Thompson v. Occidental Life Insurance

513 P.2d 353, 9 Cal. 3d 904, 109 Cal. Rptr. 473, 1973 Cal. LEXIS 236
CourtCalifornia Supreme Court
DecidedAugust 27, 1973
DocketS.F. 22951
StatusPublished
Cited by128 cases

This text of 513 P.2d 353 (Thompson v. Occidental Life Insurance) is published on Counsel Stack Legal Research, covering California Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Thompson v. Occidental Life Insurance, 513 P.2d 353, 9 Cal. 3d 904, 109 Cal. Rptr. 473, 1973 Cal. LEXIS 236 (Cal. 1973).

Opinion

*909 Opinion

BURKE, J.

We are asked to decide whether, under the particular facts of this case, a contract of life insurance existed between plaintiff’s deceased spouse and defendant insurance company, and if so, whether decedent’s alleged misrepresentations regarding the state of his health and past medical history rendered that contract void and unenforceable. The trial court, aided by an advisory jury, found in plaintiff’s favor and awarded her $200,000, plus interest. Defendant appeals. We have concluded that the judgment should be affirmed.

Donald L. Thompson, husband of plaintiff Ruth M. Thompson, was insured by defendant Occidental Life Insurance Company of California (“Occidental”) under a $15,000 life insurance policy which provided for double indemnity for accidental death. Concerned about the adequacy of his medical and life insurance, Thompson contacted John Kelly, the Oakland manager of Occidental, for the purpose of increasing his insurance coverage. Kelly then met with Thompson’s accountant to determine what type of policy Thompson should purchase and decided upon a five-year convertible term policy for $100,000 with double indemnity for accidental death. On August 5, 1964, Thompson signed an application for the recommended policy and on August 11 submitted to a medical examination.

Two days after the medical examination, Kelly went to Thompson’s office and requested payment of the first premium on the policy. Although his testimony was somewhat imprecise, perhaps because of the passage of time, Kelly recalled explaining to Thompson that if he failed to pay the first premium, he would not be covered in the meantime even if he were ultimately found insurable. However, Kelly was not able to recall whether he actually told Thompson that a premium payment would not assure interim coverage should Thompson prove uninsurable. At one point in his deposition testimony, read into the record at trial, Kelly stated that “I was thinking in terms of suppose this guy goes and completes his application, everything is done, and he wouldn’t have been insured. Here he has no coverage because he hasn’t any premium paid, and that was all that was in my mind. I wasn’t thinking in terms of all the technical stuff in here now . . . .” Thompson paid the requested premium to Kelly the next day.

Thompson’s application was received by Occidental’s underwriters on August 17. The underwriters decided to require an additional medical examination. On August 24, before he was informed of this decision, Thompson sustained an accident (falling into his bathtub and nearly suffocating) which resulted in his death four days later. Occidental determined *910 that Thompson’s death was accidental and paid plaintiff, as beneficiary, $30,000 as double indemnity under the $15,000 life insurance policy. However, Occidental notified plaintiff on September 4 that it would neither issue nor make payment under the $100,000 life insurance policy because the additional medical examination had not been completed. Thereafter, Occidental returned to plaintiff the first premium by a check drawn on its own account. Plaintiff retained the check and sued to recover $200,000 as double indemnity under the $100,000 policy and, as indicated above, judgment was entered awarding plaintiff $200,000 and $82,108.60 as interest. Defendant appeals.

1. Formation of Insurance Contract

Defendant’s first contention is that no insurance contract ever came into existence, since no policy was ever delivered to Thompson, since he had not completed the second medical examination required by Occidental, and since Thompson was ultimately found to be uninsurable by Occidental. To support its contention, defendant relies on the language of its own standard form application executed by Thompson. 1 This court, however, in Ransom V. Penn Mutual Life Ins. Co., 43 Cal.2d 420 [274 P.2d 633], considered similar contract language 2 in an almost identical factual set *911 ting 3 and resolved the issue in favor of the insured. In Ransom (p. 423), this court had to “determine whether a contract of insurance arose immediately upon receipt by defendant of the completed application with the premium payment, subject to the right of defendant to terminate the agreement if it subsequently concluded that Ransom was not acceptable, or whether . . . [defendant’s] satisfaction as to Ransom’s acceptability for insurance was a condition precedent to the existence of any contract.”

We found in Ransom (p. 425) “that a contract of insurance arose upon defendant’s receipt of the completed application and the first premium payment” and held that the “understanding of an ordinary person is the standard which must be used in construing the contract, . . .” We also found that an ordinary person reading the application could reasonably believe that “he would secure the benefit of immediate coverage by paying the premium in advance of delivery of the policy.”

We do not believe that the language of the application in Ransom reasonably can be distinguished from the language of the application and receipt in the present case. 4 As the United States Court of Appeals, Ninth *912 Circuit, observed in Metropolitan Life Insurance Company v. Grant, 268 F.2d 307, 309, the California courts make “no attempt ... to draw fine distinctions from the various phraseology used in the numerous policies . . . .” Of course, an insurance company is not precluded from imposing conditions precedent to the effectiveness of insurance coverage despite the advance payment of the first premium. However, as Ransom explains, any such condition must be stated in conspicuous, unambiguous and unequivocal language which an ordinary layman can understand. As the insurer is responsible for drafting the application, it is appropriate that he be required to choose plain and unequivocal terms. (See also Slobojan v. Western Travelers Life Ins. Co., 70 Cal.2d 432 [74 Cal.Rptr. 895, 450 P.2d 271]; Young v. Metropolitan Life Ins. Co., 272 Cal.App.2d 453 [77 Cal.Rptr. 382, 78 Cal.Rptr. 568]; Koorstad v. Washington Nat. Ins. Co., 257 Cal.App.2d 399 [64 Cal.Rptr. 882]; Wernecke v. Pacific Fidelity Life Ins. Co., 238 Cal.App.2d 884 [48 Cal.Rptr. 251]; Brunt v. Occidental Life Ins. Co., 223 Cal.App.2d 179 [35 Cal.Rptr. 492]; Metropolitan Life Insurance Company v. Wood (9th Cir.) 302 F.2d 802; Metropolitan Life Insurance Company

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

Related

Duarte v. Pacific Specialty Ins.
California Court of Appeal, 2017
Evergreen Recycle, L.L.C. v. Indiana Lumbermens Mutual Insurance Co.
350 P.3d 1091 (Court of Appeals of Kansas, 2015)
Douglas v. Fidelity National Insurance
229 Cal. App. 4th 392 (California Court of Appeal, 2014)
De La Torre v. Century Surety Co. CA4/1
California Court of Appeal, 2014
Judith Moore v. Safeco Insurance Company of Am
549 F. App'x 651 (Ninth Circuit, 2013)
Marshall Salkin v. Usaa Life Insurance Company
544 F. App'x 713 (Ninth Circuit, 2013)
Salkin v. United Services Automobile Ass'n
835 F. Supp. 2d 825 (C.D. California, 2011)
Majiman Hafiz v. Metropolitan Life Insurance Co
390 F. App'x 671 (Ninth Circuit, 2010)
Nazaretyan v. California Physicians' Service
182 Cal. App. 4th 1601 (California Court of Appeal, 2010)
Carolina Casualty Insurance Company v. Rdd, Inc.
685 F. Supp. 2d 1052 (N.D. California, 2010)
Clarendon National Insurance v. H & G Transport, Inc.
290 F. App'x 62 (Ninth Circuit, 2008)
Admiral Insurance v. Debber
442 F. Supp. 2d 958 (E.D. California, 2006)
Clarendon National Insurance v. Insurance Co. of the West
442 F. Supp. 2d 914 (E.D. California, 2006)
Mitchell v. United National Insurance
25 Cal. Rptr. 3d 627 (California Court of Appeal, 2005)
Hodgson v. Banner Life Insurance
21 Cal. Rptr. 3d 907 (California Court of Appeal, 2005)
Haynes v. Farmers Insurance Exchange
89 P.3d 381 (California Supreme Court, 2004)

Cite This Page — Counsel Stack

Bluebook (online)
513 P.2d 353, 9 Cal. 3d 904, 109 Cal. Rptr. 473, 1973 Cal. LEXIS 236, Counsel Stack Legal Research, https://law.counselstack.com/opinion/thompson-v-occidental-life-insurance-cal-1973.