Wilkes v. Phoenix Home Life Mutual Insurance

851 A.2d 204, 2004 Pa. Super. 188, 2004 Pa. Super. LEXIS 1294
CourtSuperior Court of Pennsylvania
DecidedMay 26, 2004
StatusPublished
Cited by8 cases

This text of 851 A.2d 204 (Wilkes v. Phoenix Home Life Mutual Insurance) is published on Counsel Stack Legal Research, covering Superior Court of Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Wilkes v. Phoenix Home Life Mutual Insurance, 851 A.2d 204, 2004 Pa. Super. 188, 2004 Pa. Super. LEXIS 1294 (Pa. Ct. App. 2004).

Opinion

TODD, J.

¶ 1 Appellants Andrea D. Wilkes, David H. Ehrenwerth, and Charles K. Clark, trustees of the Mark E. and Myrna L. *206 Mason Irrevocable Trust (the “Trust”), and Mark E. and Myrna' L. Mason appeal from the order of the Allegheny County Court of Common Pleas granting summary judgment in favor of Appellee Phoenix Home Life Mutual Insurance Company (“Phoenix”). We reverse, and remand.

¶ 2 The facts and procedural history of this case may be summarized as follows. In the late 1980’s, the Masons, who were then in their fifties, created an insurance trust to purchase and hold a $7 million insurance policy whose proceeds would enable the Masons’ children to pay estate taxes without having to invade the illiquid corpus of the Masons’ estate. The Trust named as trustees the Masons’ oldest daughter, Andrea Wilkes, the Mason’s lawyer, David Ehrenwerth, Esquire, and their accountant, Charles Clark (collectively, the “Trustees”). The Masons and the Trustees were seeking a policy whose out-of-pocket premium payments would cease by the time Mr. Mason retired, when the Masons would have less income available to fund premium payments, and that would avoid subjecting Myrna Mason to the financial burden of out-of-pocket premium payments in the event her husband predeceased her. To meet the Masons’ needs, Phoenix’s insurance agent Sander Lenen-berg, with whom the Masons had been acquainted since the late 1970’s, proposed that the Trustees purchase a Phoenix whole life second-to-die policy called “Sur-vivorship Life Protector” (“SLP”), with a rider known as “Optionterm.” 1 This type of policy was promoted by Phoenix on a “quick pay,” “rapid pay,” or “vanishing premium” basis, and contemplated that, after a specified number of premium payments, dividends and paid-up additions generated by the policy would be sufficient to make the policy self-sustaining so that no additional out-of-pocket payments would be due from the insured. The specific SLP policy proposed by Lenenberg for the Masons provided a targeted death benefit of $7 million on the death of the second-to-die, consisting of approximately $4.1 million of whole life insurance and $2.9 million of Optionterm. Under his proposal, which provided for a vanishing premium over time, the base premium for the coverage was to be $80,813 per year for the first five years of the policy, $60,813 per year beginning the sixth year and continuing until the tenth year, $40,813 per year from the tenth year until the fifteenth year, and finally to zero beginning in the sixteenth year of the policy (2004), and staying at zero thereafter. To support his proposal, Lenenberg provided the Masons and the Trustees with illustrations generated by Phoenix showing the out-of-pocket premium payments reducing to zero in 2004, and staying there. According to the Masons and the Trustees, these illustrations did not indicate that the death of one insured would have any impact on the premiums. Based on Lenenberg’s proposal, the Trustees purchased the SLP policy in 1989 and began making the agreed-upon premium payments.

¶ 3 In January 1994, the Trustees received an annual premium notice indicating that the premium for the sixth year would be $80,813.23 rather than the decreased amount of $60,813. In light of this discrepancy, Trustee Ehrenwerth wrote to Phoenix on January 28, 1994 and asked them to confirm that the premium due was $60,813, and otherwise confirm that the policy remained in full force and effect. In response, Phoenix sent the Trustees a new *207 illustration which showed the total out-of-pocket payment required declining more slowly than shown in the original illustration and not vanishing until the 23rd year of the policy. After the Trustees contacted Lenenberg about this inconsistency, and Lenenberg inquired of Phoenix, Phoenix ran a new set of illustrations on April 29, 1994 in which the out-of-pocket premium payment schedule conformed to the original 1989 illustration, with premium payments declining and vanishing entirely in the sixteenth year of the policy. No death scenario was included in these illustrations. Phoenix ran another set of illustrations in June 1994 which were provided to Trustee Ehrenwerth and the Masons, again confirming the original premium schedule, but again also omitting a death scenario.

¶ 4 In January 1995, after receiving the policy anniversary statement, a lawyer for the trust reviewed the policy with Lenen-berg and requested him to provide an updated projection for the policy that assumed dividends reduced by one and two percentage points. In February 1995, Phoenix ran seven illustrations showing a variety of scenarios with respect to premium schedules and dividend reductions, none of which showed a death scenario. In February and March 1996, Phoenix r,an additional illustrations to determine what would happen if the Masons varied their out-of-pocket payments for a few years. Here again, no death scenarios were shown.

¶ 5 Appellants claim that while they were being led to believe the original premium schedule would be in effect regardless of which death scenario was employed, internally, Phoenix was setting its rates on the Mason’s policy to reflect the dramatic change in actuarial status when one of the Masons died. According to those rates, which Appellants claim Phoenix never disclosed to them, under certain probable scenarios in which Mark Mason predeceased Myrna Mason, out-of-pocket premiums which had previously vanished would reappear and quickly escalate to hundreds of thousands of dollars per year.

¶ 6 In August or September 1996, the Trustees received notice of a proposed settlement of a nationwide class action brought in New York state court against Phoenix, Michels v. Phoenix Home Life Mutual Ins. Co., Index No. 5318-95 (N.Y. Sup.Ct. Albany Cty.1995). The class action notice described the allegations made in the Michels action as follows:

The Plaintiffs make allegations concerning (i) how Phoenix made use of a method of using dividends to pay premiums on a whole life policy, or interest credited on a universal life policy, rather than paying them in cash, in order that no further out-of-pocket premium would be due after a fixed period of time, which sales concept was variously referred to as “Quick Pay” or “Rapid Pay,” as well as Phoenix’s use of dividends to help meet the costs of a rider known as Op-tionterm; (ii) the sale of life insurance by portraying it as an investment, savings, retirement or other similar plan without disclosing that it is life insurance or the nature of the policy’s benefits; (iii) the replacement of any existing life insurance policy with a new life insurance policy, or the sale of a new life insurance policy funded in whole or in part using an existing policy’s cash value; and (iv) the failure to disclose material information in connection with the introduction of new methods for calculating dividends and crediting rates. The allegations in the lawsuits include claims that Phoenix misled policyowners in these and other circumstances.

*208 (Notice of Michels Class Action, August 1996, at 2 (R.R. at 1528a).) 2

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Bluebook (online)
851 A.2d 204, 2004 Pa. Super. 188, 2004 Pa. Super. LEXIS 1294, Counsel Stack Legal Research, https://law.counselstack.com/opinion/wilkes-v-phoenix-home-life-mutual-insurance-pasuperct-2004.