Nationwide Life Insurance v. American Medical Imaging Corp. (In Re American Medical Imaging Corp.)

133 B.R. 45, 14 Employee Benefits Cas. (BNA) 1763, 1991 Bankr. LEXIS 1536, 1991 WL 224604
CourtUnited States Bankruptcy Court, E.D. Pennsylvania
DecidedOctober 31, 1991
Docket15-18588
StatusPublished
Cited by2 cases

This text of 133 B.R. 45 (Nationwide Life Insurance v. American Medical Imaging Corp. (In Re American Medical Imaging Corp.)) is published on Counsel Stack Legal Research, covering United States Bankruptcy Court, E.D. Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Nationwide Life Insurance v. American Medical Imaging Corp. (In Re American Medical Imaging Corp.), 133 B.R. 45, 14 Employee Benefits Cas. (BNA) 1763, 1991 Bankr. LEXIS 1536, 1991 WL 224604 (Pa. 1991).

Opinion

OPINION

DAVID A. SCHOLL, Bankruptcy Judge. A. INTRODUCTION

The instant proceeding presents elusive issues regarding the determination of the date of termination of a group life and health insurance policy for the benefit of the Debtor corporation's employees and the impact upon the employees’ benefits when the Debtor failed to make timely payments *47 of policy premiums. Revising our own previous tentative conclusion, we hold that the policy in issue has never been terminated because the terms under which it was to be terminated became muddied through ambiguous oral modifications and because the insurer never provided any notice of its intention to terminate it to the Debtor.

However, since the policy in issue was an executory contract on the date of the filing of the Debtor’s petition in bankruptcy, we reject the Debtor’s argument that payment of only post-petition premiums will render the policy effective through its post-petition date of mutual cancellation. Instead, we hold that the Debtor must promptly move to assume the policy and cure all defaults therein and that, only failing such an assumption, will the contract be deemed rejected.

Finally, we further hold that, if the insurance contract is rejected, and thus terminated, the Debtor’s employees are entitled, pursuant to applicable state law as interpreted by an intermediate appellate state court, to a 90-day period after notice of the policy’s termination to exercise their conversion rights under the policy.

B. PROCEDURAL HISTORY

On July 81, 1991, AMERICAN MEDICAL IMAGING CORPORATION (“the Debtor”) filed the voluntary Chapter 11 bankruptcy case underlying this proceeding. On September 6, 1991, NATIONWIDE LIFE INSURANCE COMPANY (“the Plaintiff”) initiated the instant proceeding by filing a Complaint for Declaratory Judgment regarding its rights under its group life and health insurance policy with the Debtor. Expedited scheduling of the trial was sought by the Plaintiff because of its concern that the action of ceasing to honor claims of the Debtor’s employees as of August 20, 1991, could be contended by the Debtor to be a violation of the automatic stay arising from the Debtor’s bankruptcy filing. We accommodated the Plaintiff and scheduled the trial of the proceeding on September 25, 1991. At trial, we learned that some of the urgency had been dispelled by the Debtor’s replacement of the Plaintiff by a new insurance carrier on September 16, 1991. After trial, we directed the parties to submit proposed Findings of Facts and Conclusions of Law which, after brief extensions, were submitted on October 3, 1991, and October 11, 1991, respectively.

The within Findings of Fact were drawn from live testimony at trial by Brenda Flask, the supervisor of the Plaintiff’s Phoenix and Los Angeles Service Center, and Leo J. Pound, the Debtor’s chief executive officer; and from the telephonic testimony of Robert Nelson, the group sales manager of the Plaintiff’s Phoenix office.

C. FINDINGS OF FACT

1. The Debtor, as Plan Sponsor, entered into a group life and health Insurance Policy, No. 0-2211 (“the Policy”), with the Plaintiff on or about July 1, 1989.

2. Pursuant to the terms of the Policy, the Debtor was required to make payments on the first day of each month for insurance coverage for the succeeding month. The Policy included the following paragraph regarding a grace period of payment:

[a] 31-day grace period follows the due date of an unpaid premium, unless we [the Plaintiff] receive written notice before the due date to cancel insurance as of that due date_ The Plan Sponsor must pay a pro rata premium for any coverage provided during a grace peri-od_ Insurance will stay in force during the grace period. If all the premium is not paid prior to the expiration of the grace period, the Policy mil terminate on the last day of the grace period (emphasis added).

3. The Policy does not require that notice of termination be provided to the Debt- or or to the employees covered. The entire contract between the Debtor and the Plaintiff consisted of the Policy, the Debtor’s Application, and the applications for inclusion in the Policy coverage by the Debtor’s employees.

4. In the “Term of Policy and Renewal Privilege” paragraph of the Policy, it was provided that the policy continued as long *48 as the premiums were paid, or until the Policy was cancelled. The former basis for cancellation of the Policy is consistent with the language in the paragraph quoted in Finding of Fact 2, page 47 supra, since, in both paragraphs, the non-payment of insurance premiums triggers termination of the Policy. The Policy states, as to the Plaintiff’s rights to cancel it, that

[w]e may cancel the insurance as of a premium date with a 31-day advance notice in writing to the plan sponsor [the Debtor] (emphasis added).

5. The Policy stated that the individual insured employees, as well as their dependent spouses, had certain privileges to convert the benefits from the group policy to an individual policy upon the termination of the group policy, and recited the procedures for exercising these conversion privileges. Regarding these conversion privileges, as to the base plan and major medical components, the Policy notified the individual insureds of their conversion privileges as follows:

You [the individual insured] will be given written notice of the conversion privilege and its duration from the plan sponsor [the Debtor]. Notice given to you [the individual insured] in person or mailed to your last known address will be considered adequate notice. If this notice is not given at least 15 days prior to the end of the thirty-one day conversion period, the time allowed for the exercise of the conversion will be extended until 15 days after the day the notice is sent. In no event will the time allowed for the exercise of the conversion privilege extend more than 90 days from the day your coverage ends under this policy.

6. During the initial “writing” of the Policy, Art Pappas, a duly-authorized agent of the Debtor, negotiated an oral agreement with Nelson for a deferral of the cancellation of the benefits of the Policy (“the Deferral Agreement”). According to the terms of the Deferral Agreement, the Debtor would have an additional sixty (60) day extension to make premium payments beyond the normal thirty-one (31) day grace period.

7. The parties stipulated that Flask was the “custodian” of the Plaintiffs billing and payment records. Flask testified that the Policy was made on a “occurrence-made” basis, i.e., the Plaintiff was liable for payment of any insurance claims incurred before the expiration of the Policy. Although not a party to the Deferral Agreement, Flask testified to the manner in which the Plaintiff interpreted it and had administered it. She testified that the Plaintiff understood that, at the expiration of the grace period, the Debtor had an additional sixty (60) days within which to remit payment to the Plaintiff. During the grace period and the additional sixty (60) day period, the Plaintiff would process claims submitted under the Policy.

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Cite This Page — Counsel Stack

Bluebook (online)
133 B.R. 45, 14 Employee Benefits Cas. (BNA) 1763, 1991 Bankr. LEXIS 1536, 1991 WL 224604, Counsel Stack Legal Research, https://law.counselstack.com/opinion/nationwide-life-insurance-v-american-medical-imaging-corp-in-re-american-paeb-1991.