Jensen v. John Hancock Mutual Life Insurance

64 N.W.2d 183, 266 Wis. 595, 1954 Wisc. LEXIS 388
CourtWisconsin Supreme Court
DecidedMay 4, 1954
StatusPublished
Cited by4 cases

This text of 64 N.W.2d 183 (Jensen v. John Hancock Mutual Life Insurance) is published on Counsel Stack Legal Research, covering Wisconsin Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Jensen v. John Hancock Mutual Life Insurance, 64 N.W.2d 183, 266 Wis. 595, 1954 Wisc. LEXIS 388 (Wis. 1954).

Opinion

Fairchild, C. J.

The certificate of insurance held by Mrs. Dora D. Jensen, whose son is the named beneficiary and respondent here, was held by her under a master policy issued to the Blecker Beauty Shops, Inc., by John Hancock Mutual Life Insurance Company. Because the provisions of the master policy are integrated in the certificate, reference hereinafter will be to the certificate, which appears in its relevant parts in the foregoing statement of facts. All the material facts are admitted. From the record it appears *599 that the effective date of the insurance was July 17, 1948; that the insured became ill and ceased active work on the following September 8, 1948; and that her last premium contribution expired on September 11, 1948. It is also agreed that on or about September 11, 1948, the employer ceased to pay premiums on said certificate in behalf of said employee and so notified the insurance carrier.

Material to this case is the fact that in 1946 an amendment was made to the master policy as originally written in 1943. Prior to 1946 the policy was a noncontributory one. However, after the occurrence of the incident giving rise to John Hancock Mut. Life Ins. Co. v. Stanley (Tex. Civ. App.), 215 S. W. (2d) 416, a different policy was issued containing the amendment which required premium contributions from employees, and stipulating as one of the dates upon which the insurance of an employee automatically ceases, the date of expiration of the period for which the last required contribution was made by such employee (paragraph (b) of the Termination of Insurance clause of the certificate).

The other date concerned in this case and stipulated in the certificate as the date on which the insurance of the employee ceases automatically appears in paragraph (a) of the Termination of Insurance clause and is the date of termination of employment, which date is expressly defined as being “the date the employee ceased active work.” Then follows a qualifying provision which reads: “However, in case the employee ceases active work due to sickness, . . . employment will be deemed to continue thereafter, for the purposes of insurance hereunder, until terminated by the employer either by written notice to the company, or by any other means. . . .” Of these two dates that which occurs earlier is, under the terms of the certificate, the one on which the employee’s insurance automatically ceases.

*600 In this case it is agreed that the employee tendered no payments after September 11, 1948. It is also agreed that the employer ceased to pay premiums on her insurance “on or about September 11, 1948,” and so notified the insurer. September 11, 1948, then is the date which must be established as that on which the employee’s insurance automatically ceased for nonpayment of premiums and is the controlling date in this case.

We are here necessarily concerned with a contract of insurance existing between the insurer and the employee. We must regard such a contract as a deliberate agreement between competent parties, upon a legal consideration, to pay a premium on the part of one and to insure the premium payer on the part of the other, pursuant to the conditions and limitations of the insurance contract agreed to by the two parties. We must also recognize the concurrence of an intention between the two parties. There would be no existing right in favor of the insured or her beneficiary but for the rights granted her in the certificate. The determining factor here is the provision in the insurance contract providing-that the insurance shall automatically cease on the date of expiration of the period for which the last required premium contribution is made by the employee. Peyton v. Equitable Life Assur. Society, 159 Pa. Super. 318, 48 Atl. (2d) 145; Miller v. Travelers Ins. Co. 143 Pa. Super. 270, 273, 17 Atl. (2d) 907; Best v. Equitable Life Assur. Society, 165 Pa. Super. 452, 68 Atl. (2d) 400.

On September 11, 1948,' according to contract, the employee had the right to make an additional premium payment to keep her insurance in force until notice was given by her employer to the insurer that her employment had ceased. She did not do this; therefore her insurance ceased automatically on that date. As a matter of fact, the privilege of allowing her to continue payments to the time thus limited would have been of no actual benefit to her as it was *601 agreed that the employer did notify the insurer “on or about September 11, 1948,” that her employment had terminated.

In connection with the paying of additional premiums after September 11, 1948, in order to keep the insurance in force, the respondent urges that the employee’s policy matured on the date of her disability and that she was therefore’ no longer required to make premium contributions. This contention cannot be maintained. The insurance involved here is designed to grant benefits only in case of death; it does not grant benefits for disability. The policy could not mature until the death of the employee, and respondent cannot avoid lapse by creating maturity. The policy could, therefore, be kept in force only by continued payment of premiums. When these stopped, the insurance terminated for nonpayment of premiums.

Although termination of employment is not a controlling factor in the final outcome of this appeal, a discussion of such termination arises here because of respondent’s contention that employment could terminate only by means of notice to the employee from her employer; and that, such notice having never been given, certain coverage rights began to run from the date of the employee’s death. Such an interpretation of the contract would make the provision that insurance automatically ceases upon payment of the last required contribution dependent upon the accident of when an employer served his employee with formal notice of termination of employment, or whether he did so at all, since respondent eliminates the necessity of paying further premiums after disability. It would defeat the whole purpose of the amendment to the policy, which was inserted for the express purpose of avoiding such an incident as arose in the case of John Hancock Mut. Life Ins. Co. v. Stanley, supra. The certificate held by the employee is an agreement between her and the insurer only. It cannot compel her *602 employer to give notice, and if she is injured by his failure to do so, it is a matter for action between her and her employer. It is true that an employer cannot notify an employee of termination of her employment by giving notice of such termination to an insurance company or any third party. But the terms of the contract do not provide that the employee must be notified by her employer in order that her employment be terminated. On the contrary the agreement is that termination of employment shall occur on the date on which the employee ceased active work. The modifying provision applicable to an employee who ceases active work because of sickness in no way affects the date of termination of employment.

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Cite This Page — Counsel Stack

Bluebook (online)
64 N.W.2d 183, 266 Wis. 595, 1954 Wisc. LEXIS 388, Counsel Stack Legal Research, https://law.counselstack.com/opinion/jensen-v-john-hancock-mutual-life-insurance-wis-1954.