LeMay v. Metropolitan Life Insurance

262 A.D. 313, 28 N.Y.S.2d 950, 1941 N.Y. App. Div. LEXIS 5355
CourtAppellate Division of the Supreme Court of the State of New York
DecidedJuly 2, 1941
StatusPublished
Cited by1 cases

This text of 262 A.D. 313 (LeMay v. Metropolitan Life Insurance) is published on Counsel Stack Legal Research, covering Appellate Division of the Supreme Court of the State of New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
LeMay v. Metropolitan Life Insurance, 262 A.D. 313, 28 N.Y.S.2d 950, 1941 N.Y. App. Div. LEXIS 5355 (N.Y. Ct. App. 1941).

Opinion

Bliss, J.

James LeMay died on June 29, 1939, almost instantly from injuries received as the result of a fall from the second story of a building. This action is brought by his administratrix to recover the accidental death benefits under two life insurance policies issued upon his life by the defendant. The company paid the face amounts of the two policies, less certain overdue premiums and other credits due it, but refused to pay the double accidental death benefits.

Both policies were issued on a weekly premium basis in 1932 when the insured was forty-two years of age. One is a twenty-year endowment for the face amount of $370 and the other straight fife with premium payments ceasing at age seventy-four for the face amount of $594. Each policy contains the following provisions applicable to this controversy:

If any premium shall not be paid when due the policy shall lapse, subject to the provision for grace period and to the non-forfeiture privileges, and such lapse shall not be considered to have been waived by the company in any respect by reason of the acceptance of overdue premiums upon this or any other policy.

A grace period of four weeks for the payment of every premium except the first.

An accidental death benefit providing that upon receipt of proof of the accidental death of the insured while this policy is in force, and while premiums are not in default beyond the grace period specified in this policy, the company will pay an accidental death benefit equal to the face amount of the insurance payable at death. This accidental death benefit is granted without specific extra premium being charged therefor, the cost" being included in the premium for this policy.

Under non-forfeiture privileges, a free policy provision to the effect that after premiums on the policy have been fully paid for at least three years, then in case of default in the payment of any subsequent premium the company will, without action on the part of the holder, continue this policy as a non-participating free policy payable on the same conditions as this policy for a reduced amount without disability benefits.

A cash surrender provision.

[315]*315The endowment policy had lapsed and • been revived at least once and the life policy had lapsed and been revived three times. At the time of death the weekly premiums due on each policy were in arrears for a period of five weeks and two days, or one week and two days beyond the grace period. After death the defendant credited to itself the amount of premium arrears on each policy and certain other liens thereon and paid the face amounts. The plaintiff claims that the defendant thereby waived any lapse or forfeiture and demands judgment for the accidental death benefits. The defendant says that it paid the face amounts under the terms of a so-called concession ” granted by the company on March 1, 1939, which, by its terms, specifically excluded accidental death benefits. It also sets up the provisions of the accidental death benefit indorsements to the effect that such benefits are payable only “ while premiums are not in default beyond the grace period specified in this policy.”

The Special Term was of opinion that at the time of death plaintiff’s intestate was in default, that the policies had lapsed, that the defendant was not bound by the terms of the policies to pay anything and that the acceptance by the company of the overdue premium was not a waiver of default. It also held that the so-called “ concession ” of the defendant was not binding on the plaintiff and that there were no issues of any fact to be tried out. This concession above mentioned consisted of instructions to agents under date of March 1, 1939. We agree with the Special Term that the concession was not a part of the insurance contract. Nor do we need to determine whether the retention of the premium arrears by the company by deducting the same from the face amounts of the policies constituted a waiver. We believe that the questions here in issue must be resolved along other lines.

These policies were issued by a domestic life insurance company and are governed by the laws of our jurisdiction. At the time of their issue section 88 of the Insurance Law, as amended by chapter 291 of the laws of 1929, provided so far as here applicable: If any policy of life insurance (other than a term policy for twenty years or less); issued on or after January first, nineteen hundred and seven, by any domestic life insurance corporation, after being in force three full years, shall by its terms lapse or become forfeited by the non-payment of any premium * * * the reserve on such, policy * * * together with the value of any dividend additions upon said policy, after deducting any indebtedness to the company, * * * shall upon demand not later than three months after the date of lapse with surrender of the policy be applied as a surrender value as agreed upon in the policy, provided [316]*316that if no other option expressed in the policy be availed of by the owner thereof, and if the policy itself does not direct what option shall become operative in default of selection by the owner, the same shall be applied to continue the insurance in force at its full amount including any outstanding dividend additions less any outstanding indebtedness on the policy * * * and provided further that any attempted waiver of the provisions of this paragraph in any application, policy or otherwise, shall be void.”

This statute must be read into these policies and considered as part of their terms. They come within its provisions. By their terms they lapsed or became forfeited by the non-payment of premiums. Also they did not direct what option should become operative in default of selection by the owner; consequently under the statute the reserves thereon had to be applied to continue the insurance in force “ at its full amount.” While the record does not show the amount of the reserve which had been built up under each policy, and the complaint might well be amended in this respect, in view of the cash surrender value tables contained in the policy, that such reserves were greatly in excess of the amounts necessary to continue the insurance in force at its full amount for the brief period of default. The company does not contend to the contrary. Our question then is whether the words “ full amount ” in the statute include the benefits payable upon the life of the insured in case of accidental death, as contended by the appellant, or mean only the face amounts of the policies, as contended by the respondent company. The policies recognize a distinction between the amount payable in case of accidental death and the face amounts of the policies. They say that in case of accidental death the company will pay a benefit “ equal to the face amount of insurance then payable at death.” Ordinarily the expression full amount ” would include all benefits under the policies. This includes the accidental death benefit. Anything less than that is not the full amount. Further proof of this interpretation of the statute is found in the fact that when the statute was amended to its present form (Insurance Law, § 208) the expression full amount ” is no longer used and the statute now specifically excludes any additional benefits on account of death by accident. Ordinary usage of the term full amount ” includes all amounts payable under the policy.

Each policy is one single contract of life insurance. It is not a policy of life insurance and also a policy of accident insurance.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Le May v. Metropolitan Life Insurance
269 A.D. 502 (Appellate Division of the Supreme Court of New York, 1945)

Cite This Page — Counsel Stack

Bluebook (online)
262 A.D. 313, 28 N.Y.S.2d 950, 1941 N.Y. App. Div. LEXIS 5355, Counsel Stack Legal Research, https://law.counselstack.com/opinion/lemay-v-metropolitan-life-insurance-nyappdiv-1941.