West & Co. of La., Inc. v. Sykes

515 S.W.2d 635, 257 Ark. 245, 1974 Ark. LEXIS 1343
CourtSupreme Court of Arkansas
DecidedNovember 18, 1974
Docket74-157
StatusPublished
Cited by7 cases

This text of 515 S.W.2d 635 (West & Co. of La., Inc. v. Sykes) is published on Counsel Stack Legal Research, covering Supreme Court of Arkansas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
West & Co. of La., Inc. v. Sykes, 515 S.W.2d 635, 257 Ark. 245, 1974 Ark. LEXIS 1343 (Ark. 1974).

Opinion

Conley Byrd, Justice.

The issue here is whether appellant West & Co. of Louisiana, Inc. by furnishing to its employees a group hospital and surgical benefit plan is transacting the business of insurance contrary to the provisions of Acts 1959, No. 148, Ark. Stat. Ann. § 66-2001 et seq. The trial court held in favor of appellee, A. Gene Sykes, Insurance Commissioner, State of Arkansas and enjoined appellant from “assuming and agreeing to pay, and paying out of its own funds, all or any portion of such benefits” until it had complied with the Arkansas Insurance Code.

Appellee concedes that the facts are not in dispute. They show that West & Co. of Louisiana, Inc. operates a group of Department Stores in Louisiana, Arkansas, Mississippi, Alabama and Texas. It furnishes to its employees a number of fringe benefits such as sick leave, profit sharing and the “group hospital and surgical benefit plan” that is here involved. The cost of the group hospital and surgical plan is shared with those employees who participate therein. A single employee pays $9.00 per month and an employee with a family pays $18.00 per month irrespective of age, health or number of dependents covered. Appellant sustains the balance of the cost of the plan including all administrative expenses. The record shows that for the last five years appellant in addition to the administrative expenses has paid out in benefits $102,781.72, more than the employees have paid in. The undisputed evidence is that the plan, very similar to a number of medical plans offered by insurance companies generally, if carried by an insurance company would cost each employee in excess of $40.00 per month.

To sustain the action of the lower court appellee relies upon the following provisions of the Arkansas Insurance Code:

“Ark. Stat. Ann. § 66-2002 (Repl. 1966). INSURANCE DEFINED. ‘Insurance' is a contract whereby one undertakes to indemnify another to pay a specified amount or provide a designated benefit upon determinable contingencies.
“Ark. Stat. Ann. § 66-2003 (Repl. 1966). INSURER DEFINED. ‘Insurer' includes every person engaged as indemnitor, surety, or contractor in the business of entering into contracts of insurance.
“Ark. Stat. Ann. § 66-2009 (Repl. 1966). TRANSACTING INSURANCE. 'Transact' with respect to insurance includes any of the following:
(1) Solicitation and inducement.
(2) Preliminary negotiations.
(3) Effectuation of a contract of insurance.
(4) Transaction of matters subsequent to effectuation of a contract of insurance and arising out of it.”

The appellee then quotes from 12 Applcman, Insurance Law & Practice, § 7001 as follows:

“Whether the contract is one of insurance must be determined from its purpose, effect, content, terminology, and conduct of the parties, and not from its designation therein, since a contract which is fundamentally one of insurance cannot be altered by the use or absence of words in a contract itself. The Court must look also to the intention of the parties in making this determination.”

The appellant on the other hand relies upon 12 Appleman, Insurance Law & Practice, § 7002, which provides in part as follows:

“A statute designed to regulate the business of insurance, growing out of experience with them and evils developing in them, is not intended to apply to all organizations having some element of risk assumption or distribution in their operations. The question of whether an. arrangement is one of insurance may turn, not on whether a risk is involved or assumed, but on whether that or something else to which it is related in the particular plan is its principal object and purpose. The courts of the District of Columbia have been prone to regard non profit group medical and hospitalization plans as not constituting insurance.
“The courts have been prone, doubtless because of the charitable and self-sufficient nature of railroad relief associations, to hold that they are not insurance companies within the provisions of regulatory acts. Similarly, a contract made by a corporation conducting a hospital, providing that for a stated consideration a woman should be received into the hospital and cared for the rest of her life, was not considered to constitute insurance, nor to be ultra vires nor against public policy. Pure endowment or annuity contracts have been considered not true insurance contracts.”

Keeton, Insurance Law-Basic Text, 8.2(a), makes the observation that statutory definitions of insurance as provided in Calif. Ins. Code § 22 (West 1955) and Mass. Gen. Laws Ann. ch. 175, § 2, (1958), are “so broad and general as to be virtually useless as guides to determine applicability of the regulatory system in a disputed setting.” The Calif. Ins. Code § 22 provides:

“Insurance is a contract whereby one undertakes to indemnify another against loss, damage or liability arising from a contingent or unknown event.”

In a footnote at page 543 Keeton, supra, states:

“Arguably these statutes should be read not as stating that every transaction having the stated characteristics is insurance but only as saying that no transaction is insurance unless it has these characteristics. If so construed, there would seldom be any occasion to invoke them since it is not likely that a transaction lacking these characteristics would be alleged to be insurance even if there were no statutory definition of that term. Reading these statutes instead as stating that all transactions having these characteristics are insurance would be to give them a meaning plainly inconsistent with the much narrower scope of regulation in practice. Many arrangements having these characteristics are never asserted to be insurance even by the most aggressive of regulatory officials.”

Other jurisdictions generally support the above quotations from Appleman § 7002, supra, and Keeton, supra. See State v. Pittsburgh, C.C. & St. Louis Ry. Co., 68 Ohio St. 9, 67 N.E. 93 (1903) and Colaizzi v. Pennsylvania R. Co., 208 N.Y. 275, 101 N.E. 859 (1913), holding that the operation of “railroad relief associations” do not constitute the doing of an insurance business. In California-Western St. Life Ins. Co. v. State Bd. of Eq., 151 Cal. App. 2d 559, 312 P. 2d 19 (1957), the retirement fund there involved was handled by the employer, a life insurance company, in much the same manner as the “West Plan’.’ here involved. After noting that the plan offered to the employees was optional; that it was not offered to persons other than employees; and that the plan was not ac-tuarially sound and was intended that way, the court in holding that the plan did not constitute an insurance contract, stated:

“. . .

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

Related

Douglass v. Dynamic Enterprises, Inc.
869 S.W.2d 14 (Supreme Court of Arkansas, 1994)
Opinion No.
Arkansas Attorney General Reports, 1989
First Nat. Bank of Eastern Arkansas v. Eubanks
740 F. Supp. 1427 (E.D. Arkansas, 1989)
City of Marianna v. Arkansas Municipal League
722 S.W.2d 578 (Supreme Court of Arkansas, 1987)
Bell v. Employee Security Benefit Ass'n
437 F. Supp. 382 (D. Kansas, 1977)
Employe Benefit Plans
70 Pa. D. & C.2d 661 (Pennsylvania Department of Justice, 1975)
State Ex Rel. Farmer v. Monsanto Company
517 S.W.2d 129 (Supreme Court of Missouri, 1974)

Cite This Page — Counsel Stack

Bluebook (online)
515 S.W.2d 635, 257 Ark. 245, 1974 Ark. LEXIS 1343, Counsel Stack Legal Research, https://law.counselstack.com/opinion/west-co-of-la-inc-v-sykes-ark-1974.