Seals v. Appalachian National Life Insurance Co.

597 S.W.2d 904, 1979 Tenn. App. LEXIS 387
CourtCourt of Appeals of Tennessee
DecidedDecember 5, 1979
StatusPublished
Cited by1 cases

This text of 597 S.W.2d 904 (Seals v. Appalachian National Life Insurance Co.) is published on Counsel Stack Legal Research, covering Court of Appeals of Tennessee primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Seals v. Appalachian National Life Insurance Co., 597 S.W.2d 904, 1979 Tenn. App. LEXIS 387 (Tenn. Ct. App. 1979).

Opinion

OPINION

SANDERS, Judge.

This appeal is from a summary judgment in favor of the Defendant Insurance Com[905]*905pany where Plaintiffs had applied for life insurance but a policy was never issued.

On September 21, 1976, Plaintiffs, Luther B. Seals and his wife, Plaintiff-Appellant Gail T. Seals, made application through the agent of the Defendant-Appellee, Appalachian National Life Insurance Company, for a “joint family income life insurance policy” in the principal sum of $50,054. The application for insurance provided both Plaintiffs would be required to furnish the company with physical examination reports from a physician and a urine specimen. The Defendant’s agent furnished them with forms to be filled out by the examining physician and containers for the urine specimens. Because the Plaintiffs were uncertain of their bank balance they did not make any payment on the premium at the time the application was taken but about a week later Mrs. Seals gave the agent a cheek for $61.19 which he sent to the home office of the Defendant along with the application. Upon receiving the application the Defendant assigned it a file number and held it in an open file pending receipt of the physical examination reports and the urine specimens.

The Plaintiffs made appointments to have their physical examinations but before they were made the Plaintiff, Luther B. Seals, became seriously ill with a brain tumor that was not known to exist before the application was made. This resulted in the Plaintiffs’ not getting their physical examinations completed or sending their urine specimens to the Defendant.

During the 60-day period between the date the applications were received at the home office and December 1 the Defendant sent some four notices to Mr. Glenn Cunningham, their agent who had taken the application, reminding him the physical examination reports and the urine specimens had not been received. Not having received the reports or specimens, on December 1, 1976, the Defendant wrote the Plaintiffs a letter advising them that since the medical examinations had not been received the application for insurance was being withdrawn and a check was sent refunding the payment of $61.19 which had been made on the premium. The letter further advised the Plaintiffs, “If you can get the medicals completed we will be happy to reopen your file.”

In April, 1977, the Plaintiffs filed suit alleging the medical examinations were not a condition precedent to the issuance of the policy of insurance. Plaintiffs say the Defendant learned of Mr. Seals’ illness and withdrew the application for this reason. They say the payment on the premium was a binder that put the policy into effect immediately. They ask for a declaratory judgment to the effect the policy was in full force and effect.

Before the case was tried Mr. Seals died and Mrs. Seals filed an amended and supplemental complaint seeking the face value of the policy.

The Defendant filed a motion for summary judgment which was sustained by the court and Plaintiff has appealed.

The only issue for consideration on this appeal is whether or not a statement which Defendant’s agent, Mr. Cunningham, is alleged to have made to Mrs. Seals at the time she gave him the check for the payment on the premium would put the insurance into effect pending a determination by the Defendant as to whether or not it would issue a policy.

The court had before it for consideration of the motion for summary judgment the pretrial depositions of Mrs. Seals, Mr. Cunningham and Mr. Jones, Defendant’s vice-president and manager of the underwriting department, along with a number of exhibits.

Most of the material facts are not in dispute. The Plaintiff knew a policy of insurance would not be issued until satisfactory physical examinations were submitted but says Defendant’s agent agreed there would be coverage under the policy pending a determination by the Defendant as to whether or not it would issue the policy.

[906]*906The portion of the Plaintiffs testimony which is pertinent to the issue before us is as follows:

“Q. Going back to the day of the application, I believe you said that you didn’t recall precisely why the check was not presented to Mr. Cunningham that night; is that correct?
“A. That’s correct.
“Q. But that sometime after that he did — did he come to you and ask you for the check, or did you see him and offer to give him a check?
“A. He dropped by my office. He was in the Courthouse. And he just dropped by and said he needed, you know, that you go in with the application.
“Q. Did you understand then, or previously, when the application was made, that the insurance would not go into force until the record of the medical exam and the home office specimens were received?
“A. The night we signed the application, you know, that was what I understood. But, now, when I gave him the check, I think the statement he made to me was that, ‘This is insurance for you and for me’ or something to that effect. Anyway, I got the idea that — from what he said, that should anything happen before it would go into effect that would cover us. And at the same time it would cover him — or cover your company from us cancelling before that or something to that effect. But that should — at the time, you know, that the application was either granted or denied— that if it were to be denied, that we would get the check back.”

Mr. Cunningham denied having made any statement that would lead Mrs. Seals to believe that coverage would be in effect pending a determination by the company as to whether or not it would issue a policy.

This would present a question for jury determination and make summary judgment inappropriate except it becomes a question of law as to whether or not such oral statements by the agent had the effect of extending coverage.

The application for insurance provides immediately above the signature of the Plaintiffs as follows: “I understand and agree that (a) the insurance shall not take effect unless the application has been accepted and approved by the company and full first premium paid (unless otherwise provided in the binding receipt, if issued), (b) oral statements between the agent and myself are not binding on the company unless accepted by the company in writing.”

The testimony of Mrs. Seals concerning this provision of the application was as follows:

“Q. And you read that language, T understand and agree that the insurance shall not take effect unless the application has been accepted and approved by the company and full first premium paid unless otherwise provided in the binding receipt if issued’; do you remember reading that?
“A. Yes.
“Q. And you didn’t receive a binding receipt?
“A. No.
“Q. And then the next statement is ‘oral statements between the agent and myself are not binding on the company unless accepted by the company in writing.’ Do you remember that being printed on there?
“A. No, I—
“Q. The whole statement there, it is underlined. Do you remember reading that?
“A. No. I probably read it.

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597 S.W.2d 904, 1979 Tenn. App. LEXIS 387, Counsel Stack Legal Research, https://law.counselstack.com/opinion/seals-v-appalachian-national-life-insurance-co-tennctapp-1979.