Jefferson County v. Thompson

766 So. 2d 138, 1999 Ala. LEXIS 284, 1999 WL 985151
Supreme Court of Alabama·Decided October 29, 1999·No. 1980168·Published·Cited by 1 cases

Opinions

COOK, Justice.

Jefferson County appeals from a judgment entered on a jury verdict in favor of Mavis Thompson in the amount of $45,000. We reverse and remand.

This dispute began when Stanley Thompson, a Jefferson County employee suffering from health problems, requested, and was granted, an unpaid leave of absence effective November 2, 1993.1 His last day of active employment was October 27, 1993. As of that date, Thompson’s life was insured by GroupAmeriea Insurance Company under a group policy administered by Jefferson County as an employ[139] ment benefit. The policy provided benefits under (1) a “basic, noncontributory” plan (“basic plan”), and (2) a voluntary, supplemental, “contributory” plan (“contributory plan”).

The County paid the premiums for the basic plan. Payments for the contributory plan were $3.83, deducted semimonthly from Thompson’s paycheck and paid by the County to GroupAmerica. These payments were to provide coverage on Thompson’s life (1) under the basic plan in the amount of $39,000, and (2) under the contributory plan in the amount of $85,000.

Coincident with Thompson’s unpaid leave of absence, his paychecks, and, therefore, his deductions, stopped. However, in connection with his leave of absence, Thompson executed a “REQUEST FOR LEAVE OF ABSENCE” form, which included the following provision: “To insure the continuation of health, dental and other insurance coverage, I must contact the Hospital Personnel Office immediately to make arrangements for advance payment of insurance premiums.”

Thompson never returned to work. He died on April 2, 1994. His widow, Mavis Thompson, filed a claim for life insurance benefits under his group policy. Group-America paid the $39,000 under the basic plan. However, it refused to pay the $85,000 contributory-plan benefits, on the ground that Thompson had not paid the premiums after he went on leave, and, therefore, had allowed that coverage to lapse.

On July 12, 1994, Mrs. Thompson addressed a letter to the Jefferson County Personnel Department, attaching a check payable to Jefferson County in the amount of $50.00 as an offer of payment of the unpaid premiums. On October 22, 1994, she addressed a similar letter and offer of payment to GroupAmerica. Her checks were returned uncashed.

On April 2, 1996, Mavis Thompson, individually and as administratrix of the estate of Stanley Thompson, deceased, sued Jefferson County on a breach-of-contract theory. She alleged that the County “at some point in time and without notice, did stop sending in life insurance premiums for the [contributory] policy.” She also made a claim against the County based on a breach-of-fiduciary-duty theory and made claims against GroupAmerica based on various theories.

The cause proceeded to trial. At the close of the plaintiffs evidence, and again at the close of all the evidence, the County moved for a judgment as a matter of law. The court denied those motions. At some point before the jury retired to deliberate, the plaintiff settled her claims against GroupAmerica for $40,000. The jury was informed of this settlement. The jury returned a verdict in favor of the plaintiff against the County for $45,000. The trial court denied the County’s “renewed motion for judgment as a matter of law, or in the alternative, motion for a new trial.” The County appealed.

The resolution of this case turns on two questions: (1) After Stanley Thompson went on leave, did the County owe a duty to pay the premiums for the contributory plan or affirmatively to collect the premium payments from Thompson? (2) Did the plaintiff present substantial evidence indicating that Stanley Thompson paid the premiums due under the contributory plan? We answer both questions in the negative.

I. Duty

The existence of a duty is a question of law to be decided by the court. State Farm Fire & Cas. Co. v. Owen, 729 So.2d 834 (Ala.1998).

“An employer policyholder of a group health and accident plan .... does not, by reason of the peculiar position in which it is placed, become a guarantor of the payment of the insurance, nor an insurer.” 1 Eric Holmes & Mark Rhodes, Holmes’s Appleman on Insurance § 2.6, at 266-67 (2d ed.1996).

[140] Group Policy Number 908044-A, under which Thompson was insured, contained the following definitions:

“Your Basic Life Insurance is Noncontributory. Your Additional Life Insurance is Contributory.
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“LIFE INSURANCE means your life insurance under the Group Policy and includes your Basic Life Insurance and your Additional Life Insurance.
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“CONTRIBUTORY Insurance means you pay all or a part of the cost of your Insurance. If your Insurance is Contributory, the Employer determines the amount of your contribution toward the cost of your Insurance.
“NONCONTRIBUTORY Insurance means the Employer pays the entire cost of your Insurance.”

(Emphasis added.) It also provided:

“Your insurance will end automatically on the earliest of the following dates:
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“4. The last day of the last period for lohich you make the required premium contribution for your Insurance, if you contribute toward the cost of your Insurance.”

(Emphasis added.)

It is undisputed that Stanley Thompson authorized payroll deductions for the contributory-plan premium payments and that those deductions were regularly made from his paychecks. Moreover, by signing the “REQUEST FOR LEAVE OF ABSENCE” form, Thompson acknowledged his duty to keep up the premium payments on the contributory plan by means other than payroll deductions.

Thus, Stanley Thompson knew the County had not assumed the duty to pay his contributory-plan premiums, either while he was actively employed or while he was on an unpaid leave of absence. He was on notice that continued coverage depended on his making arrangements to pay the premiums during his unpaid leave. The County, therefore, had no duty to pay Thompson’s premiums for the contributory plan and had no duty to collect premium payments from him after he went on unpaid leave.

II. Sufficiency of the Evidence

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Jefferson County v. Thompson, 766 So. 2d 138, 1999 Ala. LEXIS 284, 1999 WL 985151 (Ala. 1999).

766 So. 2d 138 (Jefferson County v. Thompson) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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