Wayside Farms, Inc. v. The Hartford Life Insurance Co.

886 F.2d 139, 1989 U.S. App. LEXIS 14414, 1989 WL 110815
CourtCourt of Appeals for the Sixth Circuit
DecidedSeptember 27, 1989
Docket87-4076
StatusPublished
Cited by3 cases

This text of 886 F.2d 139 (Wayside Farms, Inc. v. The Hartford Life Insurance Co.) is published on Counsel Stack Legal Research, covering Court of Appeals for the Sixth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Wayside Farms, Inc. v. The Hartford Life Insurance Co., 886 F.2d 139, 1989 U.S. App. LEXIS 14414, 1989 WL 110815 (6th Cir. 1989).

Opinion

NATHANIEL R. JONES, Circuit Judge.

Plaintiffs, Wayside Farms, Inc. and Rebecca Pool, et al. (“Wayside Farms”), appeal from the district court’s judgment, which dismissed its claim against defendant, The Hartford Life Insurance Company (“Hartford”). For the following reasons, we affirm.

I.

Plaintiffs are beneficiaries of two life insurance policies issued by Hartford Life. The first policy, issued in 1964, insured the life of Judith Loving in the amount of $10,000.00 and designated Rebecca Pool (Loving’s daughter) as the beneficiary. The second policy, issued in 1981, insured Loving for $2 million and named Wayside Farms Nursing Home (Loving’s company) as the beneficiary. The year of birth listed on both insurance applications is 1920.

Loving died on January 24, 1985. Shortly thereafter, Pool submitted claims for both of the policies. The claims forms and death certificate submitted to Hartford Life listed Loving’s date of birth as December 15,1915. Mary Gilletti, Hartford Life’s claims manager, noticed the discrepancy between the birth date listed in the policy and the date found in the claims document and death certificate. According to Gillet-ti, upon discovery of the age discrepancy, she informed plaintiffs that there might be an age adjustment. Although Gilletti asked Pool to provide authoritative documentation regarding Loving’s date of birth, Pool failed to do so. As a result of the discrepancy, Hartford Life’s actuary calculated the amount of the age adjustment employing the N.A.I.C. model universal life regulations (N.A.I.C.). According to Gillet-ti, Hartford Life’s associate general counsel assured her that this adjustment comported with the Ohio insurance law.

Before Hartford Life made its final determination, Gilletti suggested a review of the underwriting file to confirm the date of birth. She directed David Moshier, a Hartford Life sales representative, and David Baughman, the agent who prepared both of Loving’s insurance policy applications, to conduct an informal investigation into Loving’s age. This investigation revealed that Loving had used other birth dates in addition to the 1915 and 1920 dates already known to Hartford Life. A second investigation, conducted by Equifax Services, Inc., an investigating firm specializing in national data searches, also indicated that Loving had used a wide variety of birth dates. Neither inquiry obtained an official birth certificate.

On April 16, 1985, Hartford Life finally paid the beneficiaries $1 million plus interest accrued from the date of Loving’s death. Since there was no definitive documentation as to Loving’s date of birth, Hartford Life paid the claim based on what it believed to be the most likely date of birth — 1917. Hartford Life’s payment equaled full benefits due based on the 1917 *141 date of birth, with the policy benefits readjusted to reflect the amount of insurance purchased by the premiums paid. These benefits were calculated in accordance with the N.A.I.C. method.

On January 8, 1986, Wayside Farms filed this suit for the full face amount of the policies less the amount actually paid by Hartford Life, plus consequential and punitive damages and attorney’s fees. On January 14, 1987, Wayside Farms filed a nearly identical complaint seeking damages from the Hartford Fire Insurance Company, claiming that Hartford Life was its alter ego. The two actions were subsequently consolidated for trial. From October 7-15, 1987, a jury trial was held to determine Hartford Life’s liability. On October 15, 1987, the district court granted Hartford Life’s motion for a directed verdict on all issues, and on October 23, 1987, the district court entered an Opinion dismissing Wayside Farms’ claims against both companies.

On November 20, 1987, Wayside Farms appealed from the district court’s order granting a directed verdict to the Hartford Life Insurance Company. Wayside Farms did not appeal the order directing a verdict for the Hartford Fire Insurance Company.

II.

Wayside Farms’ first major argument consists of two parts: that Hartford Life knew or should have known of the age misstatement and that Hartford Life’s failure to investigate the age discrepancy constituted bad faith. Wayside Farms first argues that under section 3911.06 of the Ohio Revised Code, an insurance company can not use an incorrect answer on an application for insurance to avoid liability unless it can demonstrate a lack of knowledge of that wrong answer. 1 Wayside Farms asserts that Hartford Life and its agent knew, or through reasonable diligence should have known, of the age discrepancy.

The district court reasoned that since section 3911.06 is part of a statutory scheme which treats age misstatements differently than other answers provided in an insurance application, this section must be read together with two other sections which relate to misstatements of age. Section 3915.05(E) requires the insurer to adjust the benefit payable in accordance with the true age of the insured and the premiums paid. 2 In addition, section 3911.07 specifically excepts an age misstatement from the limitation on defense that an insurer can raise after three annual premiums have been paid. 3

Ohio law provides that where two statutory provisions seem to conflict, the more specific statute should control. See Ohio Rev.Code Ann. § 1.51 (Baldwin 1988). In applying Ohio law to Wayside’s claim, the district court concluded that, in light of the statutory scheme, section 3911.06 is not applicable to the Loving claim. We agree with the district court that, to the extent *142 there is a conflict, sections 3915.05 and 3911.07 control because they specifically refer to age misstatements, whereas section 3911.06 refers to general information contained in the application. Because section 3911.06 is inapplicable, the district court correctly rejected Wayside Farms’ claim that Hartford Life is statutorily barred from adjusting the insurance award.

Wayside Farms also claims that Hartford Life’s failure to investigate the information in its file at the underwriting stage and to resolve the age discrepancy before the policy was issued constituted bad faith. Relying on Beard v. N.N. Investors Insurance, 21 Ohio App.3d 219, 486 N.E.2d 1255 (1985), the district court concluded that in order for Hartford Life to be bound, Loving must have fulfilled her duty to provide correct information upon which Hartford Life could rely and to respond to all questions on an insurance form in good faith. It is undisputed that Loving failed to meet that legal duty because she never informed Hartford Life that she was uncertain about her date of birth. Thus, the district court correctly found that her actions, rather than any bad faith by Hartford Life, caused the need for the benefits to be adjusted.

III.

Wayside Farms’ second major argument challenges the provision in Hartford Life’s policy which requires an adjustment if the age or sex of the insured is misstated.

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Bluebook (online)
886 F.2d 139, 1989 U.S. App. LEXIS 14414, 1989 WL 110815, Counsel Stack Legal Research, https://law.counselstack.com/opinion/wayside-farms-inc-v-the-hartford-life-insurance-co-ca6-1989.