Lamb v. Prudential Insurance

22 A.D. 552, 48 N.Y.S. 123
Appellate Division of the Supreme Court of the State of New York·Decided July 1, 1897·Published·Cited by 8 cases

Opinion

Bradley, J.:

The action was brought to recover the amount of the insurance upon the life of the plaintiff’s intestate by the policy of the defendant of date August 24, 1891. She was the wife of the plaintiff and died June 18, 1895. The defense is that, by reason of default in [553] payment of the premium, the policy had become inoperative at the time of her decease. The policy in question was one of eight policies issued by the defendant upon the lives of the plaintiff, his wife and their minor children. The aggregate amount of the premiums, payable weekly upon them, was fifty-five cents. These were paid up to April 15, 1895. The policy in question provided that “if for any reason the premium ” should not be collected by the agent when due it would be the duty of the insured, before the premium should be in arrears four weeks, to bring or send it to the home office or to the company’s agent, and in the event of the failure to perform this duty the company might “ cancel this policy without notice to any person or persons interested therein.” All the policies were presumably the same in every respect. It does not appear that any action was taken by the defendant to cancel any of the policies prior to the 17th day of June, 1895, when the plaintiff called at the office of the defendant, and ascertained that the amount of premiums then unpaid upon the eight, policies was four dollars and ninety-five cents. He then paid four dollars and forty cents and stated that he would pay the other fifty-five cents on the call of the agent at his house the next Monday. The agent did not call and the plaintiff paid that residue on July eleventh. If there had been nothing to qualify the effect of those payments, the acceptance of them would have operated as a waiver of the default. But at the time each of those payments was made, the agent of the defendant gave the plaintiff a receipt to the effect that “ if the company accept the revival application the amount paid will be credited in the premium receipt book belonging with the policy, otherwise the money will be returned,” and that upon no circumstances will the company be liable under said policy in case of death until the policy has been revived on the books of the company and the money credited in the premium receipt book belonging to said policy.”

It does not appear that the plaintiff was advised by the policy, or otherwise than by the receipt, that anything to be done by the insured or by him was requisite to the revival of the policy. He knew that the insured was nine weeks in arrears in payment of the premium when he paid the four dollars and forty cents. And by reference to the policy he could have seen the provision to the [554] effect that it would be void if the weekly premium was not paid according to its terms, with the consequence that the premiums which had been paid would be forfeited to the company, and that its agents were not authorized to make, alter or discharge contracts or waive forfeitures or receive premiums on policies in arrears beyond the time allowed by the regulations of the company, which in no case shall exceed four weeks.”

The situation was such,- when the plaintiff made the payments in June and July, 1895, as to enable the defendant to qualify the receipt of the money by the conditions expressed in the receipts, one of which conditions was the acceptance by the company of the revival application. The import of this was that some application for the purpose was to be made by or in behalf of the insured. This was not done in behalf of the plaintiff’s intestate. And it may be that if the defendant’s officer or agent, at the time the payment was made, had known her physical condition, he would have declined to receive so much of the amount as covered the weekty premium of ten cents, amounting to ninety cents in arrears on the policy issued to her. She was at that time very ill, not expected by the plaintiff to survive her then existing illness, and she died the next day. Of this condition of the insured the defendant’s agent was not advised. And when the proofs of death were soon after furnished to the company it declined to pay. Up to that time no fair and reasonable interpretation of what had occurred can permit the conclusion of waiver of the default in payment of the premium on the policy taken by the intestate, or estop the defendant from asserting forfeiture. While an insurance company will not be allowed any benefit from the doubtful construction of the terms of its policy, nor will any prejudice to the insured or those who represent him be permitted therefrom, the provisions of a policy of insurance, like those of other contracts, are to be observed, and the legal rights of the parties governed by them. It is essential to the waiver of a forfeiture of a policy that there be a recognition of its validity with knowledge of such forfeiture. (Weed v. L. & L. Fire Ins. Co., 116 N. Y. 106.) And then it can be done only by an agent who is not denied by the policy power to do it. (Marvin v. Universal Life Ins. Co., 85 N. Y. 278.)

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Lamb v. Prudential Insurance, 22 A.D. 552, 48 N.Y.S. 123 (N.Y. Ct. App. 1897).

22 A.D. 552 (Lamb v. Prudential Insurance) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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