Massachusetts Mutual Life Insurance v. Thacher

15 A.D.2d 242, 222 N.Y.S.2d 339, 1961 N.Y. App. Div. LEXIS 7006
CourtAppellate Division of the Supreme Court of the State of New York
DecidedDecember 19, 1961
StatusPublished
Cited by10 cases

This text of 15 A.D.2d 242 (Massachusetts Mutual Life Insurance v. Thacher) 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
Massachusetts Mutual Life Insurance v. Thacher, 15 A.D.2d 242, 222 N.Y.S.2d 339, 1961 N.Y. App. Div. LEXIS 7006 (N.Y. Ct. App. 1961).

Opinions

Stevens, J.

These are companion proceedings, separately brought, under article 78, to review and annul determinations of the Superintendent of Insurance (herein called respondent) dated December 28, 1960, in which he withdrew his approval of option forms submitted by each petitioner.

The questions involve the power of respondent, under the statute, the nature of such power and, if that power be discretionary, whether in these proceedings such power has been abused.

On or about January 19,1959, respondent approved an Additional Benefit Eider, known as a guaranteed insurability option (or Insurability Protection Agreement), which was attached to and offered as part of the petitioners’ public policies of life insurance. Under such rider the insured is given the option at specific future age dates, limited to age 40 to purchase new insurance without furnishing evidence of insurability, on the same terms then available to others of that age group (non-possessors of the option) who are required to furnish evidence of insurability.

[244]*244By letter dated July 23, 1959, respondent gave notice to all companies having on file approved guaranteed insurability option forms, that as the Insurance Department construed section 155 of the Insurance Law, such forms should restrict the operation of the incontestable and suicide clauses in such policies so that the respective periods in such clauses should run only from the date of issue of the original policy. No question of the limitation of the incontestability clause is involved here, but only the ruling dealing with the elimination of the suicide clause. While there are minor differences in the form and content of the petitioners’ riders, and in the substituted option form of petitioner Mutual Life, the basic question involved is the same.

Pursuant to section 141 of the Insurance Law, a hearing was requested, granted, and the hearings held in January, 1960.

On or about December 28,1960, respondent issued his decision and order, effective 90 days thereafter, withdrawing approval of the respective option forms because such forms did not restrict the applicability of the suicide clause to the date of issue of the original policy, but, instead, made such provision operative from the date of issuance of the opted policy. Respondent held this to be contrary to the provisions of section 155 (subd. 2, par. [d]) of the Insurance Law, prejudicial to the interests of the policyholder and to be unfair, unjust and inequitable.

Petitioners label the policies issued as “ new ” policies within the meaning of the statute and urge that respondent has no power to withdraw approval of “new” policies of insurance, issued pursuant to a policy rider form which contains a limitation expressly authorized by law. Petitioners deny that the rider is prejudicial or misleading.

Preliminary to any resolution of the issue involved is an ascertainment and examination of the powers, and the nature of the powers, of respondent, as contained in the statute.

Section 141 of the Insurance Law, ‘ ‘ Withdrawal of approval of policy forms ” provides: “ Whenever by the provisions of this chapter the superintendent is authorized to give his approval of any form of insurance policy * * * he may, after notice and hearing given to the insurer which submitted such form for approval, withdraw an approval previously given, if the use of such form is contrary to the legal requirements applicable to such form at the time of such withdrawal * * * or in the case of any such policy or certificate form pertaining to life insurance, or any application, rider or endorsement to be used in connection therewith, if in Ms judgment the use of such form would be prejudicial to the interests of its policy[245]*245holders or members, or it contains provisions which are unjust, unfair or inequitable.” (Emphasis added.) The withdrawal is effective 90 days after the giving of notice, and such action is subject to judicial review.

There is no issue as to procedural requirements in the section quoted, so we look to the nature of the power given respondent. The use of the words “may” and “in his judgment” indicates that the power of withdrawal of approval is discretionary, is not unlimited, and is to be exercised only under certain circumstances, i.e., if the form be contrary to applicable legal requirements, if the use of such form would be prejudicial to the interests of the policyholders, or if the Superintendent determines the provisions to be unfair, unjust or inequitable. (See, also, Insurance Law, § 154, re: powers of Superintendent.)

Section 155 (subd. 2, par. [d]) of the Insurance Law, states:

“2. No policy of life insurance delivered or issued for delivery in this state shall contain any provision which excludes or restricts liability in the event of death caused in a certain specified manner, except the following provisions, or provisions which in the opinion of the superintendent are substantially the same or more favorable to the policyholders.
“ Provisions excluding or restricting coverage in the event of death:
# # *
“ (d) As a result of suicide within two years from the date of issue of the policy.”

The section quoted limits the applicability and effect of the suicide clause to a period of two years. The use of the terms “ delivered ” and “ issued ” in the context used, indicates that such limitation is applicable to “ new ” policies. This term, in my view, may here be equated with “ original ” policies. Black, in defining the term “new” says, in part, “this word may denote novelty, or the condition of being previously unknown or of recent or fresh origin, but ordinarily it is a purely relative term and is employed in contrasting the date, origin, or character of one thing with the corresponding attributes of another thing of the same kind or class.” (Black’s Law Dictionary [4th ed.], p. 1193.) It may reasonably be construed to mean something appearing for the first time, and having an independent (again a relative term) existence.

If we examine the “rider ” and the option contained therein certain things are noted immediately. The option has no existence separate from and independent of the policy. The right expressed therein depends for its survival upon the payment [246]*246of an added premium as provided for by the terms of the original or basic policy. Thus the option merely amounts to an extended privilege. This privilege, in duration as to the time when it may be exercised, is limited by the terms of the basic policy to age 40. In the absence of statutory provisions, a rider attached to the face of the policy or referred to therein is a part of the insurance contract (Davern v. American Mut. Liab. Ins. Co., 241 N. Y. 318; Hukle v. Great Amer. Ins. Co., 230 App. Div. 477 [liability insurance policies]; Berkshire Life Ins. Co. v. Weinig, 290 N. Y. 6 [life insurance]). (Cf. Weisglass v. Northwestern Mut. Life Ins. Co., 31 Misc 2d 232; 44 C. J. S., Insurance, § 300.) “ Every policy of life * * * insurance shall contain the entire contract between the parties ’ (Insurance Law, § 142, subd. 1.)

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Bluebook (online)
15 A.D.2d 242, 222 N.Y.S.2d 339, 1961 N.Y. App. Div. LEXIS 7006, Counsel Stack Legal Research, https://law.counselstack.com/opinion/massachusetts-mutual-life-insurance-v-thacher-nyappdiv-1961.