United Fire Insurance v. McClelland

780 P.2d 193, 105 Nev. 504, 1989 Nev. LEXIS 261
CourtNevada Supreme Court
DecidedSeptember 6, 1989
Docket18705
StatusPublished
Cited by74 cases

This text of 780 P.2d 193 (United Fire Insurance v. McClelland) is published on Counsel Stack Legal Research, covering Nevada Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
United Fire Insurance v. McClelland, 780 P.2d 193, 105 Nev. 504, 1989 Nev. LEXIS 261 (Neb. 1989).

Opinion

*506 OPINION

Per Curiam:

This appeal arose from an action brought against appellants United Fire Insurance Company and its parent, United Diversified Corporation, due to United Fire’s refusal to pay Kenneth McClelland’s claims for medical treatment. A jury found appellants liable for bad faith and awarded respondents Kenneth and Joni McClelland compensatory and punitive damages.

FACTS

Kenneth received group accident and health insurance as a participant in the American Marketers Association Group Insurance Plan (AMA plan). United Fire issued the master policy of insurance to a trustee for the AMA plan, a Mississippi bank. Some 6,724 people were insured under this policy.

In November 1982, the California insurance commissioner issued a cease and desist order to United Fire requiring that it stop doing all business in California effective January 1, 1983. Two months later, the Nevada insurance commissioner served a similar order on United Fire.

On December 30, 1982, one of United Fire’s vice presidents sent a letter to all the insureds under the AMA plan notifying them of a 23.5 percent increase in premiums and cautioning them not to “change or drop” their protection. This letter mentioned nothing about the cease and desist order or about United Fire’s financial difficulties.

United Fire and California Life Insurance Company executed a reinsurance and assumption agreement (Agreement) on January 18, 1983. This Agreement provided that, as of January 1, 1983, California Life acquired all United Fire’s rights and assumed all *507 United Fire’s obligations under the “policies.” The “policies” included the AMA plan.

On January 24, 1983, United Fire’s president wrote to all of the insureds under the AMA plan informing them that California Life had assumed United Fire’s liability under the AMA policy and stating that insureds would receive an assumption certificate from California Life. California Life never sent the promised assumption certificate.

The McClellands continued to receive correspondence from United Fire through May 1983. On June 30, 1983, California Life mailed a letter to the participants in the AMA plan telling them that the coverage under the group plan would be cancelled, effective October 1, 1983. Two weeks later, California Life sent a second letter, changing the cancellation date to November 1, 1983. However, the policy expressly stated that it may be terminated upon the premium due date if written notice is given the policyholder, the Mississippi bank, at least 120 days in advance of such premium date. California Life never notified the policyholder of the cancellation.

At the time of the Agreement, Kenneth was healthy and insurable. However, in March 1983, doctors diagnosed Kenneth as having an altered renal function with stones in both kidneys. Kenneth had several operations and hospitalizations to remove stones, cure infections, and implant and replace a tube from the bladder to the kidney.

Once the dispute over insurance arose, Kenneth delayed several times in receiving hospital treatment because of a lack of money. On one occasion, Kenneth refused to go to the hospital when his infection was particularly severe. When he finally did get to the hospital, it took seven days before the infection could be controlled. Kenneth’s physician testified that the McClellands seemed emotionally distraught due to the amount of the medical-bills which accumulated with no means of paying them.

The McClellands filed suit against appellants and California Life. Just before trial commenced, California Life agreed to pay McClellands their contract benefits under the policy. The McClellands proceeded to trial against appellants. A jury awarded Kenneth compensatory damages of $143,000, Joni compensatory damages of $73,000, and $500,000 in punitive damages.

Appellants assert that as a matter of law they owed the McClellands no insurance benefits because United Fire and California Life executed the Agreement which substituted California Life as insurer in United Fire’s place. Moreover, appellants claim that expert testimony improperly invaded the jury’s province on all *508 key issues, and that no bad faith liability existed since any obligation they had to the McClellands presented unresolved questions of fact and law. Next, appellants argue that the punitive damages award was not supported by either the facts or the law. Finally, appellants contend that the trial court erred by submitting Joni’s claims to the jury. We affirm the district court’s decision except for the portion awarding Joni compensatory damages.

NOVATION

Appellants contend that they owed the McClellands no insurance benefits because the policy was transferred to California Life, with the McClellands’ knowledge and consent, before the claims giving rise to this suit arose. Thus, they argue that the evidence of novation entitled them to judgment as a matter of law.

A novation consists of four elements: (1) there must be an existing valid contract; (2) all parties must agree to a new contract; (3) the new contract must extinguish the old contract; and (4) the new contract must be valid. Boswell v. Lyon, 401 N.E.2d 735, 741 (Ind.Ct.App. 1980). If all four elements exist, a novation occurred. Id. Additionally, the intent of all parties to cause a novation must be clear. Pink v. Busch, 100 Nev. 684, 690, 691 P.2d 456, 460 (1984). However, consent to novation may be implied from the circumstances of the transaction and by the subsequent conduct of the parties. Sans Souci v. Div. of Fla. Land Sales, 448 So.2d 1116, 1121 (Fla.Dist.Ct.App. 1984).

Novation is a question of law only when the agreement and consent of the parties are unequivocal. Downing v. Dial, 426 N.E.2d 416, 419 (Ind.Ct.App. 1981). Whether a novation occurred is a question of fact if the evidence is such that reasonable persons can draw more than one conclusion. Herb Hill Ins., Inc. v. Radtke, 380 N.W.2d 651, 654 (N.D. 1986).

Appellants rely on the January 24, 1983 letter which United Fire sent to its insureds under the AMA plan to prove that a novation occurred. According to United Fire, the letter unmistakably indicated that United Fire would have no liability for claims incurred after the effective date, January 1, 1983. Appellants argue that the McClellands’ failure to submit the disputed medical bills to United Fire confirms that the McClellands derived the same understanding from the letter.

We conclude that a novation did not occur as a matter of law due to questions regarding the McClellands’ alleged consent. *509 Therefore, the district court properly submitted the issue to the jury. Moreover, the party asserting novation has the burden of proving all the essentials of novation by clear and convincing evidence. Miami Nat. Bank v. Forecast Const.

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780 P.2d 193, 105 Nev. 504, 1989 Nev. LEXIS 261, Counsel Stack Legal Research, https://law.counselstack.com/opinion/united-fire-insurance-v-mcclelland-nev-1989.