Kalodner v. Genworth Life & Annuity Insurance Co.

262 F. Supp. 3d 218
CourtDistrict Court, E.D. Pennsylvania
DecidedJune 26, 2017
DocketCIVIL ACTION NO. 16-4817
StatusPublished

This text of 262 F. Supp. 3d 218 (Kalodner v. Genworth Life & Annuity Insurance Co.) is published on Counsel Stack Legal Research, covering District Court, E.D. Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Kalodner v. Genworth Life & Annuity Insurance Co., 262 F. Supp. 3d 218 (E.D. Pa. 2017).

Opinion

MEMORANDUM

Padova, District Judge

Plaintiff Philip P. Kalodner commenced this breach of contract action against Defendant Genworth Life and Annuity Insurance Company in order to challenge the methods by which Defendant calculated the Cost of Insurance in assessing Plaintiffs premiums under a Whole Life Insurance Policy. Defendant has moved to dismiss the First Amended Complaint (“the Complaint”) pursuant to Federal Rule of Civil Procedure 12(b)(6) for failure to state a claim upon which relief can be granted. For the following reasons, we grant Defendant’s Motion.

I. BACKGROUND

The Complaint alleges that, in 1999, when Plaintiff was 68 years old, he purchased a $500,000 flexible premium adjustable life insurance policy (the “Policy”) from Defendant. (Compl. ¶¶ 1-2, 8.) The Policy provides that Plaintiff will pay monthly premiums and, consistent with that obligation, Plaintiff has made more than $145,000 in premium payments over the life of the Policy. (Id. ¶¶ 6, 21.) Defendant charges against the paid premiums a monthly “Cost of Insurance” fee as well as other charges and fees. (Id. ¶6.) At the same time, Defendant credits Plaintiffs account with monthly interest on the accumulated premiums, and the Policy guarantees that the monthly interest credited will be calculated at an annual rate of at least 4%. (Id. ¶¶ 6, 8.)

The Cost of Insurance rate is calculated by means of a formula set forth in the policy, which is “‘based on [Defendant’s] expectation of future: mortality; interest; expenses; and persistency.’ ” (Id ¶ 6 (quoting Policy, attached as Ex. A to Compl., at 12).) Specifically, the Policy provides that Defendant will use this four-factor formula to develop a “monthly mortality rate,” and then will use this monthly mortality rate to calculate the Cost of Insurance rate, which, in turn, it will use to calculate the Cost of Insurance. (Policy at 12.) The Policy therefore provides that “[a] change in [the Cost of Insurance] rate will be due to a change in [Defendant’s] expectation in one or more of [the four] factors,” i.e., mortality, interest, expenses, and per-sistency. (Id.) The Policy also states that the Mortality Table that Defendant will use to calculate rates under the Policy will be the “Commissioners 1980 Standard Ordinary Smoker or NonSmoker Mortality Table, Sex Distinct, Age Nearest Birthday.” 1 (Compl. ¶ 9 (quoting Policy at 3); see also (Policy at 3.) Finally, attached to the Policy is a schedule of guaranteed maximum monthly mortality rates, which reflect the maximum monthly mortality rates that Defendants will use each year [221]*221from Plaintiff’s age 68 to age 99. (Id. ¶ 8; Policy at 12 and 3B).)

The insurance agent who sold the Policy to Plaintiff provided Plaintiff with a “Life Insurance Illustration.” (Id. ¶ 10; see also Life Insurance Illustration, attached as Ex. B. to Compl.) “The Illustration contained tables setting forth policy values at various future points [in time], i.e., [Policy] years 2, 5, 10, 20, 26.” (Compl. ¶ 12.). The Illustration was based on an “assumption that the planned annual premiums would be paid on schedule,” and set forth three scenarios, one with an assumption of the guaranteed interest rate of 4%, one with a continuation of the current interest rate of 6%, and one with a midpoint interest rate of 5%. (Id. ¶ 12; Compl. Ex. B at 4.) The Illustration further stated that it “ ‘assumes that the currently illustrated non-guaranteed elements’ (i.e. the interest rate and [the mortality rates calculated based on Defendant’s expectations]), ‘will continue unchanged for all years shown.’ ” (Compl. ¶ 16 (quoting Compl. Ex. B. at 2.)) It simultaneously warned that “this is not likely to occur” and that “actual results may be more or less favorable than those shown” because “[c]urrently illustrated non-guáranteed elements may change at any time.” (Compl. Ex. B. at 2.) The Illustration further indicated that, with a continued interest rate of 6%, and timely payment of annual premiums, the Policy would continue in force for 26 years, i.e., until Plaintiff reached • the age of 95. (Compl. ¶¶ 13.) At the same time, the Illustration showed that, if the interest rates decrease to either 5% or 4%, the Policy would terminate at year 16 “unless a higher premium is paid.” (Compl. Ex. B at 4, 5.) Plaintiff was required to sign the Illustration both to acknowledge that he received it and to memorialize his understanding that the “non-guaranteed elements illustrated are subject to change and that actual values- and benefits based on these non-guaranteed elements may be more or less favorable than those shown.” (Compl. ¶ 17; Compl. Ex. B at 4.)

Neither the Illustration nor the insurance agent identified the applicable Cost of Insurance rates used for the Illustration or provided Plaintiff with the schedule of annual current mortality rates that were used. (Id. ¶ 14.) Specifically, the insurance agent did not provide Plaintiff with the “Schedule of Annual Current Mortality Rates dated Septémber ,6,1995” (the “1995 Mortality Schedüle”), which Defendant used to calculate the Cost of Insurance rates that it ultimately employed. (Id. ¶ 1.5; 1995 Mortality Schedule, attached as Ex. C to Compl.) Defendant has continued using the 1995 Mortality Schedule to calculate the Cost of Insurance fates. (Id. 1Í18.) Defendant nevertheless acknowledges that it was authorized under the Policy to change the Cost of Insurance rates based on its expectations of mortality, interest, expenses and persistency. (Id. ¶ 18.) Significantly to Plaintiff, the 1995 Mortality Schedule reflects a very large, 46%, increase in mortality between age 82 and 83, after only a 9% increase the prior year. (Id. ¶ 19.)

Over the life of the Policy, Defendant continuously changed the interest rates used to calculate the interest credited to the Policy, such that the rates have ranged from 4% to more than 6%. (Id. ¶ 22.) Defendant has not, however, strayed from using the mortality rates in the 1995 Mortality Schedule in calculating the Cost of Insurance charged against the Policy, in spite of “a subsequent study by the Commissioners (based on 1990-1995 mortality experience) [that] reflected a decline in mortality rates of 15%-17%.” (Id. ¶¶ 23-24.)

On March 5, 2014, Defendant responded by letter to a request from Plaintiff for an explanation of the Cost of Insurance rates that it was using. (Compl. ¶ 18; March 5, [222]*2222014 letter, attached as Ex.- 2 to Def.’s Mot.) Defendant provided Plaintiff with a copy of the 1995 Mortality Schedule,, explained that it divided -the annual rates listed on that Schedule by 12 to determine a monthly mortality rate, and then did a calculation using the monthly mortality rat,e and, the interest rate.to determine the monthly Cost of Insurance rate. (Def.’s Mot. Ex. 2 at 2.) At the same time, Defendant reminded Plaintiff that the mortality rates in the 1995 Mortality Schedule were not guaranteed, and that it could “change the[] mortality rates due to a change.in [its] expectation of one or more of these factors: mortality, interest, expenses, and persistency.” (Id. at 3.)

On April 1, 2014, Defendant responded to a follow-up inquiry, from Plaintiff as to how it developed the nonguaranteed mortality rates set forth in the 1995 Mortality Schedule. (April 1, 2014 Letter, attached as Ex.

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Bluebook (online)
262 F. Supp. 3d 218, Counsel Stack Legal Research, https://law.counselstack.com/opinion/kalodner-v-genworth-life-annuity-insurance-co-paed-2017.