Mutual of Omaha Life Insurance Company v. Johnny Costello

420 S.W.3d 873, 2014 WL 258213, 2014 Tex. App. LEXIS 718
Court of Appeals of Texas·Decided January 23, 2014·No. 14-13-00050-CV·Published·Cited by 1 cases

Opinion

OPINION

WILLIAM J. BOYCE, Justice.

United of Omaha Life Insurance Company appeals from a summary judgment in favor of Johnny Costello on his breach of contract claim seeking benefits under a life insurance policy. 1 We reverse the trial - court’s order granting summary judgment and remand for proceedings consistent with this opinion.

Background

Fatima Costello applied for life insurance with the help of underwriter Keith Sexton. After she paid the premium, United of Omaha issued a $500,000 life insurance policy to Fatima Costello with an effective date of October 1, 2002. The policy contained an incontestability provision, which stated: “We will not contest the validity of this policy after it has been in force during the lifetime of the Insured for two years from the date of issue.”

Fatima Costello died from a heart attack on July 2, 2003. This date fell within the two-year contestability period set forth in the policy. United of Omaha sent a letter to Sexton on July 15, 2003, acknowledging a claim being made on Fatima Costello’s insurance policy by her husband Johnny Costello and requesting additional information to evaluate the claim. After investigating and concluding that Fatima Costello had misrepresented her health history in her insurance application, United of Omaha denied the claim and rescinded the policy on November 10, 2003. United of Omaha concluded that Fatima Costello had failed to disclose that she had been taking medication for hypertension and elevated lipids; had multiple abnormal pulmonary tests; and had a history of chronic obstructive pulmonary disease.

Johnny Costello, individually and as Fatima Costello’s surviving spouse, sued United of Omaha on September 3, 2004, to recover the policy proceeds. United of Omaha filed a general denial on October 29, 2004 and an amended answer on November 8, 2006. In the amended answer, United of Omaha asserted for the first time that the policy is not enforceable based on affirmative defenses of fraud and misrepresentation.

On April 26, 2010, Costello filed a motion for traditional summary judgment asserting two grounds. First, Costello argued that United of Omaha waived its affirmative defenses to enforcement of the policy by failing to contest the validity of the policy within two years of the date the policy was issued. Specifically, Costello asserted that United of Omaha was required to institute a court proceeding contesting the policy’s validity or to file a defense to a pending action no later than October 1, 2004 — the second anniversary of the policy’s issuance. Costello argued that United of Omaha did not contest the policy’s validity until it asserted its affirmative defenses in the amended answer *875 filed on November 8, 2006. Second, Costello claimed that all conditions precedent to his recovery under the policy had been fulfilled and, as a matter of law, he was entitled to judgment on his contract claim awarding him all proceeds due under the policy. United of Omaha responded that the policy remained contestable because Fatima Costello died before the policy’s second anniversary.

The trial court signed an order granting Costello’s motion for partial summary judgment in his favor on his breach of contract claim; the trial court signed a separate order barring all of United of Omaha’s affirmative defenses. The trial court signed a final judgment awarding Costello policy proceeds, pre- and post judgment interest, damages under Article 21.55 2 , attorney’s fees, and costs. 3 This appeal followed.

Analysis

In two issues on appeal, United of Omaha argues that the trial court erred in granting summary judgment. First, United of Omaha asserts that the trial court erred in prohibiting United of Omaha from establishing that it properly rescinded the policy based on the incontestability provision. Second, United of Omaha claims that the policy was not incontestable, and that United of Omaha’s investigation and rescission of the policy did not waive United of Omaha’s defenses.

I. Standard of Review

The trial court granted Costello’s traditional motion for summary judgment under Texas Rule of Civil Procedure 166(a). We review a trial court’s grant of summary judgment de novo. City of Lorena v. BMTP Holdings, L.P., 409 S.W.3d 634, 645 (Tex.2013). The party moving for traditional summary judgment bears the burden to show that no genuine issue of material fact exists and that he is entitled to judgment as a matter of law. Mann Frankfort Stein & Lipp Advisors, Inc. v. Fielding, 289 S.W.3d 844, 848 (Tex.2009).

I. Incontestability Provision

The operative policy language says that United of Omaha will not contest the validity of Fatima Costello’s life insurance policy “after it has been in force during the lifetime of the Insured for two years from the date of issue.” This appeal focuses on whether the insured must survive the two-year contestability period in order for an insurance policy to become incontestable.

Costello asserts that United of Omaha was required to institute a court proceeding or file a defense asserting a basis for recission before the policy became incontestable on October 1, 2004. United of Omaha did not assert fraud or misrepresentation as a basis for recission until it filed its amended answer on November 8, 2006. Thus, Costello argues that United of Omaha no longer can contest the policy’s validity. United of Omaha argues that it still can contest the policy’s validity *876 because Fatima Costello died during the contestability period.

Our resolution of this issue depends on our interpretation of one statute and one regulation. See Tex. Ins.Code Ann. § 1101.006 (Vernon 2009); 28 Tex. Admin. Code § 3.104(a) (1982) (Tex. Dep’t of Ins., Incontestable Clause). Our interpretation of these provisions is consistent with the policy language.

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Mutual of Omaha Life Insurance Company v. Johnny Costello, 420 S.W.3d 873, 2014 WL 258213, 2014 Tex. App. LEXIS 718 (Tex. Ct. App. 2014).

420 S.W.3d 873 (Mutual of Omaha Life Insurance Company v. Johnny Costello) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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