Legal Cases - Snippets

  • Carriers marketed interest rate-sensitive insurance under a host of premium payment options, including the `vanishing premium' plan.

2009 -  LC - Kaldenbach v. Mutual of Omaha - Court of Appeals of California, Fourth District, Division Three. 78 Cal.App.4th 830 (2009) 100 Cal.Rptr.3d 637 - Google Scholar-Kaldenbach-2009

Reasonable Consumers

  • Reasonable consumers acting reasonably recognize sales pitches and ordinarily discount them accordingly.
  • In addition, to acknowledge that consumers understand that future interest rates will affect their future premium rates is reasonable and even respectful of individual intelligence, personal accountability and good common sense (see, Fischel & Stillman, supra, at 16).

 LC - Gaidon v Guardian

Breach of Contract/Duty of Good Faith

  • Ohio law, because a fiduciary relationship exists in the context of insurance contracts, the insurer has a duty to act in good faith in handling the claims of the insured. Hoskins v. Aetna Life Ins. Co., 6 Ohio St.3d 272, 275, 452 N.E.2d 1315 (1983).
    • However, this implied duty does not supplant express contract terms. Ed Schory & Sons, Inc. v. Soc. Nat’l Bank, 75 Ohio St.3d 433, 662 N.E.2d 1074 (1996).
    • Rather, it requires good faith in performing those contract terms. Lakota Local School Dist. Bd. of Edu. v. Brickner, 108 Ohio App.3d 637, 671 N.E.2d 578, 584 (1996) (“good faith is part of a contract claim and does not stand alone.”).
  • Here, the Universal Life policy does not impose a duty on Defendant to set future premiums at or near $21,000, and, thus, the implied duty of good faith and fair dealing cannot create such a duty. Id. at ¶¶ 27-29 (granting motion to dismiss claim for breach of the duty of good faith and fair dealing where the parties’ contract did not require the insurer to search a death master file to determine whether their insureds were deceased).

2014 - LC - Costigan v John Hancock, Case: 5:14-cv-01002-GJL Doc #: 35 Filed: 03/26/15 14 of 16.  - govinfo.gov/content/pkg/USCOURTS-ohnd-5_14-cv-01002/pdf/USCOURTS-ohnd-5_14-cv-01002-0.pdf

Reasonable Reliance

  • (Trial Court Opinion, 2/14/03, at 7.) The trial court further held that it was unreasonable as a matter of law for the Trustees and the Masons to rely on any representations of Phoenix or its agent, Lenenberg, that were contrary to or inconsistent with the notice and settlement package.  (Id. at 8.)
  • According to the trial court, “[s]ince Phoenix was the opponent in the Michels lawsuit which Plaintiffs joined, they cannot be heard to say that it was reasonable to rely upon representations of Phoenix or the man they say they believed was its agent regarding the effect of the settlement.  
    • ⇒  This is a matter about which reasonable minds could not differ.  
    • ⇒  You do not consult your enemy about how to interpret documents in dispute.

2004 - LC - Wilkes v. Phoenix Home Life Mutual Insurance Company - caselaw.findlaw.com/pa-superior-court/1101716.html>

Duty to Read Policy

  • The Alabama Supreme Court rejected the fraud and negligence claims of an insured who admittedly did not read his policy, reversed a jury verdict in favor of the insured, and  entered judgment in favor of the insurer in AmerUS Life Insurance Co. v. Smith.336 
  • On appeal, the court held that a plaintiff who is capable of reading documents, but who does not read them or investigate facts that should provoke inquiry, has not reasonably relied upon a oral representations that contradict the written terms in the  documents.337 (p544)

 2009 - American Bar - Recent Development in Health Insurance, Life Insurance, and Disability Insurance Case Law, by Hasman, J., Chittenden, W., Doolin, E., & Wall, J.Tort Trial & Insurance Practice Law Journal, 44(2), 501-549.  

Puffery

  • See State Farm Fire & Cas. Co. v. Slade, 747 So. 2d 293, 322-23 (Ala. 1999)
    • (holding that insurance agent's statements that the purchased insurance policy was "the Cadillac of all insurance" and "the very best" amounted to mere puffery that could not reasonably be relied upon in light of the insured's level of education and degree of sophistication). (p20)

2010 - LC - Maloof v John Hancock, Alabama Supreme Court Opinion - 39p  ---  [BonkNote]