Rizzo v. Travelers Insurance Co.

549 N.E.2d 810, 193 Ill. App. 3d 67, 140 Ill. Dec. 159, 1989 Ill. App. LEXIS 1991
CourtAppellate Court of Illinois
DecidedDecember 29, 1989
Docket1—88—0471, 1—88—1255 cons.
StatusPublished
Cited by6 cases

This text of 549 N.E.2d 810 (Rizzo v. Travelers Insurance Co.) is published on Counsel Stack Legal Research, covering Appellate Court of Illinois primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Rizzo v. Travelers Insurance Co., 549 N.E.2d 810, 193 Ill. App. 3d 67, 140 Ill. Dec. 159, 1989 Ill. App. LEXIS 1991 (Ill. Ct. App. 1989).

Opinion

JUSTICE JOHNSON

delivered the opinion of the court:

Plaintiff, Elsie Rizzo, the widow and beneficiary of Fred Rizzo, brings this appeal after a grant of summary judgment in favor of defendants, Travelers Insurance Company (Travelers) and Local No. 1 Hotel Employees and Restaurant Employees (Local No. 1). On appeal, plaintiff contends that the court erred in its construction of a benefit provision of a life insurance policy, thereby serving to deny plaintiff the correct benefit amount under the policy.

On August 1, 1982, a group life insurance policy was purchased by Local No. 1 from Travelers to provide insurance for Local No. 1 employees and union members. When the policy was issued, decedent was employed by Local No. 1 and held the position of “Business Agent” with the union.

The policy’s “Schedule of Benefits” provided, in pertinent part, as follows:

“LIFE INSURANCE-FOR YOU ONLY
Occupation or Position Amount of Life Insurance
Prior to Age 65
I. Actively Employed Officer $40,000
II. Business Agent $10,000
III. All other occupations & positions $6,000
Changes in amounts of insurance due to change in your occupation or position will become effective on the Policy Anniversary following the date your occupation or position is changed. Such new amounts of insurance will be determined in accordance with the table above upon the basis of your occupation or position as of the first day of the third insurance month next preceding such Policy Anniversary.”

All sums are doubled in the event of an accidental death.

June 1, 1983, and the same date each year thereafter was designated as the policy anniversary date. March 1 of each year was designated as the date on which Travelers determined the amount of insurance each employee and union member would be entitled to for the upcoming policy year.

On April 23, 1984, decedent was elected secretary of the union, thereby changing his position to “Actively Employed Officer”; however, Local No. 1 failed to record the change. On December 21, 1984, decedent accidentally died of a gunshot wound to the neck.

Plaintiff, as the named beneficiary to decedent’s life insurance policy, made a claim for benefits. Travelers tendered $20,000 to plaintiff, which was calculated as double the $10,000 benefit due when a “Business Agent” dies accidentally. Plaintiff maintains that she is entitled to $80,000, which is double the $40,000 benefit allowed for beneficiaries of an “Actively Employed Officer” who dies accidentally.

Plaintiff, as the executor of decedent’s estate, brought suit against Travelers and Local No. 1. The complaint consisted of four counts. Count I prayed for declaratory relief against both defendants. Counts II and III alleged breach of contract by Travelers and Local No. 1, respectively. Count IV alleged negligence against Local No. 1. Plaintiff did not assert any of the causes of action available to her under the Employee Retirement Income Security Act of 1974, 29 U.S.C. §1001, et seq. (1982) (hereinafter ERISA). Travelers’ filed a motion for summary judgment which was adopted by Local No. 1. Defendants’ motion argued that any change in an insured’s occupation or position must occur more than three months before the policy anniversary date, i.e., before March 1, before any new amount of life insurance coverage would become effective. If an insured’s occupation or position changed after March 1, any new amount of life insurance coverage would not become effective, until the following year. Defendants argued that since decedent’s change in occupation or position occurred after March 1, 1984, he would remain insured as a “Business Agent” until June 1, 1985, i.e., the next policy anniversary date. Had decedent lived, the increased coverage provided for an “Actively Employed Officer” would have become effective on June 1, 1985. Defendants believe that the first sentence grants benefits and defines when the benefits will become effective; the second sentence describes calculation of the benefits and when a new benefit amount will be determined.

In response to defendants’ motion for summary judgment, plaintiff argued that the schedule of benefits provision of the insurance policy was ambiguous when properly interpreted. Plaintiff interpreted the first sentence of the benefits provision to mean that “changes in the amounts of insurance, due to change in occupation or position, [became] effective on the policy anniversary following the date the occupation or position is changed.” Plaintiff believed that the second sentence of the benefits provision “raise[d] an ambiguity to the otherwise clear intent of the first sentence.”

After hearing defendants’ motion, the court entered judgment for defendants and denied plaintiff’s cross-motion for summary judgment. On appeal, plaintiff raises the following issues: (1) the trial court erred by ordering enforcement of an insurance contract which contains ambiguous and inconsistent provisions; (2) the insurance contract must be interpreted in a manner which expresses the intent of the policy and reconciles two ambiguous and inconsistent provisions; and (3) ambiguities should be construed against the insurer that drafted the policy. Plaintiff’s arguments assume that the insurance policy is ambiguous and in need of construction. Travelers argues that (1) plaintiff’s complaint, which is based on State common law, is preempted by ERISA and should be dismissed for want of subject mater jurisdiction; (2) preemption by ERISA is a challenge to the court’s subject matter jurisdiction and cannot be waived; (3) defendant would be entitled to summary judgment under an ERISA action in Federal court; and (4) if the court finds that plaintiff’s cause of action is not preempted, the trial court correctly ruled that the insurance policy was not ambiguous. Plaintiff responds to defendant’s arguments by asserting that (1) the mere allegation that an insurance policy is part of an “employee welfare benefit plan” is insufficient to preempt a State cause of action; (2) defendant Travelers failed to establish that it is a fiduciary under ERISA; (3) defendants’ reliance on Pilot Life Insurance Co. v. Dedeaux (1987), 481 U.S. 41, 95 L. Ed. 2d 39, 107 S. Ct. 1549, is premature; and (4) this case must be decided under the applicable rules of construction for insurance contracts in Illinois.

Initially we must determine whether the group life insurance policy issued to employees of Local No. 1 is an employee welfare benefit plan governed by ERISA and, if so, do the State courts have subject matter jurisdiction over plaintiff’s claim.

Under ERISA, an “employee welfare benefit plan” is broadly defined to include the following:

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Coulas Viking Partners v. Belt Ry. Co. of Chicago
2020 IL App (1st) 190836-U (Appellate Court of Illinois, 2020)
Scholtens v. Schneider
274 Ill. App. 3d 102 (Appellate Court of Illinois, 1995)
Robertson v. Gem Insurance Co.
828 P.2d 496 (Court of Appeals of Utah, 1992)
Summers v. United States Tobacco Co.
574 N.E.2d 206 (Appellate Court of Illinois, 1991)
Thomas v. General American Life Insurance
568 N.E.2d 937 (Appellate Court of Illinois, 1991)

Cite This Page — Counsel Stack

Bluebook (online)
549 N.E.2d 810, 193 Ill. App. 3d 67, 140 Ill. Dec. 159, 1989 Ill. App. LEXIS 1991, Counsel Stack Legal Research, https://law.counselstack.com/opinion/rizzo-v-travelers-insurance-co-illappct-1989.