Jones v. Georgia Pacific Corp.

90 F.3d 114, 1996 WL 406101
CourtCourt of Appeals for the Fifth Circuit
DecidedJuly 22, 1996
Docket96-60071
StatusPublished
Cited by21 cases

This text of 90 F.3d 114 (Jones v. Georgia Pacific Corp.) is published on Counsel Stack Legal Research, covering Court of Appeals for the Fifth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Jones v. Georgia Pacific Corp., 90 F.3d 114, 1996 WL 406101 (5th Cir. 1996).

Opinion

DeMOSS, Circuit Judge:

W.J. Higgins’ group life insurance policy with his company terminated when he reached age 65. The policy provided that for 31 days following his sixty-fifth birthday he had the right to purchase an individual life insurance policy without a medical examination. If he died during that period he would receive death benefits just as if he had bought the new policy. Higgins did not purchase the individual policy within the 31-day period, and he died on the thirty-second day following his sixty-fifth birthday. Because the thirty-first day after his birthday was a Sunday, his family argues that he should have been covered for an extra day. Applying federal common law, we hold (1) that the unambiguous terms of the policy control and (2) that Higgins was not covered by the policy on the day he died. Therefore, we reverse the judgment of the district court and render judgment in favor of Georgia Pacific and Prudential.

*115 BACKGROUND

W.J. Higgins worked for Georgia Pacific Corporation until he was disabled in 1978. As a Georgia Pacific employee, Higgins was covered by a group life insurance plan issued by Prudential Insurance Company. After being disabled, Higgins was allowed to remain in the group plan until he reached age 65. Higgins turned 65 on September 23, 1993.

Shortly before his sixty-fifth birthday, Prudential sent Higgins a letter informing him that his group life insurance coverage would terminate on September 23, 1993, and that he had 31 days from his birthday in which to convert his insurance to an individual policy, by making an application and paying the first premium during the 31-day period. 1

The “thirty-first day immediately following” Higgins’ sixty-fifth birthday was Sunday, October 24, 1993. Higgins neither made application to acquire an individual policy nor submitted the first premium by that date. Likewise, on Monday, October 25, neither Higgins nor any of his heirs made application for the individual policy nor submitted the first premium required for such individual policy. Higgins died on Monday, October 25, 1993, at approximately 3:20 p.m., and that day was the thirty-second day after his sixty-fifth birthday.

After Higgins’ death, his widow and two children (“Higgins’ heirs” or the “heirs”) sought payment on the policy from Prudential. They argued that because the thirty-first day after Higgins’ sixty-fifth birthday was a Sunday (a day on which Prudential’s offices were closed), Higgins had no reasonable opportunity to comply that day, so the acquirement period (and insurance coverage) should be extended one more day. Prudential refused the claim, and Higgins’ heirs sued Georgia Pacific and Prudential (the “companies”) in Mississippi state court. The companies removed the case to federal district court pursuant to 28 U.S.C. § 1331, based upon the existence of a federal question under the Employee Retirement Income Security Act of 1974 (ERISA), 29 U.S.C. §§ 1001, et seq.

The parties stipulated that there were no genuine issues of material fact and cross-moved for summary judgment. The district court denied the companies’ motion for summary judgment and granted Higgins’ heirs’ motion for summary judgment. The district court agreed with the heirs that because the final day of the acquisition period ended on a Sunday, the period should be extended for one day. Thus, in the district court’s view, Higgins died within the acquisition period and was still covered by the life insurance policy. The companies filed a timely notice of appeal.

DISCUSSION

Our review of this appeal turns on two questions: First, are the relevant provisions of the policy ambiguous; and second, under federal common law, when a private *116 contract provides that an offer is to be accepted within a certain number of days, and the last day falls on a Sunday, must the offeree accept by that day, or is he given until the next business day to accept. We hold that the offeree must accept by the last day provided for in the offer, even if it is a Sunday.

We begin by noting that federal common law, rather than state law, applies in this case. Todd v. AIG Life Ins. Co., 47 F.3d 1448, 1451 (5th Cir.1995). 2 In ascertaining the applicable federal common law, we may “draw guidance from analogous state law.” Brandon v. Travelers Ins. Co., 18 F.3d 1321, 1325 (5th Cir.1994) (internal quotation omitted). ‘We must nevertheless bear in mind that, in so doing, we may use state common law as a basis for new federal common law ... only to the extent that state law is not inconsistent with congressional policy concerns.” Todd, 47 F.3d at 1451 (internal quotation and brackets omitted; ellipses in original).

We have held that in construing ERISA plans we follow the rule of contra •proferentem, which dictates that “when plan terms remain ambiguous after applying ordinary principles of contract interpretation, courts are to construe them strictly in favor of the insured.” Todd, 47 F.3d at 1452. In construing the contract language “[w]e interpret ERISA plans in an ordinary and popular sense as would a person of average intelligence and experience.” Id. n. 1 (internal quotation omitted).

After reviewing the insurance policy we hold that the provisions at issue in this case are not ambiguous. A person of ordinary intelligence and experience would understand what the policy provides and requires of the insured: after a person ceases being a covered individual in the group life insurance plan, he has a 31-day “acquirement period” in which to apply for and pay the first premium on an individual life insurance plan. If he does not make such application and pay such premium he will not be entitled to an individual policy. Likewise, if the individual “dies within the thirty-one day period immediately following the date he ceased to be a covered individual” under the group policy, then his beneficiaries will receive payment under the group policy as if he had applied for and paid the premium on the individual policy. These provisions are not ambiguous.

In this case, the starting date of this 31-day period is the date of Higgins’ sixty-fifth birthday — a fixed date, both as to the day of the month and the day of the week. The period consists of the 31 days immediately following the starting date. The qualifying phrase “immediately following” can have no other meaning than the 31 days in their normal and natural sequence, without concern as to the days of the week or to the fact that the first day or the thirty-first day or any day in between may be a Saturday or a Sunday or a holiday or a Monday or a Wednesday.

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

Related

Andre Lesgras v. Aetna Life Insurance
786 F.3d 1233 (Ninth Circuit, 2015)
Humana Health Plan, Inc. v. Nguyen
17 F. Supp. 3d 638 (S.D. Texas, 2014)
Vercher v. Alexander & Alexander Inc.
379 F.3d 222 (Fifth Circuit, 2004)
Provident Life and Accident Ins. Co. v. Sharpless
253 F. Supp. 2d 874 (M.D. Louisiana, 2003)
Tucker v. Shreveport Transit Management Inc.
226 F.3d 394 (Fifth Circuit, 2000)
Transitional Learnin v. US OPM
220 F.3d 427 (Fifth Circuit, 2000)
Manning v. Hayes
212 F.3d 866 (Fifth Circuit, 2000)
Roberts v. Richard
743 So. 2d 731 (Louisiana Court of Appeal, 1999)
Sandria F. Walker v. Wal-Mart Stores, Inc.
159 F.3d 938 (Fifth Circuit, 1998)
Jackson v. Delchamps Inc
Fifth Circuit, 1998
Wegner v. Standard Insurance
129 F.3d 814 (Fifth Circuit, 1997)
Jones v. Georgia Pacific Corporation
90 F.3d 114 (Fifth Circuit, 1996)

Cite This Page — Counsel Stack

Bluebook (online)
90 F.3d 114, 1996 WL 406101, Counsel Stack Legal Research, https://law.counselstack.com/opinion/jones-v-georgia-pacific-corp-ca5-1996.