Ledoux v. Old Republic Life Insurance Company

233 So. 2d 731, 1970 La. App. LEXIS 5517
CourtLouisiana Court of Appeal
DecidedMarch 26, 1970
Docket2991
StatusPublished
Cited by53 cases

This text of 233 So. 2d 731 (Ledoux v. Old Republic Life Insurance Company) is published on Counsel Stack Legal Research, covering Louisiana Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Ledoux v. Old Republic Life Insurance Company, 233 So. 2d 731, 1970 La. App. LEXIS 5517 (La. Ct. App. 1970).

Opinion

233 So.2d 731 (1970)

Mrs. Bessie B. LEDOUX et al., Plaintiffs and Appellees,
v.
OLD REPUBLIC LIFE INSURANCE COMPANY, Defendant and Appellant.

No. 2991.

Court of Appeal of Louisiana, Third Circuit.

March 26, 1970.
Rehearing Denied April 14, 1970.

*733 Seale, Smith, Baine & Phelps, by Donald S. Zuber, Baton Rouge, for defendant-appellant.

Frugé & Foret, by Jack C. Frugé, Ville Platte, for third party defendant.

Young & Burson, by I. J. Burson, Eunice, for plaintiff-appellee.

Before SAVOY, HOOD and CULPEPPER, JJ.

CULPEPPER, Judge.

This is a suit for benefits and penalties under a group policy of credit life insurance. The plaintiffs are (1) Mrs. Bessie B. Ledoux, widow of Wilbur Ledoux, whose life was insured, and (2) the Basile State Bank, creditor of the debt which was insured. The defendant, Old Republic Life Insurance Company, issued the policy in question. Defendant filed a third party demand against its agents who wrote the insurance. From an adverse judgment, defendant appealed.

The substantial issues are: (1) Are three certificates of insurance totaling $16,800, issued to Mr. Ledoux in connection with loans he made from the bank, subject to the $10,000 limitation of coverage set forth in the group policy held by the bank? (2) Is the defendant insurer barred by estoppel, waiver or ratification to urge as a defense the $10,000 limitation in its group policy? (3) Is defendant's third party demand against its agents barred by ratification? (4) Penalties?

There is little dispute as to the facts. In May of 1967 a Mr. Wilson, representing Old Republic Life Insurance Company, contacted Mr. Fulton A. Bacon, president of the Basile State Bank, requesting that the bank use defendant's credit life insurance facilities. Following these discussions, the defendant entered into an agency agreement whereby Mr. Bacon, the president of the bank, was appointed agent to issue certificates of insurance under a group policy which was held by the bank. Mr. Bacon in turn designated certain bank employees to actually write the insurance at the time of the loans.

The agency agreement provides that the agent shall not bind the company "in an amount greater than $10,000 on any one life." The group policy delivered to the bank provides generally that subject to its terms and conditions and upon receipt of *734 proof of death of any insured debtor, the insurer agrees to pay to the bank the amount of insurance then in force with respect to such debtor. Any balance remaining after payment of the debtor's indebtedness to the bank is paid to the estate of the debtor. The policy contains a limitation that "In no event, however, shall the aggregate amount of insurance under this policy on the life of any one debtor exceed at any time $10,000."

During the year 1968 Mr. Wilbur Ledoux made several loans with the Basile State Bank. The defendant, Old Republic Life Insurance Company, through its agents at the bank, issued credit life insurance certificates on three of these loans. The form used for these certificates provides for two types of insurance. The first is "Decreasing Term Life Insurance" on which the premium rate is 1% of the loan and the benefits decrease as the indebtedness decreases. The other type is "Level Term Life Insurance" on which the premium rate is 2% of the amount of the loan and the benefit remains the same throughout the term of the insurance. All three of the certificates issued by defendant to Mr. Ledoux were for Level Term Insurance. The first was issued on March 7, 1968 in the sum of $6,000 for a term of one year, the second on June 6, 1968 in the sum of $8,000 for a term of three months and the third on July 24, 1968 in the sum of $2,800 for a term of two months.

Mr. Wilbur Ledoux died on August 26, 1968 at which time he owed the bank about $30,000, insured by various companies. The face amount of three certificates of insurance issued by defendant and in effect was $16,800. On receiving notice of the death of Mr. Ledoux, the defendant tendered to the plaintiffs two drafts, one in the sum of $6,000, which was accepted, and the other in the sum of $4,000, which was refused. Defendant contends the benefits are limited to $10,000 under the limitation in the group policy.

The first issue is whether the $10,000 limitation, which appears in the group policy held by the bank but does not appear in the certificates of insurance issued at the time of each loan, is a part of the contract between the parties. The pertinent facts show that the certificates of insurance set forth the name of the insured, the name of the bank, the amount of insurance issued at the time of each loan, the effective dates of the coverage and then state in part:

"This is to certify that the person named above, who is indebted to the creditor, also named above, is insured under and subject to all of the terms and conditions of group policies (then follows a description of the group policy in question) * * *"

* * * * * *

"The group policies are in the possession of the policy holder and may be inspected by the insured at any time during business hours at the office of the policy holder."

As a general rule, any application, rider, endorsement, or other paper becomes a part of a contract of insurance if sufficiently attached or referred to in the documents concerned, 43 Am.Jur.2d 345-350, Verbo Insurance, Sections 283, 287; 44 C.J.S. Verbo Insurance, § 301, pp. 1209-1214. However, the manner in which the document is attached or referred to must clearly indicate an intention of the parties that it and the policy are parts of the same contract and must be construed together, Annotation 38 A.L.R. 1520, et seq. These general rules are followed in Louisiana cases dealing with certificates which refer to group policies of insurance, Austin v. Metropolitan Life Insurance Company, 142 So. 337 (La.App. 2d Cir. 1932); Loubat v. Audubon Life Insurance Company, 248 La. 183, 177 So.2d 281 (1965); Finch v. Baton Rouge Production Credit Association, 154 So.2d 60 (La.App. 1st Cir. 1963).

Under these principles of law, it is clear that both the certificate of insurance and the group policy in the present case *735 must be construed together to determine the contract between the parties. The certificate specifically refers to the group policy and expressly states that the coverage is subject to the terms and conditions of the group policy. Hence, the $10,000 limitation is part of the contract intended and limits the amount of insurance on any one debtor at any one time to $10,000.

The next issue is whether the defendant insurer is barred by (1) estoppel, (2) waiver or (3) ratification to urge as a defense the $10,000 limitation in its group policy. These terms, particularly waiver and estoppel, are often used interchangeably but there are important distinctions pertinent to the present case.

Equitable estoppel (as distinguished from promissory estoppel with which we are not concerned here) arises when one by his actions, or by his silence when he ought to speak, induces another to believe certain facts and the other relies on these facts to his prejudice. In the law of agency, estoppel does not require knowledge or consent by the principal as to the unauthorized acts of his agent. See the comment, Waiver and Estoppel in Louisiana Insurance Law, 22 La.L.Rev. 202 at pages 208-211 and the authorities cited.

Waiver has been generally defined as the intentional relinquishment of a known existing legal right.

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Bluebook (online)
233 So. 2d 731, 1970 La. App. LEXIS 5517, Counsel Stack Legal Research, https://law.counselstack.com/opinion/ledoux-v-old-republic-life-insurance-company-lactapp-1970.