Kasper v. Metropolitan Life Insurance

244 A.D. 508, 279 N.Y.S. 810, 1935 N.Y. App. Div. LEXIS 5858
Appellate Division of the Supreme Court of the State of New York·Decided May 8, 1935·Published·Cited by 7 cases

Opinion

Crosby, J.

Defendant issued two so-called industrial policies upon the life of Frank Kuta. They were identical in form, excepting as to amounts, one being for $462, and one for $186. . Each policy, by its terms, was payable “ to the executor or administrator of the Insured, unless payment be made under the provisions of the next succeeding paragraph.” The next succeeding paragraph provides that: “ The Company may make any payment * * * provided herein to the Insured, husband or wife, or any relative by blood or connection by marriage of the Insured, or to any other person appearing to said Company to be equitably entitled to the same by reason of having incurred expense on behalf of the Insured, or for his or her burial,” etc.

The provision last quoted is called a facility of payment ” clause, and notwithstanding the fact that the policy, by its terms, is payable to the executor or administrator, the facility of payment ” provision is intended to give the insurer the option to pay to any one equitably entitled,” for any of the reasons stated therein, so as to save the expense of administration. These industrial policies are usually for small amounts, and oftentimes the normal expenses of administration would consume all or a substantial part of the avails.

After the death of the insured the defendant paid the full amount of the policies to a daughter of the insured who not only was appointed administratrix of his estate, but who, after her appointment, paid the funeral expenses of the assured. It would seem that the right of defendant to pay to this daughter was assured not only under the primary provision of the policies, but also under the terms of the facility of payment ” clause, for the insured lived with her, was cared for by her in his last illness, and his funeral was held from her home, and she afterward paid his debts and funeral expenses.

Plaintiff, however, claims the right to be paid under the following statement of facts, which, of course, must be stated as favorably to plaintiff as the record will warrant, since the jury found in his favor.

[510] Plaintiff is a nephew of the insured. While he is not named in the pohcies as beneficiary, he paid all the premiums, the policies were delivered to him, and were at all times in his possession until the death of the insured, and he thereafter delivered them to an agent of the insurer, together with proofs of death and the receipt book showing that all premiums had been paid. Plaintiff testified that, when the first policy was applie .1 for, the plaintiff, the insured, defendant’s soliciting agent and one Kenney, an assistant superintendent of defendant, were present, and that plaintiff was assured by Kenney and the soliciting agent that he (plaintiff) would be the beneficiary, and would be paid the amount of the policy, at the death of the- insured, provided he paid the premiums. Plaintiff also testified that, when the second, and smaller, policy was applied for, the same assurance was given him by the defendant’s soliciting agent.

Defendant’s agent, Kenney, disputes this version of the transaction and says that plaintiff was promised payment on the policy only if he furnished proof of having paid the funeral expenses. But we must accept the plaintiff’s version of this matter, for the question was left to the jury and they have found in plaintiff’s favor.

Plaintiff made proof by two former soliciting agents of defendant, that there was a custom of the defendant to pay the policy benefit to whomsoever paid the premiums.

Plaintiff bases his right to recover upon the doctrine of “ present election ” laid down in the case of Shea v. United States Industrial Insurance Co. (23 App. Div. 53). The instant case bears some resemblance to the Shea case, in which it is held that an oral agreement, made when the policy is applied for, that the premium payer would be paid the amount of the policy at the death of the insured, did not violate the rule against varying the terms of a written instrument by parol, but constituted a “ present election ” by the insurer to pay to someone other than the administrator pursuant to the option reserved to the insurer under the facility of payment ” clause. In other words, that the insurer exercised its option at the inception of the contract rather than waiting until the death of the insured. The Shea case has been followed in many Special term decisions and cited with approval in many more. (See, for example, Foryciarz v. Prudential Ins. Co., 95 Misc. 306; affd., 177 App. Div. 952; also Tarasowski v. Prudential Ins. Co., 113 Misc. 248.)

The doctrine of the Shea case is also upheld in La Raw v. Prudential Ins. Co. (12 F. [2d] 142).

However, I am of opinion that the doctrine of the Shea case is not controlling here. The Shea case was saturated with fraud from beginning to end, particularly at the end when, under the authority [511] of the “ facility of payment ” clause, the insurer, by paying one-fifth of the amount of the policy, obtained a settlement in full from one whose equities were no better than the plaintiff’s, and payment was not made to an administrator. The policy, by its terms, was payable to an administrator, as in the instant case.

Furthermore, in the Shea case the agent of the insurer imposed on the plaintiff, who could not read, by misinterpreting the terms of the policy at the time it was applied for. In the instant case the plaintiff could read, and he had the policies in his possession for several years, and should have known their provisions. (Metzger v. Ætna Ins. Co., 227 N. Y. 411; Minsker v. John Hancock Mutual Life Ins. Co., 254 id. 333.)

In another important particular the Shea case differs from the instant case. In the former it was stated that the defendant had instructed its agents to represent to customers that persons paying the premiums would be the beneficiaries of the policies, and that the representations were made by one having authority to bind the insurer. In the instant case plaintiff’s only proof in regard to Kenney was that he was an “ assistant superintendent.” The only proof concerning his authority and duties was given by defendant’s witness Segerson who testified that Kenney’s only duty was to supervise the work of the soliciting agents and to assist them “ to sell new business.”

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Kasper v. Metropolitan Life Insurance, 244 A.D. 508, 279 N.Y.S. 810, 1935 N.Y. App. Div. LEXIS 5858 (N.Y. Ct. App. 1935).

244 A.D. 508 (Kasper v. Metropolitan Life Insurance) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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