Zepeda v. American National Insurance Co.

527 S.W.2d 467, 1975 Tex. App. LEXIS 2764
CourtCourt of Appeals of Texas
DecidedMay 28, 1975
DocketNo. 15367
StatusPublished
Cited by1 cases

This text of 527 S.W.2d 467 (Zepeda v. American National Insurance Co.) is published on Counsel Stack Legal Research, covering Court of Appeals of Texas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Zepeda v. American National Insurance Co., 527 S.W.2d 467, 1975 Tex. App. LEXIS 2764 (Tex. Ct. App. 1975).

Opinion

CADENA, Justice.

Plaintiff, Gregorio P. Zepeda, Jr., seeks reversal of a judgment, following a non-jury trial, denying him recovery for the death of his minor child under a family life insurance policy issued by defendant, American National Insurance Company.

Plaintiff purchased the insurance in question from defendant on November 8, 1965. At that time plaintiff was married to Maria Elena Zepeda. The policy named plaintiff as “the insured,” and named his then wife, Maria Elena, as “insured spouse.” Under the terms of the policy, defendant bound itself to pay $5,000.00 upon the death of plaintiff, the insured, $1,000.00 on the death of the “insured spouse” and $1,000.00 on the death of “each covered child.”

Two children were born to plaintiff and Maria Elena, one in 1966 and the other in 1968. The amount of premium payable under the policy was not affected by the number of children covered by the policy. The premium for the insurance on the life of plaintiff is $6.97 per month, and the premium for the insurance covering the “insured spouse” is $1.30 per month.

Plaintiff and Marie Elena were divorced in the spring of 1969, and in January, 1970, plaintiff married his present wife, Consuelo. Two children were born to plaintiff and Consuelo, the younger of which was Rachel Marie, who was born on July 30, 1972. Rachel Marie died on November 23, 1972, and by this suit plaintiff seeks to recover for death of such child. The judgment of the trial court is based on the conclusion that the deceased infant, Rachel Marie, was not a “covered child” under the policy.

It is undisputed that plaintiff has paid all premiums due and that the policy was in full force and effect at the time of the death of Rachel Marie. The policy was never changed to substitute Consuelo Zepe-da, plaintiff’s second wife, for Maria Elena Zepeda as “insured spouse.”

The policy contains the following definitions:

“THE INSURED: The term ‘THE INSURED’ shall mean the Insured named in the application for this Policy and specified on the Policy Data. Page.
INSURED SPOUSE: The term ‘INSURED SPOUSE’ shall mean the Spouse named in the application for this Policy and specified on the Policy Data Page.
COVERED CHILD: A child or legally adopted child of the Insured and Insured Spouse or a stepchild of the Insured or Insured Spouse shall be a Covered Child provided such child was named in the application and was born at least 15 days prior to the effective date of this Policy. A child born to the Insured and Insured Spouse after the effective date of this Policy shall become a Covered Child on the date such child attains age 15 days. A child legally adopted by the Insured after the effective date of this Policy shall become a Covered Child on the date such child was adopted or on the date such child attains age 15 days, whichever [469]*469date is later. A child shall cease to be a Covered Child on the policy anniversary following such child’s 25th birthday.”

Both the application for the policy and the “policy data page” identify “the insured” as plaintiff, Gregorio P. Zepeda, Jr. The application names plaintiff’s then wife, Maria Elena, as “spouse.” The “policy data page” identifies “insured spouse” as Maria Elena Zepeda. It is clear, then, that in reading the policy, the term “the insured” must be read as “Gregorio P. Zepeda, Jr.,” while “insured spouse” must be read as “Maria Elena Zepeda.” With this in mind, the definition of “covered child” establishes the following categories:

1. A child of Gregorio P. Zepeda, Jr., and Maria Elena Zepeda, who is named in the application and was born at least 15 days prior to November 8,1965, the date of the policy. No contention is made that the deceased infant is included within this category.

2. A stepchild of Gregorio P. Zepeda, Jr., who is named in the application and was born at least 15 days prior to November 8, 1965. The deceased infant clearly does not fall within this category.

3. A stepchild of Maria Elena Zepeda who is named in the application and was born at least 15 days prior to November 8, 1965. This category does not include the deceased infant.

4. A child born to Gregorio P. Zepeda, Jr., and Maria Elena Zepeda after November 8, 1965, and who attains age 15 days. Rachel Marie, the deceased infant, was born to Gregorio P. Zepeda, Jr. and his second wife, Consuelo Zepeda, and, therefore, is not a “covered child” within this portion of the definition.

5. A child legally adopted by Gregorio P. Zepeda, Jr., after November 8, 1965, and who has attained age 15 days. The deceased child does not fall within this class.

If effect is given to the plain language of the policy, it must be concluded that Rachel Marie was not within any of the categories established by the definition of “covered child.”

Plaintiff argues that the “definition of ‘covered child’ was a description of the limits of relationship between the insured and a minor child so as to constitute said child a. ‘covered child,’ and not an all-inclusive, exhaustive definition of all relationships which constituted a ‘covered child.’ ” That is, plaintiff asserts that the definition of “covered child” merely describes “the outside limits or parameters of the covered relationships,” and that, since the coverage “extends to an adopted child of the insured alone,” it “necessarily includes relationships within the outer limit, to-wit: a natural child of the insured alone.”

We find nothing in the language of the policy to support this interpretation. In effect, plaintiff contends that the definition of “covered child” should be construed as though it were prefaced by the clause, “the term ‘Covered Child’ shall include, but shall not be limited to, the following:” or that the definition of “insured spouse” should be changed to, “The term ‘Insured Spouse’ shall mean the Spouse named in the application for this Policy and specified on the Policy Data Page, or any subsequent Spouse of the Insured.” It might be pointed out that even this re-wording of the definition of “insured spouse” would not be sufficient to justify plaintiff’s interpretation of the policy as extending to a “natural child of the insured alone,” since the term “natural child,” in both its technical and popular meaning, means an illegitimate child. Gibson v. Dickson, 178 S.W. 44, 48 (Tex.Civ.App.—Dallas 1915, writ ref’d); State v. Coliton, 73 N.D. 582, 17 N.W.2d 546, 549 (1945). We find no basis in the policy for changing the definition to read, “The term ‘Covered Child’ shall mean any child, adopted child or stepchild of the Insured.”

Plaintiff, relying on the testimony of one of defendant’s agents, insists that for 12 years preceding the trial of this case, defendant had interpreted the definition of “covered child” to mean “that if the child’s [470]*470last name was the same as ‘the insured,’ then it was a ‘covered child’ under the definition.”

The testimony of the defendant’s employee does not support plaintiff’s contention. It is clear from the testimony that this employee was merely testifying as to representations which he made to persons whom he described as “my policyholders.” His testimony clearly relates to what he describes as “my own opinion” and his understanding. He stated, “As far as I understand ... as long as they have the same last name, step-children or natural-born children,” they are covered.

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Bluebook (online)
527 S.W.2d 467, 1975 Tex. App. LEXIS 2764, Counsel Stack Legal Research, https://law.counselstack.com/opinion/zepeda-v-american-national-insurance-co-texapp-1975.