Security Life Insurance Co. of America v. Meyling

146 F.3d 1184, 98 Cal. Daily Op. Serv. 5375, 22 Employee Benefits Cas. (BNA) 1430, 98 Daily Journal DAR 7545, 1998 U.S. App. LEXIS 15190, 1998 WL 379067
CourtCourt of Appeals for the Ninth Circuit
DecidedJuly 9, 1998
DocketNo. 97-15595
StatusPublished
Cited by1 cases

This text of 146 F.3d 1184 (Security Life Insurance Co. of America v. Meyling) is published on Counsel Stack Legal Research, covering Court of Appeals for the Ninth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Security Life Insurance Co. of America v. Meyling, 146 F.3d 1184, 98 Cal. Daily Op. Serv. 5375, 22 Employee Benefits Cas. (BNA) 1430, 98 Daily Journal DAR 7545, 1998 U.S. App. LEXIS 15190, 1998 WL 379067 (9th Cir. 1998).

Opinions

• PER CURIAM.

Garry Meyling appeals the district court’s grant of summary judgment in favor of Security Life Insurance Company of America in Security’s diversity action seeking to rescind its insurance contract with Meyling, its insured. Security sought rescission due to material misrepresentations in Meyling’s insurance application. He failed to disclose his prior negative medical history. We reverse.

BACKGROUND

Meyling is a co-owner, officer, and director of Hubbard, Krause & Meyling, Inc., a small company doing business as HKM Machine and Fabrication. In February 1993, HKM purchased health insurance from Security for its employees and their dependents, including Meyling. The parties do not dispute that the HKM insurance plan is an ERISA1 plan, nor do they dispute that HKM is the plan administrator.

As part of Security’s application process, each HKM employee including Meyling, was required to fill out an insurance application. The application asked the applicant to describe his medical history. In the five years prior to applying for coverage, Meyling had suffered and been treated for high blood pressure, back pain and back spasms, hyperventilation, and a panic disorder. However, on his application, Meyling falsely indicated that he had not been treated for or diagnosed with any of those illnesses.

Based on Meyling’s representations of good health, Security issued a policy to HKM at a discounted initial premium. The parties agree that the difference in premiums initially charged would be at least $5,775, which came about because the premium was 15% below normal, rather than 20% above normal, as it should have been.

However, under the Security Life policy, premiums do not remain fixed. Rather, if new health information is received which would have altered the amount of premiums, the insured is retroactively charged so that the insured ultimately pays the same premium as if the correct information had been given in the application. Specifically, in a section labeled “Premium Changes Due to Misstatements,” the Security Life policy provides that when misrepresentations are discovered:

There will be a charge to the Policyholder or refund from the Insurer to adjust for past premium payments. This charge or refund will be equal to the difference between: (i) premiums previously billed; and (ii) the premiums that, based on the most current data, should have been billed.

Aside from retroactive premium adjustment, the policy does not expressly provide Security Life any remedy for misstatements regarding health information. There is no provision for rescission, and the termination section does not include misrepresentation as a basis upon which to cancel the policy.

[1187]*1187Although the policy does not make any reference to common law remedies for misrepresentation, it contained an incontestability clause providing that the policy could not be contested after two years from the date of issue except for non-payment of premiums. The policy also provided that:

All statements made by the insured employee in the absence of fraud are representations and not warranties. A statement made by the insured employee may be used to contest entitlement to insurance only if: (i) it is part of a written application; (ii) a copy of the application has been given to that person; and (iii) the insurance for which the statement was made has been in effect for less than two years duiing the life of the insured employee.

The policy identified the contract as being composed of (a) the policy; (b) the policyholder’s application attached to the policy; (c) the individual applications of the insured persons, if any; and (d) the employer’s written statements as approved by the insurer.

After Security issued the policy, it asked Meyling to review his medical history responses, and for the first time warned that failure to disclose accurate information could result in rescission. Meyling did not correct the misrepresentations on his application.

In November 1994, Meyling suffered an aneurysm in the wall of his heart. He spent approximately three and a half months in the hospital and accrued medical bills in the amount of $670,000. Based on its discovery that Meyling had misrepresented his health history in his insurance application, Security refused to pay Meyling’s claim. Instead, it brought suit to rescind Meyling’s insurance policy. Meyling counterclaimed for breach of contract and bad faith under California law, and filed an amended complaint stating those claims under ERISA.

In July 1996, Security filed two motions for summary judgment. The first argued that Meyling’s state law claims were preempted by ERISA. That motion was granted and has not been appealed. The second motion asked the court to find as a matter of law that Security was entitled to rescission of the insurance contract based on material misrepresentations by Meyling. Meyling admitted the misrepresentations, but argued that under California Insurance Code sections 10700-10718.7 (hereafter sometimes referred to as AB 1672), insurance policies are not subject to rescission. The district court also granted Security’s second motion. It found that provisions of California’s Insurance Code which specifically permit rescission based on misrepresentations were not preempted by ERISA, that the provisions were not inconsistent with AB 1672, and that Security was entitled to rescission of its agreement with Meyling. Meyling appealed that determination.

JURISDICTION AND STANDARD OF REVIEW

The district court had jurisdiction over this case pursuant to 28 U.S.C. §§ 1331, 1332. We have jurisdiction under 28 U.S.C. § 1291.

We review de novo a district court’s grant of summary judgment. Cisneros v. UNUM Life Ins. Co. of America, 134 F.3d 939, 942 (9th Cir.1998); Babikian v. Paul Revere Life Ins. Co., 63 F.3d 837, 839 (9th Cir.1995). “ ‘[T]he district court’s interpretation and application of ERISA provisions and its determination that ERISA preempts a state law,’ ” are also reviewed de novo. Babikian, 63 F.3d at 839 (citation omitted); see also Serrato v. John Hancock Life Ins. Co., 31 F.3d 882, 884 (9th Cir.1994) (“ We also review de novo the district court’s interpretation and application of ERISA provisions and its determination that ERISA preempts a state law.’ ”) (citation omitted).

DISCUSSION

A. ERISA PREEMPTION of CALIFORNIA INSURANCE CODE §§ 331, 359, 10380

The district court based its grant of summary judgment in favor of Security on California Insurance Code sections 331, 359, and 10380, which allow an insurer to rescind an insurance contract when the insured has concealed or misrepresented material facts.2 [1188]*1188Meyling argues that these provisions are preempted by ERISA. We agree.

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146 F.3d 1184, 98 Cal. Daily Op. Serv. 5375, 22 Employee Benefits Cas. (BNA) 1430, 98 Daily Journal DAR 7545, 1998 U.S. App. LEXIS 15190, 1998 WL 379067, Counsel Stack Legal Research, https://law.counselstack.com/opinion/security-life-insurance-co-of-america-v-meyling-ca9-1998.