Jackson v. Western & Southern Life Insurance Co.

451 So. 2d 1244, 1984 La. App. LEXIS 9011
CourtLouisiana Court of Appeal
DecidedJune 6, 1984
DocketNo. CA 1351
StatusPublished
Cited by1 cases

This text of 451 So. 2d 1244 (Jackson v. Western & Southern Life Insurance 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
Jackson v. Western & Southern Life Insurance Co., 451 So. 2d 1244, 1984 La. App. LEXIS 9011 (La. Ct. App. 1984).

Opinion

GARRISON, Judge.

This is an appeal from a judgment of the district court dated April 26, 1983, granting judgment in favor of Mrs. Florine Jackson and awarding her $5,000.00, with an 8% penalty from August 31, 1982 until paid, plus judicial interest and all costs. From that judgment which we affirm, defendant Western & Southern Life Insurance Company appeals.

On July 1, 1974, Mrs. Florine Jackson purchased a life insurance policy with a face amount of $2,000.00 issued by defendant, insuring her life and naming her children as beneficiaries. At that time she also purchased a life insurance policy insuring her minor children and naming herself as beneficiary, which policy was given the sales name “Family Children Security Protector” policy, (hereinafter FCSP policy).

The FCSP policy provided for several types of coverage (benefits):

1. Death
2. Loss of Sight or Limbs
3. Accidental Death
4. Death, Accidental Death or Loss of Sight/Limbs While a Fare-Paying Passenger on a Public Conveyance

The FCSP policy covered the child until his 25th birthday or the FCSP “Cease Date,” in this case 7/1/99. The FCSP policy also provided exclusions for suicide under the Accidental Death Benefits and under the Loss of Sight of Limbs Benefit, which ex-[1246]*1246eluded “intentionally self-inflicted injury or self-inflicted injury while insane.” The trial judge apparently found that the FCSP policy did not provide a suicide exclusion under the Death Benefits provision. Lastly, the FCSP policy also provided an exchange clause:

“EXCHANGE While this agreement is in force an Insured Child may, upon written request and payment of the first premium within 31 days prior to the earlier of his 25th birthday and the Family Children Security Protector Cease Date, exchange the insurance on his life as of such date without evidence of insurability for any endowment or level premium limited payment life plan then issued by Western and Southern. The amount shall not be less than $1,000 nor more than five times the Life Insurance Amount. The premium rate will be that charged for the plan and amount at the then attained age of such child. No waiver of premium, accidental death, loss of sight or limbs or other additional benefit shall be included in the policy except with the consent of Western and Southern.” (emphasis supplied)

Kenneth Jackson’s FCSP policy expired on March 10, 1979, his 25th birthday. Pursuant to the exchange clause, Kenneth Jackson exchanged his FCSP policy for a new life insurance policy number 41242393 face amount $5,000.00 issued October 9, 1981. The new policy contained the following suicide exclusion:

“We will not pay any benefits if the Insured dies by suicide ... within two years from the policy date. If the policy is in force at that time, we will return the premiums you paid less any policy loan.”

While a death certificate is admissible to show only that a death occurred' and not to show the cause of death, all parties have agreed that Kenneth Jackson died by suicide on May 31, 1982.

Mrs. Florine Jackson made a claim against the policy and defendant issued a check to her in the amount of $4,509.00 and to the funeral parlor in the amount of $491.00. Mrs. Jackson negotiated the check, depositing it in a homestead account. Defendant then stopped payment on both checks and plaintiff brought this suit.1

The trial judge granted judgment in favor of plaintiff and, on a denial of a motion for new trial, provided the following written reason for judgment:

“The ‘then issued’ limitation on the exchange clause is potestative and invalid.”

On appeal, defendant-appellant argues:

1. That the FCSP policy did contain a suicide exclusion, hence the policy issued to Keith Jackson for the face amount of $5,000.00 was not more restrictive than the FCSP policy.
2. The “then issue” clause is not a potestative condition.
3. The issue of compromise is not before the court.

Counsel for plaintiff raised the third argument that defendant’s issuance of the initial checks in response to plaintiff’s claim under the policy was evidence of a compromise. This issue is blatently erroneous as no denial of coverage was in exis-tance at the time the check was issued and no suit or demand in response to a denial was filed or made. While there is an interesting negotiable instrument question inherent in this fact situation, it deals with persons who are not party to this suit and the issue is not properly before this court. Accordingly, this issue .will not be further addressed.

The Kenneth Jackson policy issued for the face amount of $5,000.00 contained the following language:

“We will not pay any benefits if the Insured dies by suicide, while sane or insane, within two years from the policy date. If the policy is in force at that time, we will return the premiums you paid less any policy loan.” (emphasis supplied)

[1247]*1247Because this policy was issued as a result of the exercise of the exchange clause in the FCSP policy, the $5,000.00 policy also contained the following additional language:

“This policy is issued under a right to exchange or option in another policy, number 7458651, or in a rider attached to it. This policy requires the insured to be in good health when the policy is received and the first premium is paid. We waive this requirement. This policy also provides that the incontestable period will start with this policy’s date. We will use an earlier date. That date will be the date of the other policy of the applicable rider or, if reinstated, the date of the last reinstatement.” (emphasis supplied)

Under the above language, we find that the “policy date” of the $5,000.00 policy is July 1, 1974, the date of the previous policy. Accordingly, Kenneth Jackson’s death by suicide, occurring on May 31,1982 was well beyond the “two years from the policy date” time period which thus ended on July 1, 1976. See also: R.S. 22:170(B)(3).

In Brady v. Fidelity Mutual Life Association, 13 Orl.App. 35 (1916), Judge Charles F. Claiborne as organ of the court stated:

“A clause in a policy making it incontestable after two years from its date will control an agreement in the application that death by suicide is not covered by the policy so that such death by suicide after the expiration of that period will not defeat liability on the policy.”
⅝ ⅝ ⅜! Sfc ⅝! ⅜
“The usual clause rendering the policy incontestable after it has been in force for a specified time excludes the defense of breach of condition by suicide, after the policy has thus become incontestable.” (AT 39).

The actual language of the FCSP policy is as follows:

“DEATH BENEFIT

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Related

Brindis v. Mutual Life Ins. Co. of New York
560 N.E.2d 722 (Massachusetts Appeals Court, 1990)

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Bluebook (online)
451 So. 2d 1244, 1984 La. App. LEXIS 9011, Counsel Stack Legal Research, https://law.counselstack.com/opinion/jackson-v-western-southern-life-insurance-co-lactapp-1984.