can be contested only if allowing coverage extends the risk beyond that contemplated by the insurer when the policy was written. Continental's exposure was not increased because the Jacksons' thirty-five year union was not blessed by the sacrament of matrimony. Their unmarried state, a very technical point in this factual situation, was apparently insignificant to Phillip and Beulah Jackson. He listed her as his "spouse" for insurance purposes. One who is, for all practical purposes, a spouse should not be barred from recovery by an irrelevant legal status. "[A]n immaterial, technical breach of condition should not be the occasion for forfeiture." 1979 Ill.Law Forum 817.

A dependent concubine or "common law wife" can recover workmen's compensation benefits because the insurer should not "benefit by the windfall" of discovering that there was an illicit rather than licit relationship. Henderson v. Travelers Insurance Co., 354 So.2d 1031 at 1034 (La.1978). Similarly, Continental, who has been paid premiums for life insurance coverage on Beulah Jackson, should not benefit from the belated discovery that she maintained a marital relationship without a legal marriage. For purposes of group insurance, there is no reason to distinguish between a dependent concubine who is scheduled as the "spouse" in an insuring agreement and a legal spouse.

The incontestability provision bars the defense urged by Continental because Jackson's policy had been in force over two years and the premiums had been paid. See Bernier v. Pacific Mut. Life Ins. Co. of California, 173 La. 1078, 139 So. 629 (1932).

For the foregoing reasons, the judgment of the trial and appellate courts herein are reversed and judgment is entered in favor of plaintiff, Phillip Jackson, for the benefits due under his policy with Continental Casualty Company for the death of Beulah Jackson.

REVERSED AND RENDERED.

CALOGERO, J., concurs and assigns reasons.

DENNIS, J., concurs with reasons.

*1366 LEMMON, J., dissents.

BLANCHE and MARCUS, JJ., dissent and assign reasons.

CALOGERO, Justice, concurring.

I respectfully concur being of the opinion that the insurer in this case was barred by the incontestability clause in the policy from disputing the status of Beulah Jackson at the time of her death. I believe, however, that the distinction between a legal spouse and a common law spouse is more than an "immaterial, technical breach of condition" and that such a distinction may allow an insurer to defend against liability under a dependant coverage policy provision if the insurer contests the designation within the time limits of the policy's incontestability clause.

DENNIS, Justice, concurring.

I respectfully concur.

The incontestability clause in the insurance contract is very broad and general. It says that:

"Coverage as to any Insured Employee shall be incontestable, except for non-payment of premium after such coverage has been in force for two years from the Effective Date, and any statement made by any Insured Employee relating to his insurability under this policy shall not be used in contesting the validity of insurance with respect to which such statement was made unless it is contained in a written statement signed by the Insured Employee, nor shall such statement be used at all after the insurance has been in force prior to the contest for a period of two years during the lifetime of the Insured Employee."

The ordinary rules of construction apply to the incontestable provisions. In the absence of any doubt as to the meaning of the contract, the intention of the parties must be ascertained from the instrument.

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

Related

State v. Monroe
198 So. 3d 259 (Louisiana Court of Appeal, 2016)
Washington v. COLONIAL LIFE & ACCIDENT INSURANCE COMPANY
974 So. 2d 721 (Louisiana Court of Appeal, 2007)
Clements v. FOLSE EX REL. CLEMENTS
830 So. 2d 307 (Louisiana Court of Appeal, 2002)
Yumukoglu v. Provident Life & Accident Insurance
131 F. Supp. 2d 1215 (D. New Mexico, 2001)
Crigler v. Crigler
671 So. 2d 1199 (Louisiana Court of Appeal, 1996)
Groll v. Safeco Life Insurance
3 Pa. D. & C.4th 49 (Montgomery County Court of Common Pleas, 1989)
Hebert v. Hebert
535 So. 2d 1266 (Louisiana Court of Appeal, 1988)
Harris v. First Assurance Life of America
526 So. 2d 245 (Louisiana Court of Appeal, 1988)
Matherne v. Rise
479 So. 2d 580 (Louisiana Court of Appeal, 1985)
Hebert v. Neyrey
432 So. 2d 396 (Louisiana Court of Appeal, 1983)
Carter's Ins. Agency, Inc. v. Franklin
428 So. 2d 808 (Louisiana Court of Appeal, 1983)
McClelland v. Security Indus. Ins. Co.
426 So. 2d 665 (Louisiana Court of Appeal, 1982)

Cite This Page — Counsel Stack

Bluebook (online)
412 So. 2d 1364, 1982 La. LEXIS 10762, Counsel Stack Legal Research, https://law.counselstack.com/opinion/jackson-v-continental-cas-co-la-1982.