OSBORN ESTATE v. Gerling Global Life Ins. Co.

529 So. 2d 169, 1988 WL 82122
CourtMississippi Supreme Court
DecidedJuly 27, 1988
Docket57651
StatusPublished
Cited by3 cases

This text of 529 So. 2d 169 (OSBORN ESTATE v. Gerling Global Life Ins. Co.) is published on Counsel Stack Legal Research, covering Mississippi Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
OSBORN ESTATE v. Gerling Global Life Ins. Co., 529 So. 2d 169, 1988 WL 82122 (Mich. 1988).

Opinion

529 So.2d 169 (1988)

ESTATE OF Ethel Irene OSBORN
v.
GERLING GLOBAL LIFE INSURANCE COMPANY, et al.

No. 57651.

Supreme Court of Mississippi.

May 11, 1988.
As Modified on Denial of Rehearing July 27, 1988.

William Lee Watt, Roberts & Clisby, Oxford, for appellant.

Michael S. Allred, Satterfield & Allred, Jackson, for appellee.

En Banc

ON PETITION FOR REHEARING

ZUCCARO, Justice, for the Court:

This case is an appeal from the Circuit Court of Montgomery County, where on June 17, 1986 a summary judgment was entered dismissing the complaint of the Estate of Ethel Osborn against Gerling Global Life Insurance Company. The Estate of Ethel Osborn appeals this decision. We reverse.

FACTS

On November 9, 1982, Ethel Osborn bought a health insurance policy from State Security Life Insurance Company (hereinafter State Security). The term of the policy was November 25, 1982 through May 25, 1983. By renewal, the policy term was extended through November 25, 1983.

The financial base of State Security was shaky at best, and there existed constantly questions concerning its ability to pay the claims of policyholders. Consequently, Insurance Commissioner George Dale demanded that State Security show cause why its license to sell insurance in Mississippi should not be revoked. In response to the Insurance Commissioner's demands, State Security began to negotiate a reinsurance agreement with Gerling Global Life Insurance Company (hereinafter Gerling *170 Global). While these negotiations were in process, the president of State Security was required by Dale to pledge a personal letter of credit in the amount of $250,000 for the protection of policyholders. On July 15, 1983, State Security and Gerling Global entered into an agreement whereby Gerling Global would coinsure a portion of State Security's risks on all of its accident and health insurance policies. It is this reinsurance agreement that forms the basis for the present case.

On August 3, 1983, Ethel Osborn was found to have a malignant cancerous growth in her pancreas (metastatic adenocarcinoma). As a result of this condition, Osborn was hospitalized for sixty-five (65) days between July 25 and October 21, 1983. The claims of Osborn for her bills and expenses resulting from the infliction were ultimately denied by State Security.

On March 1, 1984, Osborn filed suit against State Security, its agents, and Gerling Global for $25,256.45 in compensatory damages plus $2,500,000 in punitive damages. Subsequently, Osborn died on September 14, 1984, but her suit, which forms the basis for the present appeal, was revived by her estate. Further, the axe of financial instability finally fell on State Security, and it was declared insolvent by the Insurance Commissioner on October 12, 1984. State Security was placed into receivership by the Chancery Court of Rankin County, and Osborn's lawsuit, like all other suits against State Security, was stayed in order to allow the receiver to assume control of the business. See State Security Life Insurance Co. v. State, 498 So.2d 825 (Miss. 1986).

On November 4, 1985 Gerling Global filed its motion for summary judgment on the grounds that appellant had failed to state a claim upon which relief could be granted. The trial court granted Gerling Global's motion holding:

(1) Mrs. Osborn did not have any privity of contract with Gerling Global and therefore cannot base any claim against Gerling Global based on breach of contract, and
(2) Mrs. Osborn cannot maintain any claims based on a third party beneficiary because the reinsurance contract was not intended to benefit Mrs. Osborn or any other insured of State Security.

It is this adverse decision that the Estate of Osborn now appeals.

I. DID THE LOWER COURT ERR IN HOLDING THAT THE SUBJECT INSURANCE AGREEMENT WAS A TRUE CONTRACT OF REINSURANCE SO AS TO DENY OSBORN A DIRECT RIGHT OF ACTION AGAINST GERLING GLOBAL?

The July 15, 1983 insurance agreement reached by State Security and Gerling Global, entitled "Reinsurance Agreement," was entered into solely for the purpose of allowing State Security to continue writing insurance policies in the State of Mississippi. The obvious reason for Insurance Commissioner Dale requiring State Security's procuring additional resources was to protect policyholders. In the present case, the lower court determined that appellant, just such a policyholder, could not directly sue Gerling Global on the subject insurance contract due to it being a "reinsurance" agreement.

In determining whether the lower court reached the right conclusion of law, we recognize that true "reinsurance" is a very specialized type of insurance in which, "one insurer for a consideration contracts with another to indemnify it against loss or liability by reason of a risk which the latter has assumed under a separate and distinct contract as the insurer of a third person." J. Appleman, Insurance Law and Practice § 7693 at 523 (1976). Reinsurance is a process by which an insurance company reduces the extent of its possible loss under any issued policies by distributing all or part of its potential loss to another insurance company. Fontenot v. Marguette Casualty Co., 258 La. 671, 247 So.2d 572 (1971). More specifically, it has been stated that:

The vital distinction between reinsurance and liability insurance is that reinsurance indemnifies the insurer for a loss which *171 is actually sustained, whereas liability insurance is protection against the liability of an insured. (Emphasis in original)

247 So.2d at 576-577.

As a general rule, since true "reinsurance" contracts are contracts of indemnity, they are not enforceable by original insureds, such as Osborn, because original insureds are not in privity of contract with the reinsurer. Mosely v. Liverpool & London & Globe Ins. Co., 104 Miss. 326, 61 So. 428 (1913). There is, in the ordinary reinsurance contract, no privity which would enable the insured to bring an action against the insurer. J. Appleman, Insurance Law and Practice § 7694 at 528-529 (1976); 46 C.J.S. Insurance § 1232 at 217-218 (1946). If this general rule applied here, Osborn would have no direct action against Gerling Global, and the trial court's actions would have been proper. However, a reinsurance agreement may be written in such form and with such provisions so as to create a liability on the part of the reinsurer directly to the original insured. First National Bank of Kansas City v. Higgins, 357 S.W.2d 139, 143 (Mo. 1962); Homan v. Employers Re-Insurance Corporation, 136 S.W.2d 289 (Mo. 1939). Further, Higgins states:

In any case where the contract of reinsurance is more than a mere contract of indemnity, and is made for the benefit of the policyholders of the reinsured, and by it the reinsurer assumes the liability of the latter on its policies, the liability of the reinsurer may be directly enforced by the insured, or by his privies. (Emphasis added)

Higgins, 357 S.W.2d at 143 quoting Couch Encyclopedia of Insurance Law, § 2276 at 7434.

As seen above, the critical inquiry that must be addressed in the present case is whether the subject "reinsurance" agreement provided for indemnity against an actual loss

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Bluebook (online)
529 So. 2d 169, 1988 WL 82122, Counsel Stack Legal Research, https://law.counselstack.com/opinion/osborn-estate-v-gerling-global-life-ins-co-miss-1988.