Prudential Insurance Co. of America v. Durante

443 S.W.3d 499, 2014 Tex. App. LEXIS 9723, 2014 WL 4259434
CourtCourt of Appeals of Texas
DecidedAugust 29, 2014
DocketNo. 08-12-00077-CV
StatusPublished
Cited by15 cases

This text of 443 S.W.3d 499 (Prudential Insurance Co. of America v. Durante) is published on Counsel Stack Legal Research, covering Court of Appeals of Texas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Prudential Insurance Co. of America v. Durante, 443 S.W.3d 499, 2014 Tex. App. LEXIS 9723, 2014 WL 4259434 (Tex. Ct. App. 2014).

Opinion

OPINION

YVONNE T. RODRIGUEZ, Justice. .

The Prudential Insurance Company and Pruco Life Insurance Company (collectively “Pruco”) appeal a judgment entered against them in favor of Irasema Sagarna-ga Durante (“Sagarnaga”). This case [502]*502arises out of Pruco’s non-payment of life insurance proceeds based on a rejected change of beneficiary form by the insured. Pruco brings six issues: (1) Sagarnaga lacked standing to sue Pruco for breach of the insurance policy and common-law and statutory bad faith; (2) the evidence is legally and factually insufficient to support the finding Pruco breached the insurance policy; (3) the evidence is legally and factually insufficient to support the finding that Pruco breached common-law and statutory duties of good faith and fair dealing, specifically Chapters 541 and 542 of the Texas Insurance Code; (4) the trial court erred in admitting expert testimony over Pruco’s objection; (5) the trial court erred by awarding Sagarnaga 18 percent statutory penalty interest on the claim amount of $375,000; and lastly (6) the trial court erred by awarding Sagarnaga attorney’s fees. Sagarnaga cross-appealed, asserting in a single issue the trial court abused its discretion by failing to award her post-trial and appellate attorney’s fees. We affirm in part, reform the judgment, and remand in part.

BACKGROUND

Dr. Arturo Garcia Fernandez was married to Margarita Henric Chavez, with whom he had three children: Eloísa, Cecilia, and Arturo Garcia Henric, Jr. In July 2002, Dr. Garcia purchased a Pruco life insurance policy (the “Policy”) for a death benefit of $750,000. In the application, Dr. Garcia designated his wife, Margarita, as the primary beneficiary and contingent beneficiaries were their three children. After Margarita’s death in 2005, Dr. Garcia married Irasema Sagarnaga Durante in 2007.

In February 2008, Dr. Garcia called Pruco regarding the Policy. In that recorded conversation, Dr. Garcia requested a change of beneficiary form (“COB”) for the Policy. Pruco instructed Dr. Garcia that they would complete the COB form and send it to him for his approval and signature. The Pruco representative asked Dr. Garcia for the names of the beneficiaries and the percentages each would be assigned.1 Dr. Garcia replied that he wanted to designate his wife, Sa-garnaga as a 50 percent beneficiary and his adult children as the remaining 50 percent beneficiaries. Pruco sent the COB form to Dr. Garcia, but the requested beneficiary designations were not included on the COB form.

On April 3, 2008, Dr. Garcia and Sagar-naga went to the El Paso Prudential office. Dr. Garcia spoke with Solis, a Pruco associate, and Schmid, a Pruco, insurance agent. Sagarnaga, who speaks some English, was able to understand some of the discussion between her husband, Solis, and Schmid. Dr. Garcia explained to Sagarna-ga the changes he was making to the Policy. Sagarnaga understood, during this meeting, Dr. Garcia executed the COB form making her a 50 percent beneficiary and the children the remaining 50 percent beneficiaries of the Policy.

Dr. Garcia’s COB form, dated April 3, 2008, listed the beneficiaries as follows: the primary beneficiary designation stated Sagarnaga was to receive 50 percent of the Policy proceeds, 12 percent to Arturo Garcia, Jr., 13 percent to Eloísa, and 25 percent to Cecilia. The contingent beneficiary, however, in the section titled “Additional! Special Beneficiary Requests [503]*503[Emphasis added] on the COB form, read as follows:

Pay 50% to Irasema Sagarnaga Durante, wife, if living otherwise same proportion of this to my two daughters and son, Arturo Garcia, Cecilia Garcia, Eloí-sa Garcia, if living, otherwise pay balance if any to Irasema Sagarnaga Durante, wife.

Pursuant to Pruco’s contract, a policy owner could change, inter alia, the beneficiary, by sending to Pruco a request “in a form that meets our needs.” According to the terms of the Policy, if Pruco received a COB request, Pruco would record the change and file it. The change of beneficiary would be effective as of the date the request was signed. Pruco’s internal procedures were clear that in order for a COB to be accepted in its entirety, it “must clearly specify the settlement to be in effect at the death of the Insured.”

The signed COB form by Dr. Garcia was received by Pruco on April 10, 2008. The COB form was routed to the “settlement options” department where it was re-viewed by Mehrotra, a Pruco associate. While the primary beneficiary designation was satisfactory, Mehrotra found Dr. Garcia’s changes for the contingent beneficiary or “additional/special beneficiary designation” to be “ambiguous.” Based on the ambiguity regarding the contingent beneficiaries, Mehrotra initiated a “turn-down procedure,” in which Pruco did not accept or record, in its entirety, Dr. Garcia’s COB form. Pruco then prepared a new COB form. The new COB form did not change the primary beneficiary designation, it only modified the language for the additional/special beneficiary section, based on what Mehrotra believed Dr. Garcia was attempting to do. The beneficiary provision proposed by Mehrotra was as follows:

50% of the proceeds ... to Irasema Sagarnaga Durante, Beneficiary, wife of the Insured, if living, otherwise as follows:
50% of such fund to Celcilia M. Garcia Henric ...
26% of such fund to Eloísa Garcia Hen-ric ...
24% of such fund to Arturo Garcia Hen-dric ...
25% of proceeds to said Cecilia M. Garcia Henric ...
13% of proceeds to said Eloísa Garcia Henric ...
12% of proceeds to said Arturo Garcia Henric ...

Mehrotra sent the new COB form to Dr. Garcia on April 14, 2008, and requested he review it. If after the review, the COB form stated what Dr. Garcia intended for the additional/special beneficiary section, he was to sign and return it to Pruco. If not, Dr. Garcia should contact Pruco to obtain a corrected COB form. Dr. Garcia received this correspondence, but there is no evidence the letter was opened or read by Dr. Garcia before he died.2

Dr. Garcia died in Brazil on September 22, 2009. Dr. Garcia’s daughter, Eloísa, advised Pruco of his death two days later. The children each filed a claim for benefits under the Policy in October 2009.

On October 21, 2009, Sagarnaga met with Schmid in El Paso. She asserted that Dr. Garcia had changed the beneficiary designation to include her under the Policy. Pruco informed Schmid about the issue of Dr. Garcia’s COB form. Schmid suggested Sagarnaga contact Pruco direct[504]*504ly. Sagarnaga then called Pruco and was advised Dr. Garcia’s COB form naming her as a 50 percent beneficiary had not been accepted or recorded. Pruco stated Sa-garnaga was not a beneficiary under the Policy. Pruco instructed Sagarnaga to submit a written statement regarding her claim including any additional supporting information within fifteen days.3

That same day, October 21, after her telephone call to Pruco, Sagarnaga sent a letter stating she was a beneficiary and made a claim for benefits.

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Bluebook (online)
443 S.W.3d 499, 2014 Tex. App. LEXIS 9723, 2014 WL 4259434, Counsel Stack Legal Research, https://law.counselstack.com/opinion/prudential-insurance-co-of-america-v-durante-texapp-2014.