Warner v. CONTINENTAL CASUALTY COMPANY

534 P.2d 695
CourtCourt of Civil Appeals of Oklahoma
DecidedApril 24, 1975
Docket47622
StatusPublished
Cited by9 cases

This text of 534 P.2d 695 (Warner v. CONTINENTAL CASUALTY COMPANY) is published on Counsel Stack Legal Research, covering Court of Civil Appeals of Oklahoma primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Warner v. CONTINENTAL CASUALTY COMPANY, 534 P.2d 695 (Okla. Ct. App. 1975).

Opinion

BOX, Judge.

An appeal by Continental Casualty Company, defendant below, from a decision of the District Court of Canadian County, entering judgment in favor of Clarence E. Warner, appellee and plaintiff below.

Warner, who was then Chairman of the State Republican Committee, brought an action against Continental' Casualty Company, seeking reformation of an insurance policy issued to him by Continental. The controversy arose out of the following events:

The State Republican Committee had been dissatisfied with its existing group major medical policy. In an effort to obtain a more favorable premium rate, Warner directed the Committee’s finance secretary to contact A1 Snipes, president of an independent fire and casualty insurance agency, with reference to obtaining a similar group health plan from some other insurer.

Snipe was well acquainted with most of the employees of the Committee and had handled the insurance needs of the Committee in numerous other situations. Snipes agreed to help the Committee secure such a policy and obtained a copy of the existing group insurance policy in order to make a comparison with other insurance plans.

Although he was a licensed agent for Continental, Snipes was not familiar with the group major medical plan it offered. He consulted Mr. Gerald Snow, a Continental field representative, and informed him that the Committee was seeking another group insurance plan. Snow had contacted Snipes on numerous occasions in an effort to solicit business for Continental. As a field representative, Snow apparently had no authority to take applications for insurance directly from customers but was limited solely to encouraging agents to sell Continental insurance.

Snipes could not recall whether he had actually informed Snow that the Committee was seeking to obtain major medical coverage but he apparently did outline the kind of group coverage the Committee then had. He gave Snow the necessary data concerning the number of employees; their age, sex and names and also told him that the Committee was interested in increasing its hospital “room benefits” and wanted to compare rates in order to determine if changing insurance would be logical.

Snow and Snipes arranged for a sales presentation to be given the employees of *697 the State Committee. On April 1, 1971 Snow presented the Continental group plan and Snipes presented a major medical policy provided by Aetna Insurance Company.

During the presentation both Snow and Snipes made remarks to the effect that the two policies were essentially the same. At the beginning of his presentation, Snow stated that there was no appreciable difference between the policies. After Snow and Snipes had finished their presentations, the employees discussed the two plans and put questions to both. When Snipes was asked what he thought of the Continental plan he stated that it sounded good to him; that it would be adequate; that the Aetna plan certainly did not match it as far as premiums were concerned; and that the Aetna policy (which was clearly a major medical plan) and the Continental policy were essentially the same.

The evidence clearly indicates that the Committee employees, including Warner, relied upon the representations of Snow and Snipes in selecting the Continental policy over the Aetna policy, and believed that they had chosen a major medical plan similar to the Aetna policy presented by Snipes. All of the employees signed applications for a group policy without knowing or being informed by either Snow or Snipes that they were in fact making application for a group hospital plan rather than a group major medical plan.

Warner never discovered that the Continental policy did not include major medical coverage until nearly a year later when he sustained serious injuries from an automobile accident. Warner presented numerous hospital and medical bills to Snipes, who helped him tender his claim to Continental. Snipes visited Warner on one occasion and reaffirmed his belief that the policy contained major medical coverage. After Continental informed Warner that his policy did not provide major medical coverage, Snipes wrote a letter to the Continental office stating that at the sales presentation both he and the employees were of the opinion that the Continental policy covered major medical; that Snipes had no reason to doubt the policy terms as presented by Snow; and because of the misunderstanding Continental should pay Warner’s claim.

Despite Snipes’ efforts, Continental continued to refuse to pay Warner’s claim. In response, Warner brought this suit to reform the policy to conform to the alleged understanding of the parties that the Continental policy would pay 80 percent of all medical bills, subject to certain limitations and exceptions not material to this discussion. He also sought judgment against Continental for 80 percent of his outstanding medical bills. The trial court rendered judgment in favor of Warner.

Continental asserts several grounds for setting aside the judgment for plaintiff, as follows:

(1) It argues that Snipes lacked the authority to bind Continental to the antecedent oral agreement;
(2) That the trial court erred in finding that the evidence supported the conclusion that a mutual mistake had occurred; and
(3) That Warner’s failure to obtain the desired insurance coverage was due solely to his own negligence and for that reason, and for the additional reason that Warner failed to read his policy when he received it, that he is now es-topped to seek reformation.

The record reveals that Snipes was licensed with the State Insurance Commission as an agent for Continental. Consequently he was an agent within the meaning of 36 O.S.1971, § 1302. Continental does not contest this fact but contends that Snipes was a “soliciting agent” rather than a “policy writing agent” and thus lacked the authority to bind it to a risk not previously approved by its underwriting division. Continental asserts that since the application approved by Continental’s underwriters was an application for group hospital insurance rather than major medical *698 insurance, Snipes representations to Warner cannot bind it.

The evidence is less than conclusive as to Snipes exact status and the trial court made no finding of fact on this issue. Snipes himself was unsure of the extent of his authority as agent for Continental. It appears that the customary practice was that an agent’s authority was restricted to the solicitation of applications and submission to' the Continental underwriting department for approval or rejection.

The often quoted language of Phipps v. Union Mutual Ins. Co., 50 Okl. 135, 150 P. 1083, provides a general definition of a “soliciting agent” under Oklahoma law, as follows:

“Syllabus by the Court.
“Ordinarily a mere ‘soliciting agent’ for an insurance company — that is, one whose power is confined to taking applications for insurance, which, when taken, are to be forwarded to the company for its approval or rejection — has no power to bind the company to a contract of insurance; nor has he, after the policy is issued, any authority to waive any of the terms or provisions therein.”

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Bluebook (online)
534 P.2d 695, Counsel Stack Legal Research, https://law.counselstack.com/opinion/warner-v-continental-casualty-company-oklacivapp-1975.