Premsingh v. UNUM Life Insurance Co. of America

929 F. Supp. 1391, 1996 U.S. Dist. LEXIS 9456, 1996 WL 370128
CourtDistrict Court, D. Kansas
DecidedJune 4, 1996
DocketCivil Action 95-2275-EEO
StatusPublished
Cited by4 cases

This text of 929 F. Supp. 1391 (Premsingh v. UNUM Life Insurance Co. of America) is published on Counsel Stack Legal Research, covering District Court, D. Kansas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Premsingh v. UNUM Life Insurance Co. of America, 929 F. Supp. 1391, 1996 U.S. Dist. LEXIS 9456, 1996 WL 370128 (D. Kan. 1996).

Opinion

MEMORANDUM AND ORDER

EARL E. O’CONNOR, District Judge.

This matter is before the court on defendant’s motion for summary judgment (Doc. # 39). The court has considered the parties’ briefs and submissions and is now prepared to rule. For the reasons set forth below, defendant’s motion will be granted.

Factual Background

This case centers around a denial of overhead disability insurance coverage for failure to make timely premium payments. The *1393 following facts are uncontroverted or deemed admitted pursuant to Federal Rule of Civil Procedure 56(c) and District of Kansas Rule 56.1.

In 1989, plaintiff Nalani Premsingh purchased an overhead expense disability policy, Policy # LAD074190 (“the policy”), from UNUM Life Insurance Company Of America (“UNUM”). The policy became effective September 1, 1989, and was non-cancelable to age 65. The policy provides for reimbursement of certain overhead expenses under stated conditions, in exchange for the payment of premiums on each September 1 policy anniversary, or within a 31-day grace period thereafter. The policy also provides for reinstatement in the event of a lapse for failure to make premium payments as follows:

If this policy terminates because a premium is not paid by the end of the Grace Period, you may apply to reinstate this policy at any time until the first unpaid premium is six months overdue.
In order to reinstate this policy, two requirements must be met. They are:
1. a reinstatement application must be completed (to complete a reinstatement application means you submit the reinstatement application with evidence of the Insured’s insurability and the full amount of overdue premium); and
2. we approve the reinstatement application.
A reinstatement application must be prepaid, and we will issue a prepayment agreement. The date of the prepayment agreement will be the date the reinstatement application has been completed.
If we approve the reinstatement application, this policy will be reinstated on the approval date. If the overdue premium is paid without submitting a reinstatement application and we keep the premium without requesting a reinstatement application within a reasonable time, this policy will be reinstated the date we receive the premium. If we issue a prepayment agreement and do not approve or disapprove the reinstatement application within 45 days from the date of the prepayment agreement, this policy will be reinstated on the 45th day.
If this policy is reinstated, it will only cover:
1. injury that occurs on or after the date this policy is reinstated; or
2. sickness which is first diagnosed or is first treated more than 10 days after this policy is reinstated.
It WILL NOT cover:
1. any injury or sickness which is excluded by name or description; and
2. any preexisting condition excluded by the reinstatement application.

The “General Provisions” of the policy state, “[ujnless we tell you something else, years, months and anniversaries that we refer to are calculated from the Policy Date shown on page 3.”

Plaintiff Premsingh failed to pay her premium for the policy period September 1, 1992, through August 31, 1993, by the September 1, 1992, due date, or within 31 days thereafter. A check for the full amount of the annual premium for that policy period, $6,767.67, was received and deposited by UNUM on November 19,1992. Premsingh’s coverage for the September 1, 1992, through August 31, 1993, policy period was reinstated as of the date of the payment, November 19, 1992.

In 1993, Premsingh again failed to pay the premium for the policy period September 1, 1993, through August 31, 1994, by the September 1, 1993, due date, or within 31 days thereafter. Premsingh received notices of unpaid premiums on the policy on or about August 12, 1993, September 10, 1993, and October 12, 1993. On December 10, 1993, Premsingh tendered a check dated October 30, 1993, in payment of the full premium for the 1993-94 policy period.

Rather than automatically reinstating plaintiffs policy as it had done in 1992, UNUM conditioned reinstatement upon receipt of a completed reinstatement application showing evidence of insurability. UNUM forwarded a reinstatement application and prepayment agreement to Premsingh on December 10, 1993, with a cover letter informing her that her premium pay *1394 ment would be refunded if her completed application was not received by January 3, 1994.

Defendant received plaintiffs reinstatement application and prepayment agreement, dated December 22, 1993, on December 28, 1993. On December 24,1993, two days after the date on plaintiffs reinstatement application and four days before defendant received the application, plaintiff suffered a stroke.

When UNUM learned that plaintiff had suffered a stroke, it immediately rejected plaintiffs reinstatement application because of her recent medical history, and returned plaintiffs premium. UNUM subsequently denied plaintiffs claim for coverage on the ground that the policy was not in effect on the date when plaintiff suffered the disabling event.

Plaintiff Chrisman-Sawyer Bank, fik/a/ First City Bank (the “Bank”), claims that it was entitled to notice of overdue premiums as an assignee of the policy. On June 12, 1992, plaintiff executed an Assignment of Disability Income Policy form, which was provided by defendant, and assigned “only [her] rights to receive benefit payments” from the policy to the Bank. The assignment form states, “In all matters pertaining to the rights hereby assigned, you may rely conclusively on the authority granted herein and deal with the assignee of the policy.” The policy provides that assignments are permitted if they were in writing, specify the rights to be assigned, and are on a form satisfactory to UNUM. However, the policy specifically provides that UNUM is “not responsible for the validity or effect of any assignment.”

Standards Governing Summary Judgment

Summary judgment is appropriate “if the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any, show that there is no genuine issue as to any material fact and that the moving party is entitled to a judgment as a matter of law.” Fed.R.Civ.P. 56(c); accord Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 247, 106 S.Ct. 2505, 2509-10, 91 L.Ed.2d 202 (1986); Vitkus v. Beatrice Co., 11 F.3d 1535, 1538-39 (10th Cir.1993).

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Cite This Page — Counsel Stack

Bluebook (online)
929 F. Supp. 1391, 1996 U.S. Dist. LEXIS 9456, 1996 WL 370128, Counsel Stack Legal Research, https://law.counselstack.com/opinion/premsingh-v-unum-life-insurance-co-of-america-ksd-1996.