Johnson v. Metropolitan Life Insurance

24 Misc. 3d 956, 880 N.Y.S.2d 842
CourtNew York Supreme Court
DecidedMay 21, 2009
StatusPublished

This text of 24 Misc. 3d 956 (Johnson v. Metropolitan Life Insurance) is published on Counsel Stack Legal Research, covering New York Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Johnson v. Metropolitan Life Insurance, 24 Misc. 3d 956, 880 N.Y.S.2d 842 (N.Y. Super. Ct. 2009).

Opinion

OPINION OF THE COURT

Michael D. Stallman, J.

In this action to recover under two insurance policies, plaintiffs Janet Johnson and Albert Nicklas (Nicklas) move, pursuant to CPLR 3212, for summary judgment on the complaint, and for the dismissal of defendant’s counterclaims. Defendant Metropolitan Life Insurance Company (MetLife) cross-moves for leave to amend its answer to include a claim under the New Jersey Insurance Fraud Prevention Act (FPA).

These motions raise unusual questions concerning choice of law and the applicability of the USA PATRIOT Act’s anti-money laundering provisions.

Background

On June 10, 2003, MetLife issued two policies of life insurance on the life of George Nicklas (decedent), Johnson’s uncle, a policy for $700,000, policy number xxx-xxx-909-xx (909 policy), of which Johnson was the beneficiary, and a policy for $250,000, policy number xxx-xxx-869 xx, of which Nicklas was [958]*958the beneficiary. As relevant herein, the decedent, a New Jersey resident, indicated on the applications that he would be paying the premiums on the policies. (See aff of Thomas M. Campbell, exhibit 1, complaint, exhibits 1, 2.) On July 10, 2003, ownership of the 909 policy was transferred to Johnson. (Notice of motion, exhibits 3, 4.)

Despite the indication on the applications that decedent would be paying the premiums on the policies, all of the premiums appear to have been paid by Johnson’s husband, Tony Stanley.1 On three occasions, Stanley overpaid the premiums, and, on each occasion, the refund was returned to decedent, as if he had paid the premium.

In a letter dated November 29, 2004, MetLife unilaterally purported to void both policies ab initio, on the ground that Stanley, as an unidentified third party, had been making the premium payments. MetLife has not returned the premiums already paid, although it claims that it has attempted to do so on at least two occasions, but has received no instructions from plaintiffs as to how that should be accomplished.

Decedent died on August 12, 2005. Plaintiffs provided notices of claim to MetLife on September 23, 2005. (Complaint, exhibit 4.) MetLife disclaimed in a letter dated November 2, 2005 (id., exhibit 5), on the ground that the policies had been previously voided, as well as on the ground that there were “questions raised as to the possibility that [the insured] may not have even participated in the application process.” (Id. at 1.)

Plaintiffs maintain that they are entitled to summary judgment because MetLife cannot provide a viable excuse for its failure to pay on the policies, in that it had no right to void them. They claim that there is no express provision in the policies which prevents the payment of premiums by anyone other than the person named therein. Indeed, the applications provide a space to identify an “other” payor of the premiums, albeit with questions concerning his or her relationship to decedent, and annual income. (Id.)

MetLife contends that the payment of the premiums by Stanley may have been a form of illegal speculation in insurance, which is disallowed under its underwriting practices, in con[959]*959junction with, and mandated by, the federal “USA PATRIOT Act,”2 in order to avoid potential money laundering in furtherance of terrorism. It claims to have a “strict policy” of not accepting third-party checks without knowledge of the source of the funds, especially where payment of the premiums is made by a party who is not closely related to the insured. MetLife argues that decedent falsely represented that he would be paying the premiums, and that plaintiffs actively concealed the identity of the true payor.3 It claims that it would not have issued the policy had it known that the decedent would not be paying as represented. MetLife maintains that “at minimum, MetLife would have postponed issuing the policy while it conducted an investigation with respect to whether the intended premium payor had an acceptable explanation for paying the premiums” so that it could “properly estimat[e] the degree and character of the risk it was assuming.” (MetLife’s mem of law in opposition at 2.)

MetLife also contends that decedent’s medical conditions at the time he died, which included, among other things, cirrhosis of the liver, liver failure, hepatitis, diabetes and hypertension (see aff of James J. McCarthy, exhibit E, emergency room report, dated Oct. 7, 2004), indicate illnesses of long standing, suggesting that the decedent’s true medical condition at the time that he applied for the policy, less than two years after execution of the applications, was dire. Yet, in the applications, decedent denied having any negative medical conditions at all. (Reply aff of Campbell, exhibit 1.) MetLife claims that this situation suggests that decedent misrepresented the state of his health on the applications, and insists that it needs further discovery to document decedent’s medical condition at the time of the applications, to determine whether his answers to the questions regarding his health were fraudulent.

MetLife also moves for leave to amend its answer to plead a counterclaim under the FPA, so as to avoid the two-year statute of limitations created by New York’s “incontestibility provision,” which is contained in all policies issued in this state.

[960]*960I

Cross Motion for Leave to Amend

It is well established that leave to amend pleadings “ ‘shall be freely given’ absent prejudice or surprise resulting directly from the delay.” (McCaskey, Davies & Assoc. v New York City Health & Hosps. Corp., 59 NY2d 755, 757 [1983], quoting CPLR 3025 [b]; see also Eighth Ave. Garage Corp. v H.K.L. Realty Corp., 60 AD3d 404 [1st Dept 2009].) MetLife’s cross motion to amend presents an issue as to whether this court can permit MetLife to assert a claim based on a New Jersey statute.

Although MetLife makes very little effort to present a choice of law analysis for the court’s consideration, it is apparent that choice of law standards allow for an amendment to include the FPA. “Determining which state’s law controls in [a] contract case is a matter of ‘grouping contacts’ to establish which group has ‘ “the most significant relationship to the transaction and the parties.” ’ ” (Equis Corp. v Mack-Cali Realty Corp., 6 AD3d 264, 266 [1st Dept 2004] [citations omitted].) Factors to be considered are “the places of the contracting, negotiation and performance of the contract, the location of the subject matter of the contract, and the domicile or place of business of the parties.” (Id.) With regard to contracts of insurance, under the “grouping of contacts” approach, a contract for liability insurance should be governed by the law of the state “which the parties understood to be the principal location of the insured risk,” unless another state has “a more significant relationship ... to the transaction and the parties.” (Certain Underwriters at Lloyd’s, London v Foster Wheeler Corp., 36 AD3d 17, 22 [1st Dept 2006], affd 9 NY3d 928 [2007] [internal quotation marks and citations omitted].)

The court finds that, as with a liability policy, the insured risk in a life insurance policy can be found in the state bearing the greatest relationship with the insured, i.e., the insured’s state of residence. In the present case, decedent resided in New Jersey.

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Cite This Page — Counsel Stack

Bluebook (online)
24 Misc. 3d 956, 880 N.Y.S.2d 842, Counsel Stack Legal Research, https://law.counselstack.com/opinion/johnson-v-metropolitan-life-insurance-nysupct-2009.