Mardirossian v. Paul Revere Life Insurance

831 A.2d 60, 376 Md. 640, 2003 Md. LEXIS 524
CourtCourt of Appeals of Maryland
DecidedAugust 28, 2003
DocketMisc. No. 2, Sept. Term, 2002
StatusPublished
Cited by11 cases

This text of 831 A.2d 60 (Mardirossian v. Paul Revere Life Insurance) is published on Counsel Stack Legal Research, covering Court of Appeals of Maryland primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Mardirossian v. Paul Revere Life Insurance, 831 A.2d 60, 376 Md. 640, 2003 Md. LEXIS 524 (Md. 2003).

Opinion

ELDRIDGE, J.

In this Certified Question case, pursuant to the Maryland Uniform Certification of Questions of Law Act, Maryland Code (1974, 2002 Repl.Vol.), §§ 12-601 through 12-613 of the Courts and Judicial Proceedings Article and Maryland Rule 8-305, the United States District Court for the District of Maryland has certified the following question of Maryland law:

“Does Maryland law provide a judicial cause of action, entirely independent of the Maryland Insurance Code, for a claim to compel specific performance on an oral contract for disability insurance?”

Our answer to the question shall be “yes.”

I.

The Certification Order recites that the facts are in dispute and that, therefore, the Order sets forth the facts in a light most favorable to the plaintiff Mardirossian. In 1995 and 1996, the defendant, The Paul Revere Life Insurance Company (“Paul Revere”), issued two disability income insurance policies to Aris Mardirossian. In 1997, Mardirossian decided to procure additional disability income insurance coverage. Subsequently, in November 1997, Mardirossian was diagnosed with sarcoidosis, a disease of unknown cause characterized by the presence of small tumor-like masses of tissue containing inflammatory cells.

In January 1998, Mardirossian’s long-time insurance broker, Robert Weigert, contacted Mardirossian to discuss the possibility of obtaining additional disability income insurance coverage. At this time, Mardirossian told Weigert that he had been diagnosed with sarcoidosis. Mardirossian also discussed an application he had submitted to another insurance company, MetLife, which had just been rejected based on his history of sarcoidosis. Mardirossian explained to Weigert that, before *643 he submitted another insurance application, he wanted to be certain that his history of sarcoidosis would not be a disqualifying factor. Thus, Mardirossian asked Weigert to ascertain from Paul Revere, in advance of submitting a formal application, whether his history of sarcoidosis would be a problem. Paul Revere offered a “Pre-underwriting Consideration” review process, which allowed an applicant to inquire whether his or her application would be accepted or rejected in advance of submitting a formal application. The review process sometimes included a review of the future applicant’s financial status and medical history.

Soon thereafter, Weigert submitted Mardirossian’s financial information to Paul Revere for a pre-underwriting consideration review. Based on the information submitted, Paul Revere’s underwriting department prepared a series of proposals for insurance coverage. Weigert then contacted Tim Tehan, a managing agent at Paul Revere, to advise him of Mardiros-sian’s sarcoidosis diagnosis and of Mardirossian’s full recovery. 1 Tehan responded that he would have to check with the underwriting department to determine whether Mardiros-sian’s history of sarcoidosis would be an issue.

Subsequently, Weigert contacted Mardirossian to inform him that Tehan stated that “sarcoidosis would not be a problem.” Weigert also mentioned Tehan’s suggestion that Mardi-rossian submit to a medical examination. On May 1, 1998, Paul Revere’s underwriting department approved the final proposal in Paul Revere’s “Pre-underwriting Consideration” review process. The proposal provided for $6,150 per month in benefits until age 67, at an annual cost of $4,369.06. Both Weigert and Mardirossian understood, however, that a formal application would have to be submitted to and underwritten by Paul Revere.

Based on the assurances he received from Paul Revere, on August 4, 1998, Mardirossian met with Weigert to complete *644 the first part of his formal application for additional insurance coverage from Paul Revere. The application requested the same terms which had been approved in the May 1, 1998, final proposal, disclosed that Mardirossian had been diagnosed with “minor sarcoidosis,” and asserted that Mardirossian had experienced a “full recovery all gone!” The application was executed by Mardirossian and submitted to Paul Revere, along with a premium deposit check in the amount of $1,040.

Thereafter, a physician’s assistant met with Mardirossian at his home to complete part II of the application, which was the medical part. It was reported on part II that Mardirossian had been diagnosed with sarcoidosis, that the “condition cleared,” and that it was “last checked July 1998 — chest x-ray normal.” After answering all the physician’s assistant’s questions, Mardirossian signed the application on August 31, 1998, and submitted it to Paul Revere, together with a check in the amount of the first two months’ premium payments.

Based on the amount of coverage with Paul Revere that Mardirossian already had and the additional amount of coverage for which he was applying, Paul Revere’s underwriting department requested a second medical examination and blood test, along with copies of Mardirossian’s medical records. These additional items were furnished in September 1998.

On September 21, 1998, Paul Revere’s underwriting department denied Mardirossian’s application in light of his history of sarcoidosis. The decision was based on Paul Revere’s underwriting guideline for sarcoidosis, which provides that an application must be denied if sarcoidosis is “generalized or present.” In a letter dated September 28, 1998, Mardirossian received notice that his application was rejected because of his history of sarcoidosis. Paul Revere also enclosed a refund check in the amount of $1,040.

On October 14, 1998, Mardirossian’s attorneys sent Paul Revere a letter demanding that Paul Revere “issue the policy forthwith.” The letter also contained the refund check sent by Paul Revere, along with another check in the amount of $4,280.78, representing “the entire first annual premium.” *645 Both checks were returned to Mardirossian by Paul Revere on October 29, 1998.

Mardirossian filed a complaint with the Maryland Insurance Administration (“MIA”) against Paul Revere in October 1998. The investigator assigned to Mardirossian’s complaint, Suzanne Ballogdajan, consulted with the Chief Enforcement Officer for the MIA, John Riggle. Riggle indicated he would not be interested in pursuing an investigation, because it would be inappropriate to hold an insurance company respon-' sible for issuing a disability policy based upon an agent’s indication that the policy would be issued. Ballogdajan subsequently informed Mardirossian of the MIA’s “preliminary finding.” Mardirossian did not pursue the administrative complaint to a higher level within the MIA. 2

On March 23, 1999, Mardirossian filed a complaint against Paul Revere in the Circuit Court for Montgomery County. The complaint sought specific performance of the alleged oral contract, pursuant to which Paul Revere purportedly agreed that, upon receipt of an application and premium deposit, it would issue a disability insurance policy to Mardirossian based upon the terms previously approved by its underwriting department, notwithstanding his history of sarcoidosis.

Pursuant to 28 U.S.C. §

Related

Boyd v. Goodman-Gable-Gould
Court of Special Appeals of Maryland, 2021
United Insurance Co. of America v. Maryland Insurance Administration
144 A.3d 1230 (Court of Appeals of Maryland, 2016)
Carter v. Huntington Title & Escrow, LLC
24 A.3d 722 (Court of Appeals of Maryland, 2011)
In Re UnitedHealth Group Inc. Shareholder Derivative Litigation
754 N.W.2d 544 (Supreme Court of Minnesota, 2008)
Rausch v. Allstate Insurance
882 A.2d 801 (Court of Appeals of Maryland, 2005)
Hollaway v. UNUM Life Insurance Co. of America
2003 OK 90 (Supreme Court of Oklahoma, 2003)

Cite This Page — Counsel Stack

Bluebook (online)
831 A.2d 60, 376 Md. 640, 2003 Md. LEXIS 524, Counsel Stack Legal Research, https://law.counselstack.com/opinion/mardirossian-v-paul-revere-life-insurance-md-2003.