Kahn v. Great-West Life Assurance Co.

61 Misc. 2d 918, 307 N.Y.S.2d 238, 1970 N.Y. Misc. LEXIS 1940
CourtNew York Supreme Court
DecidedJanuary 27, 1970
StatusPublished
Cited by11 cases

This text of 61 Misc. 2d 918 (Kahn v. Great-West Life Assurance Co.) 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
Kahn v. Great-West Life Assurance Co., 61 Misc. 2d 918, 307 N.Y.S.2d 238, 1970 N.Y. Misc. LEXIS 1940 (N.Y. Super. Ct. 1970).

Opinion

John A. Garbarino, J.

The plaintiff, Mindy H. Kahn, is the designated beneficiary on a certificate of group life insurance issued by the defendant, the Great-West Life Assurance Company, an alien Canadian company licensed to do business in Illinois, to Sidney H. Kahn, a New York dentist who was insured for $25,000 under a group life policy issued to the American Dental Association in Chicago, Illinois, by the defendant insurer. The plaintiff beneficiary moves for summary judgment pursuant to CPLR 3212 and the defendant insurer has made a cross motion pursuant to CPLR 2215 to dismiss the complaint.

Involved herein is a choice of laws problem and counsel for both parties are agreed that if New York law is applicable, the court’s decision should be in favor of the plaintiff beneficiary, but if the court holds that the law of Illinois is applicable, then its decision should be in favor of the defendant insurer.

For the reasons set forth below, the court holds that the law of Illinois is applicable and its decision is in favor of the defendant insurer.

[919]*919The undisputed facts in this case as they appear from the pleadings and the affidavits are that Sidney Herbert Kahn was a dentist in practice on Staten Island and was a member of the American Dental Association which maintains its central office in Chicago, Illinois. Some time prior to January 16, 1967, the defendant, in an advertisement in the Dental Association’s publication, invited members of the association to become insured under the group life insurance policy issued by the defendant to the American Dental Association. Dr. Kahn mailed a coupon clipped from the advertisement to the defendant from his home in Staten Island. In response, the defendant insurer mailed Dr. Kahn an application which he filled out and mailed to the defendant, together with a check for the first premium.

In response to the application, on or about January 16, 1967, the defendant mailed to Dr. Kahn at his New York residence a certificate of life insurance. However, and this is the crux of this entire matter, the defendant insurer did not mail a copy of the application of Dr. Kahn to the insured or to the beneficiary while Dr. Kahn was alive. The insured died in Staten Island on May 26, 1968, well within the two-year period of contestability.

The plaintiff beneficiary has demanded the policy amount of $25,000 and the defendant carrier has offered to return the premiums. The plaintiff sues in two causes of action, (1) for $25,000, the amount of the policy, and (2) for reasonable counsel fees in accordance with subdivision 4 of section 59-a of the Insurance Law of the State of New York.

The affidavit of Mindy H. Kahn submitted in support of the motion for summary judgment states candidly, page 4: the defendant has refused and still refuses to pay the said sum- of $25,000.00 to the plaintiff on the grounds that the statements of the insured in his application for insurance were false and untrue as to his physical and medical condition on the date of application; and that in truth and fact, the statements made in said application by the insured were false and. untrue when so made.”

The parties are agreed that if New York law is controlling on the failure of the defendant insurer to forward a copy of the application, the defendant insurer may not avail itself of the defense based on the fraudulent misrepresentations of the insured. Under Hlinois law, however, the insurer may defend for such fraudulent misrepresentations even though no copy [920]*920of the insured’s application had been forwarded to him or his beneficiary during the contestability period.

This brings us to the issuance of the group policy to the American Dental Association in 1934 and the issuance of the certificate to the insured in 1967, both of which documents are exhibits herein.

In evaluating the factual background, no less than the legal issues involved, it must be borne in mind that a distinction must be drawn between a certificate of insurance and the group policy (cf. Insurance Law, § 204, subd. 1; Cutler v. Hartford Life Ins. Co., 22 N Y 2d 245). New York could, by statute, regulate the certificate issued for delivery in New York, but not the group policy issued in Illinois (cf. Federal Trade Comm. v. Travelers Health Assn., 362 U. S. 293).

Prior to June 30, 1934, the American Dental Association (hereinafter called “ADA”) applied to the defendant, Great-West Life Assurance Company (hereinafter called the “ insurer ”) for a group policy to cover eligible members. Out of 30,000 eligible members, 8,000 were then insured under a group policy by a Texas company which was to terminate on June 30, 1934. The original policy, before any amendments, provided that “ The place of this policy contract for all purposes shall be the head office of the Company at Winnipeg ’ ’. However, in a covering letter dated February 13, 1935, it was stated, “ Notwithstanding the statement in the policy that the place of contract is the Head Office of the Company in the City of Winnipeg the construction of the terms of the policy is subject to the provisions of the Illinois Statutes made applicable thereto ”. The policy was substantially amended in 1959 but the above provision on the applicability of Illinois law was retained.

The master policy, as amended, constituted the contract of insurance between the individual insured members of the ADA and the defendant insurer. The certificate issued to the plaintiff’s insured in New York was merely evidence of that insurance (cf. King v. Sperry Gyroscope Co., 57 N. Y. S. 2d 684).

When Dr. Kahn applied for insurance in 1967, the following provisions, among others, were in effect:

“1. eligibility for ixsuraxce. — A Member who has not attained his 60th birthday is eligible for insurance under this policy.

“ 2. effective date of ixsuraxce.— The insurance of an eligible Member who makes written .application on the form [921]*921furnished by the Company, shall become effective, on the date the Company approves evidence of his insurability furnished by him without expense to the Company.

‘ ‘ 6. individual certificate.— The Company shall issue to each Member insured an Individual Certificate subject to the terms and conditions of this policy setting forth the insurance to which he is entitled, to whom it is payable, and containing any and all provisions regarding the termination or reduction of the Member’s insurance.

‘1 The individual Certificate shall not constitute a part of this policy, but shall contain a statement to the effect that this policy is on file at the office of the Group Policyholder and may be inspected at any reasonable time on any business day.

“17. incontestability.— The validity of this policy shall not be contested, except for non-payment of premiums, after it has been in force for two years from its date of issue, and no statement made by any Member insured under this policy relating to his insurability shall be used in contesting the validity of the insurance with respect to which such statement was made after such insurance has been in force prior to the contest for a period of two years during such Member’s lifetime nor unless it is contained in a written application signed by him.

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Bluebook (online)
61 Misc. 2d 918, 307 N.Y.S.2d 238, 1970 N.Y. Misc. LEXIS 1940, Counsel Stack Legal Research, https://law.counselstack.com/opinion/kahn-v-great-west-life-assurance-co-nysupct-1970.