Wareham v. American Family Life Insurance Co.

922 S.W.2d 97, 1996 Mo. App. LEXIS 859, 1996 WL 266135
CourtMissouri Court of Appeals
DecidedMay 21, 1996
DocketNo. WD 51852
StatusPublished
Cited by4 cases

This text of 922 S.W.2d 97 (Wareham v. American Family Life Insurance Co.) is published on Counsel Stack Legal Research, covering Missouri Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Wareham v. American Family Life Insurance Co., 922 S.W.2d 97, 1996 Mo. App. LEXIS 859, 1996 WL 266135 (Mo. Ct. App. 1996).

Opinion

HANNA, Presiding Judge.

Susan H. Wareham appeals from an order of the circuit court granting summary judgment in favor of American Family Life Insurance Company and denying her motion for summary judgment and motion to strike.

On July 18, 1994, Ralph I. Wareham, the decedent, applied for a life insurance policy with American Family, naming the appellant as the beneficiary. On his application, the decedent disclosed that he had been cited in 1990 and 1993, for driving under the influence of alcohol. With his application, the decedent tendered to American Family a payment equivalent to two months of premiums at the standard rate. The application submitted by the decedent provided:

[ejxeept as may be provided in the Conditional Receipt, no insurance takes effect unless the Policy We issue is accepted by the Applicant and the first full premium is paid. Such acceptance and payment must occur while the health and insurability of the Proposed Primary Insured and the Payor named in Question 22 ... are the same as stated on the date of this Application.

On July 19, 1994, American Family issued the decedent a Conditional Receipt for life insurance. The Conditional Receipt contained the following condition precedent: “As of the effective date below, the Proposed Insured(s) must qualify under the Company’s rules and practices for the coverage(s) applied for at the company’s standard rates.” The Conditional Receipt further provided that:

THIS RECEIPT PROVIDES NO INSURANCE IF THE CONDITIONS ARE NOT MET. If one or more of the conditions in this Receipt is not met exactly for all Proposed Insured(s), this Receipt provides NO insurance and the Company’s only liability is to return the Payment submitted to the Applicant.

According to the terms and provisions of the life insurance policy for which the decedent applied, the insurance coverage commenced upon the delivery of the policy to the insured, or as provided by the Conditional Receipt. On July 28, 1994, the decedent committed suicide. At no time prior to the decedent’s death did American Family issue or deliver any life insurance policy to the decedent or any of his agents or representatives.

Due to the decedent’s negative driving history, he did not qualify for coverage at American Family’s standard rates. In fact, the decedent’s premiums would have been more than three times American Family’s standard rate. Following the decedent’s death, American Family remitted the premiums paid by the decedent.

Mrs. Wareham brought suit to recover the proceeds of the life insurance policy. Both parties moved for summary judgment. Appellant alleged that American Family was [99]*99estopped from claiming failure of a condition precedent, or alternatively had waived the same. The trial court denied appellant’s motion on the grounds that she failed to plead estoppel in her petition and, further, failed to submit any facts, either by affidavit or deposition, to support her allegations.

In its motion for summary judgment, American Family claimed that, pursuant to the terms of the application and Conditional Receipt, no contract for insurance existed because: (1) the decedent was not insurable at American Family’s standard rates, and (2) no policy was ever issued. The trial court sustained American Family’s motion on these grounds. Appellant raises three points on appeal.

Appellate review of the propriety of summary judgment is essentially de novo. ITT Commercial Fin. Corp. v. Mid-America Marine Supply Corp., 854 S.W.2d 371, 376 (Mo. banc 1993). The record is viewed in the light most favorable to the party against whom summary judgment was entered, and that party is afforded all reasonable inferences that may be drawn from the evidence. Id. Summary judgment will be affirmed on appeal if the reviewing court determines that no genuine issues of material fact exist and the movant has a right to judgment as a matter of law. General Motors Corp. v. Kansas City, 895 S.W.2d 59, 61 (Mo.App.1995), cert. denied, — U.S. -, 116 S.Ct. 277, 133 L.Ed.2d 197 (1995).

In her first and second points, appellant argues that the trial court erred in granting American Family’s motion for summary judgment and denying her motion for summary judgment because the doctrines of es-toppel and/or waiver barred American Family from denying the decedent coverage. In making her argument, the appellant points to two facts: (1) the decedent disclosed his driving record on his initial application, and (2) an agent of American Family indicated that the decedent was an “excellent risk” on his application. Appellant argues that, despite American Family’s knowledge of the decedent’s driving record, it accepted the decedent’s premium payment and issued him a Conditional Receipt of insurance. Thus, she contends, American Family waived and/or is estopped from denying coverage.

As both the trial court and American Family noted, the appellant failed to affirmatively plead her theory of estoppel, or to allege facts supporting such an allegation in her petition. Nor did she attempt to amend her petition to reflect her estoppel argument. It is well-established Missouri law that a party relying on the doctrines of waiver and/or estoppel as support for a cause of action must plead such doctrines. Phipps v. Shelter Mut. Ins. Co., 715 S.W.2d 930, 934 (Mo.App.1986).

However, even if the defenses were properly raised, no contract for insurance was in existence when the decedent died. A contract cannot be created by estoppel and/or waiver where none exists. State Farm Mut. Automobile Ins. Co. v. Hartford Accident & Indem. Co., 646 S.W.2d 379, 381 (Mo.App.1983).

American Family argues that no contract for insurance existed under either the application or the Conditional Receipt. An application for insurance is but an offer, and does not become a completed contract until it is accepted by the insurer, and all conditions precedent are met. Kopff v. Economy Radiator Serv., 838 S.W.2d 449, 453 (Mo.App.1992); Soutiea v. American Nat’l Ins. Co., 595 S.W.2d 467, 470 (Mo.App.1980). Coverage under the Conditional Receipt was contingent upon the decedent qualifying for coverage at its standard rates.1 The decedent’s negative driving record precluded him from qualifying for coverage at American Family’s standard rates and, as such, he failed to meet “exactly” all of the conditions precedent in the Conditional Receipt. For this reason, American Family rejected his application and denied him coverage.

Appellant does not dispute the fact that the decedent failed to fulfill all conditions precedent, as required by the Conditional Receipt. Nor does she dispute the fact that [100]*100American Family did not issue a policy to the decedent or otherwise accept the decedent’s offer.

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Bluebook (online)
922 S.W.2d 97, 1996 Mo. App. LEXIS 859, 1996 WL 266135, Counsel Stack Legal Research, https://law.counselstack.com/opinion/wareham-v-american-family-life-insurance-co-moctapp-1996.