Matousek v. South Dakota Farm Bureau Mutual Insurance Co.

450 N.W.2d 236, 1990 S.D. LEXIS 2, 1990 WL 211
CourtSouth Dakota Supreme Court
DecidedJanuary 3, 1990
Docket16701
StatusPublished
Cited by6 cases

This text of 450 N.W.2d 236 (Matousek v. South Dakota Farm Bureau Mutual Insurance Co.) is published on Counsel Stack Legal Research, covering South Dakota Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Matousek v. South Dakota Farm Bureau Mutual Insurance Co., 450 N.W.2d 236, 1990 S.D. LEXIS 2, 1990 WL 211 (S.D. 1990).

Opinion

PER CURIAM.

ACTION

Lynette Matousek appeals a summary judgment in fayor of South Dakota Farm Bureau Mutual Insurance Company (insurer) in her lawsuit on behalf of the estate of Robert Matousek for supplemental death benefits under an automobile insurance policy. We affirm.

FACTS

Robert Matousek was employed as a semi-truck driver and, at the time of his death, lived with his wife Lynette in Co-lóme, South Dakota. In December 1986 Robert purchased a Chrysler automobile and contacted Darrel Pochop (Pochop), an agent for insurer, requesting that he compute the premium for full insurance coverage on the Chrysler. The two met on December 20 and, during the course of their meeting, Pochop offered Robert supplemental “accidental death benefit” coverage in the amount of $10,000. This offering was made in accordance with the requirements of SDCL 58-23-7 and SDCL 58-23-8. 1 It is clear that Pochop never explained the exclusions and limitations on the coverage to Robert inasmuch as Pochop testified that he himself was not fully aware of the exclusions until after Robert’s death.

Robert agreed to purchase the insurance policy from Pochop along with the supplemental death benefit coverage. Pochop and Robert began the process of completing Robert’s application for the insurance with an effective date of December 20, 1986. It became necessary for Robert to leave and Pochop completed the application in Robert’s absence. Lynette stopped by Pochop’s office later in the day, paid the premium and signed the application. The application contained no information on the exclusions or limitations relating to the supplemental “death coverage” requested on the form.

Four days later, on December 24, 1986, Robert was killed while driving his truck from Hot Springs, South Dakota, back to his home. After Robert’s death, Pochop advised insurer that he had transmitted an application for insurance for Robert and that Robert had been killed in a truck accident. Insurer’s claims manager later phoned Pochop and informed him that insurer would not pay Lynette’s claim because Robert’s death occurred while he was driving his truck and that was one of the limitations in the policy.

No insurance policy relative to Robert’s application for insurance was issued to Robert or Lynette prior to Robert’s death. Lynette denies ever receiving a copy of the policy. Pochop claims that he delivered a *238 copy of the policy to her sometime in May 1987 and testified that the policy was late because of changes Lynette had made in the policy after Robert’s death.

Lynette ultimately brought the present action against insurer seeking the $10,000 death benefit coverage Robert purchased in December 1986 plus damages for mental distress, punitive damages and attorney’s fees. Summary judgment was granted for insurer based upon the policy exclusions on the death benefit coverage. Lynette appeals.

ISSUE

WHETHER THE TRIAL COURT ERRED IN GRANTING INSURER SUMMARY JUDGMENT?

DECISION

The standards for reviewing a summary judgment are well established and will not be substantially repeated. Generally, a summary judgment will be affirmed if there are no genuine issues of material fact and the legal questions have been correctly decided. Bego v. Gordon, 407 N.W.2d 801 (S.D.1987).

The material facts of this matter are relatively undisputed. Particularly, no issue is raised over the fact that Robert’s December 20, 1986, application for' insurance constituted a “binder” of insurance. Thus, this court’s decision turns on the legal propriety of the trial court’s application of the terms of the insurance policy purchased by Robert to the binder of insurance he procured prior to his death.

Lynette’s sole argument on appeal is that the binder provided for “death coverage” without exclusions and that insurer could not retroactively limit that coverage by a policy issued after Robert’s death. Accordingly, she contends that the trial court erred in granting insurer summary judgment. We disagree.

The general principles on the coverage afforded an insured by an insurance binder are outlined in 12A J.A. Appleman & J. Appleman, Insurance Law and Practice § 7232 (1981):

The terms and provisions which control in the construction of the coverage afforded by a binder are those contained in the ordinary form of policy usually issued by the company at that time upon similar risks. The binder is subject to the conditions of the policy contemplated, though such 'policy may never issue. The standard form of contract in use by the insurer at that time may be referred to, to ascertain the coverage.... And where the parties have previously contracted upon similar policies, those conditions, limitations, and exclusions will be enforced though not mentioned in the preliminary conversations leading to the issuance of the contract. (footnotes omitted), (emphasis added).

Similar principles have been endorsed by courts in a number of jurisdictions. See e.g. Alabama Farm Bureau Mutual Cas. Ins. Co. v. Adams, 289 Ala. 304, 267 So.2d 151 (1972); National Emblem Insurance Co. v. Rios, 275 Cal.App.2d 70, 79 Cal.Rptr. 583 (1969); Howell v. U.S. Fire Ins. Co., 185 Ga.App. 154, 363 S.E.2d 560 (1987); State Automobile Mutual Insurance Co. v. Babcock, 54 Mich.App. 194, 220 N.W.2d 717 (1974); Pape v. Mid-America Preferred Ins. Co., 738 S.W.2d 882 (Mo.Ct.App.1987); First Protection Life Ins. Co. v. Compton, 230 Va. 166, 335 S.E.2d 262 (1985).

These principles are codified in South Dakota in SDCL 58-11-29:

Binders or other contracts for temporary insurance may be made orally or in writing, and shall be deemed to include all the usual terms of the policy as to which the binder was given together with such applicable endorsements as are designated in the binder, except as superseded by the clear and express terms of the binder, (emphasis added). 2

*239 Two questions are raised in applying the foregoing principles to the instant case: first, what were the usual terms of insurer’s policy relative to the supplemental death benefit coverage purchased by Robert, and, second, did the clear and express terms of the binder supersede the usual terms of the policy?

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Bluebook (online)
450 N.W.2d 236, 1990 S.D. LEXIS 2, 1990 WL 211, Counsel Stack Legal Research, https://law.counselstack.com/opinion/matousek-v-south-dakota-farm-bureau-mutual-insurance-co-sd-1990.