CAROLYN DINEEN KING, Circuit Judge:
Conseco Life Insurance Company's predecessor issued a flexible premium life insurance policy to Johnston & Johnston on the life of Mary Ann D. Johnston in 1988. The Policy's cash surrender value dropped below zero dollars in December 2010, causing it to enter a sixty-one-day grace period. The Policy terminated in February 2011, after Johnston & Johnston failed to make any payments on the Policy during the grace period. Ms. Johnston died in August 2012. The key question is whether any of the several notices Conseco Life Insurance Company sent to Johnston & Johnston satisfied the requirements of Louisiana Revised Statutes § 22:905, which outlines notice requirements for lapsing life insurance policies. The district court held that the notices did not. Conseco Life Insurance Company timely appealed. For the following reasons, we REVERSE and REMAND for entry of judgment in favor of Conseco Life Insurance Company.
On April 12, 1988, Plaintiff-Appellee Johnston & Johnston ("J & J") purchased an insurance policy from Philadelphia Life Insurance Company on the life of Mary
The Policy was a "flexible premium adjustable life insurance plan." Unlike a term or whole life insurance policy, which requires periodic premium payments to maintain coverage, a flexible premium policy does not have scheduled premium due dates. Rather, the policyholder can change both the amount and the frequency of premium payments. See, e.g., La. Admin. Code tit. 37, § 8503 (2013) (defining "Flexible Premium Universal Life Insurance Policy" as a "universal life insurance policy which permits the policyowner to vary, independently of each other, the amount or timing of one or more premium payments or the amount of insurance").
Under the terms of the Policy, J & J chose the amount and frequency of its premium payments.
The Policy had a cash value.
With J & J paying premiums only on an intermittent basis, but deductions coming on a monthly basis, it was possible that, at some point, the Policy's cash value might not be sufficient to cover deductions for the next month. The Policy addressed such a scenario:
The Policy's grace period section provided, in relevant part:
As per the grace period provision, failure to pay the planned periodic premium — the $32,451.00 that J & J elected to pay annually — would not affect coverage unless, on a monthly anniversary day,
Separately, J & J was a class member in a class action settlement of a case against Conseco in federal district court in California. Pursuant to J & J's rights as a class member, if the Policy terminated, J & J was entitled to a "death benefit extension period" after the grace period ended. This period would provide coverage to J & J for the Policy's $1 million face amount for an additional 183 days following termination of the Policy.
The April 13, 2010 annual policyholder statement, the last available, informed J & J that the Policy would terminate on June 12, 2010, if J & J made no further contribution. J & J made a payment sufficient to maintain the Policy. However, the Policy entered a grace period a few months later, on September 12, 2010. Conseco notified J & J that the grace period would expire if J & J did not pay $38,778.46 before November 12, 2010. J & J paid this amount on October 6, 2010, preventing the Policy from reentering a grace period until December 12, 2010.
Separate from the September 12 grace period notification, on September 21, 2010, Conseco sent J & J a planned periodic premium notice, informing J & J that a premium of $32,451.00 would be due on October 12, 2010.
On December 12, 2010, Conseco sent J & J a notice that the Policy had again entered a grace period as of that date. According to the December 12, 2010 grace notice, J & J was required to pay $28,794.14 by February 11, 2011, to avoid termination of coverage. Thus, the notice set out a specific amount necessary to maintain the Policy, rather than the planned periodic payment amount of $32,451.00. On January 6, 2011 — thirty-six days before February 11 — Conseco sent J & J a second grace notice, again stating that J & J would need to pay $28,794.14 by February 11, 2011, in order to avoid termination of coverage.
J & J did not make a payment on the Policy during this period of time. The grace period expired on February 11, 2011,
J & J's accountant, Ralph Speirs, Jr., was out of the office due to illness during the grace notice periods, and he did not review the grace notices until February 13, 2011, a Sunday. He called Conseco on February 14, seeking to pay the amount set out in the notices. A Conseco representative informed Mr. Speirs that "it was too late to pay the premiums," but that J & J could apply for reinstatement of the Policy.
J & J applied for reinstatement of the Policy on August 25, 2011. Conseco sent a notice on September 12, 2011, to inform J & J that the death benefit extension period had terminated as of that date. Conseco refused J & J's reinstatement application on September 15, 2011, "[d]ue to the evaluation of our underwriting department" and "due to Ms. Johnston's medical history."
Between the Policy's inception in 1988 and its termination in 2011, J & J paid $1,233,195.97 in policy contributions. The Policy entered the grace period a total of twenty-two times over the course of its life.
J & J filed suit in federal district court on June 7, 2012, seeking declaratory relief and specific performance. J & J argued that Conseco's notices violated Louisiana Revised Statutes § 22:905, which requires an insurer to provide notice to the insured fifteen to forty-five days before a "premium" is "payable" before the insurer can declare a policy forfeited for nonpayment of premiums. As detailed below, § 22:905 also requires that the notice set out the correct premium amount. J & J contended that the "due date" for § 22:905 purposes was October 12, 2010 — the date on which the planned periodic premium was scheduled to be paid — and that the September 21 planned periodic premium notice listed the incorrect amount necessary to maintain the Policy, in violation of § 22:905. J & J further contended that the December 12, 2010 and January 6, 2011 grace notices were deficient because they were sent after the October 12, 2010 premium due date. J & J sought a declaration that Conseco's termination of the Policy was void, and an order requiring Conseco to accept premium payments sufficient to continue coverage under the Policy. On October 8, 2012, J & J amended its complaint to reflect that Mary Ann D. Johnston died on August 15, 2012, and to correct its pleadings for diversity jurisdiction purposes.
Conseco moved to dismiss the complaint or, in the alternative, for summary judgment. It principally argued that the relevant date under § 22:905 was February 11, 2011, since that was when J & J needed to pay its premiums to avoid the Policy terminating. Conseco contended that because the January 6, 2011 grace notice fell within the fifteen- to forty-five-day window prescribed by § 22:905, it did not violate § 22:905. J & J also filed a motion for summary judgment, reasserting the arguments and allegations in its complaint.
On October 11, 2012, the district court: (1) denied Conseco's motion to dismiss the complaint or, in the alternative, for summary judgment; (2) granted J & J's motion for summary judgment; and (3) entered judgment in favor of J & J. Departing from both parties' arguments, the court held that the operative due date for § 22:905 purposes was December 12,
Subsequently, Conseco filed a Rule 59(e) motion to alter or amend the judgment, arguing that the district court erred in construing December 12, 2010, as the operative due date for § 22:905 purposes. Conseco asserted that "no premium was due on December 12, 2010, nor was any premium past due between December 12, 2010 and February 11, 2011." Conseco further argued that construing December 12, 2010, as the due date would lead to absurd consequences. As Conseco explained, a policy owner could withdraw funds from her policy less than fifteen days before a payment is due — too late for the insurer to provide fifteen to forty-five days of notice, as required under § 22:905 — and thereby receive free insurance for a year, since that is the penalty for an insurer's failure to comply with § 22:905's notice requirements. Finally, Conseco contended that using the December 12, 2010 date renders meaningless § 22:905(B), which prohibits any policy from being declared forfeited until at least thirty days after a compliant notice has been mailed.
The district court denied Conseco's motion, concluding, inter alia, that Conseco was simply reasserting arguments it had made in its motion to dismiss. The court further stated that if the due date had been February 11, 2011, as Conseco contended, then Conseco still would not prevail because Conseco failed to provide an additional thirty-day grace period, as required by Regulation 36, promulgated by the Louisiana Insurance Commissioner. La. Admin. Code tit. 37, § 8511. Regulation 36 requires flexible premium policies to "provide for a grace period of at least thirty days (or as required by state statute) after lapse," and defines "lapse" as follows: "Unless otherwise defined in the policy, lapse shall occur on that date on which the net cash surrender value first equals zero." Id. § 8511(A)(6)(b).
The court reasoned that one of the Policy's clauses, "The Company will send written notice that the policy will lapse 30 days before the end of the grace period," redefined "lapse" as the end of the grace period, rather than when the cash value equals zero dollars. Because lapse was the end of the grace period, the court reasoned that Regulation 36 required Conseco to provide an additional thirty-day grace period after the sixty-one-day grace period ended.
Conseco timely appealed to this court, seeking review of both the district court's grant of summary judgment to J & J and the court's denial of Conseco's Rule 59(e) motion.
We review de novo a grant of summary judgment, applying the same standard as the district court. First Am. Title Ins. Co. v. Cont'l Cas. Co., 709 F.3d 1170, 1173 (5th Cir.2013). Summary judgment is appropriate "if the movant shows that there is no genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law." Fed. R.Civ.P. 56(a). The court "view[s] all evidence in the light most favorable to the nonmoving party and draw[s] all reasonable inferences in that party's favor." In re Katrina Canal Breaches Litig., 495 F.3d 191, 205-06 (5th Cir.2007).
"A federal court sitting in diversity applies the substantive law of the forum state. A district court's determination of state law is reviewed de novo." Learmonth v. Sears, Roebuck & Co., 710 F.3d 249, 258 (5th Cir.2013) (internal citations omitted). "If a state's high court has not spoken on a state-law issue, we defer to intermediate state appellate court decisions, unless convinced by other persuasive data that the higher court of the state would decide otherwise." Id. (citation and quotation marks omitted). "In making an Erie-guess in the absence of explicit guidance from the state courts, we must attempt to predict state law, not to create or modify it." Id. (citation and quotation marks omitted).
Under Louisiana law, "[t]he fundamental question in all cases of statutory construction is legislative intent and the reasons that prompted the legislature to enact the law." SWAT 24 Shreveport Bossier, Inc. v. Bond, 808 So.2d 294, 302 (La. 2001). "When a law is clear and unambiguous and its application does not lead to absurd consequences, it shall be applied as written, with no further interpretation made in search of the legislative intent." Id. (citing La. Civ.Code art. 9).
Section 22:905 is a forfeiture statute, since it concerns the forfeiture of insurance benefits, and under Louisiana law, forfeiture statutes are strictly construed. First Am. Bank & Trust of La. v. Tex. Life Ins. Co., 10 F.3d 332, 335 & n. 6 (5th Cir.1994) (citing Lemoine v. Sec. Indus. Ins., 569 So.2d 1092, 1096 (La.Ct.App. 1990)). Insurance policy provisions are also subject to strict construction: "If after applying the other general rules of construction an ambiguity remains, the ambiguous contractual provision is to be construed against the drafter, or, as originating in the insurance context, in favor of the insured." La. Ins. Guar. Ass'n v. Interstate Fire & Cas. Co., 630 So.2d 759, 764 (La.1994).
The parties' dispute centers on a provision of the Louisiana Insurance Code, § 22:905, which provides, in relevant part:
Section 22:905's purpose "is to protect the insured from losing coverage due to mere inadvertence and to give the insured a `fair chance to meet the payments when due.'" Turner v. OM Fin. Life Ins. Co., 822 F.Supp.2d 633, 637 (W.D.La.2011) (quoting Vining v. State Farm Life Ins. Co., 409 So.2d 1306, 1309-10 (La.Ct.App.1982)); accord Ochsner v. IdeaLife Ins. Co., 945 So.2d 128, 131 (La. Ct.App.2006).
Under Louisiana law, a "premium" means:
La.Rev.Stat. Ann. § 22:46(13). This definition applies "unless the context otherwise requires." Id. § 22:46.
Regulation 36, codified in Title 37 of the Louisiana Administrative Code, §§ 8501-8517, "supplement[s] existing regulations on life insurance policies in order to accommodate the development and issuance of universal life insurance plans," id. § 8501, flexible premium policies among them, id. § 8503. Regulation 36 further states:
Id. § 8511(A)(6).
The provider of a flexible premium policy must give the policyholder annual reports on the policy's status. Id. §§ 8511(A)(1)-(2), 8513, 8515. The insurer's report must inform the policyholder if "the policy's net cash surrender value will not maintain insurance in force until the end of the next reporting period unless further premium payments are made." Id. § 8515(A)(2)(h).
The critical question in this case is when the insurance premium necessary to maintain the Policy was "payable" under § 22:905, since that date determines whether or not Conseco's notices satisfied § 22:905's timing requirements. If the notices did not satisfy § 22:905's requirements, then J & J was entitled to an additional year of coverage under the Policy.
We conclude that the district court erred in finding that December 12, 2010, is the operative date for § 22:905
Conseco's January 6, 2011 notice satisfied the requirements of § 22:905 in its timing and its contents. The notice fell within the fifteen-to forty-five-day period, since Conseco sent it thirty-six days before February 11, 2011, and stated the correct amount "due" in order to maintain coverage under the Policy. The Policy terminated on February 11, 2011, at the close of the sixty-one-day grace period provided for under the terms of the Policy. There was no second grace period. The death benefit extension expired on September 12, 2011, and all rights under the Policy had terminated nearly a year before the insured's death in August 2012.
The language of § 22:905 and Regulation 36 lead us to our conclusion that February 11, 2011, is the operative date for calculating notice. This conclusion is consistent with § 22:905's purpose and the relevant caselaw.
The parties do not dispute that § 22:905 applies, since the Policy was "not issued upon the payment of monthly or weekly premiums or for a term of one year or less." La.Rev.Stat. Ann. § 22:905(A); see First Am. Bank & Trust, 10 F.3d at 335 n. 6. We note, however, that the mechanics of applying § 22:905 in the flexible premium policy context are far from clear, since, as our analysis demonstrates, "due dates" and "premiums" are not straightforward when it comes to flexible premium policies.
Nonetheless, the language of § 22:905 points to the conclusion that February 11, 2011, is the operative date because the premium was "payable" and "due," meaning that it was required to be paid, by that date. As noted earlier, § 22:905 addresses an insurer's right to declare a policy "forfeited or lapsed ... for nonpayment when due of any premium ... or any portion thereof." La.Rev.Stat. Ann. § 22:905(A). Section 22:905 requires notice fifteen to forty-five days before the date when "any premium ... required by the terms of the policy to be paid" is "payable." Id. A "premium" is "all sums charged, received, or deposited as consideration for the purchase or continuance of insurance...." Id. § 22:46(13).
The terms "payable" and "due" are not defined in § 22:905. Additionally, "payable" is susceptible to multiple meanings when used in the context of a premium being "payable," principally required to be paid or capable of being paid.
We must next determine if, in the flexible premium context, required to be paid means the date the policyholder was required to pay in order to maintain a positive cash value for a policy (i.e., December 12, 2010), or the date the policyholder was required to pay in order to avoid a policy's termination (i.e., February 11, 2011). This inquiry is likewise complicated by the inapplicability of the concept of due dates in the context of flexible premiums. With a flexible premium policy, an insured might make a payment once every year, or even once every several years, which would be acceptable so long as the cash value remained sufficient to maintain the policy.
The language of § 22:905 supports the conclusion that the payment that is "due," "payable," and required to be paid is the payment at the end of the grace period, on February 11, 2011. Section 22:905 addresses "default in payment of any premium" that is "required by the terms of the policy to be paid." In the flexible premium context, the only payments required are those that are sufficient to maintain the policy. Therefore, the payment "required by the terms of the policy to be paid" is the payment necessary to prevent the Policy from terminating. Here, that is the payment on February 11, 2011, at the conclusion of the grace period. The insured's failure to make a payment on December 12, 2010, only resulted in the Policy entering a sixty-one-day grace period. The Policy was capable of being paid on December 12, 2010, but it was not required to be paid at that point. Thus, payment was "due" and "payable" on February 11, 2011.
J & J argues that premiums were due on December 12, 2010, because that is when "the policy lacked sufficient value to maintain coverage and lapsed." To keep a policy in force, J & J contends, a payment must be made at the time the cash surrender value drops below zero dollars.
J & J contends that because an insurer sends a grace notice during a grace period, and a grace period by definition only begins after a premium is past due, then the premiums here were "due" on December 12, 2010. To the contrary, Turner, which we find compelling, indicates that a grace notice, sent during a grace period, can satisfy § 22:905 with respect to a policy termination that will come at the conclusion of the grace period.
J & J cites Boring to support the proposition that "payable," as used in § 22:905, should be defined as "due," such that the premium was "due" on December 12, 2010.
This argument is unpersuasive, and Boring is inapplicable. The policy in Boring called for semi-annual premiums with set due dates, whereas the Policy at issue is a flexible premium policy with no premium due dates. As such, Boring offers no guidance on how to interpret the "due dates" here. Additionally, we find it more persuasive to consider the "premium" "payable" and "due" on February 11, 2011, when the Policy would terminate without another payment, rather than December 12, 2010.
We find Time Ins. Co. v. Vick, 250 Ill.App.3d 465, 190 Ill.Dec. 48, 620 N.E.2d 1309, 1315-17 (1993), on which the district court relied, likewise distinguishable.
Regulation 36 also supports our conclusion. By promulgating Regulation 36, which outlines notice requirements for flexible premium policies, the Louisiana Insurance Commissioner provided guidance on applying § 22:905 in the context of flexible premium policies, and offered additional protection for policyholders. Regulation 36 extends the notice period to at least thirty days, La. Admin. Code tit. 37, § 8511(A)(6)(a), makes the notice period and grace period contemporaneous, id. § 8511(A)(6)(a)-(b), and further requires flexible premium insurers to provide annual reports setting out a policy's status, including whether the policy will terminate before the end of the reporting period if no further premium payments are made, id. §§ 8511(A)(1)-(2), 8513, 8515.
There is no question that Conseco complied with these requirements. J & J was afforded each of these protections. Unfortunately, J & J missed each opportunity to pay the premium necessary to maintain the Policy. Given Conseco's compliance with the notice requirements, J & J cannot convincingly claim that Conseco failed to provide it with fair notice.
Thus, our conclusion is consistent with the Louisiana Legislature's intent in enacting § 22:905 — "to protect the insured from losing coverage due to mere inadvertence and to give the insured a fair chance to meet the payments when due." Turner, 822 F.Supp.2d at 637 (quotation marks omitted). As a result, our conclusion remains faithful to the core concern of Louisiana's statutory interpretation rules. See SWAT 24, 808 So.2d at 302.
We note that providing legally adequate notice before the beginning of a grace period is a practical impossibility if a policyholder makes a withdrawal from a policy less than fifteen days before a monthly anniversary day. Although a policyholder seeking to defraud an insurer in this way might not benefit from § 22:905's penalty for violating the notice requirement due to equitable reasons, the consequences of this scenario highlight the unworkability of the
Further, requiring the insurer to give yet another notice, prior to the grace period, is unnecessary when the grace notice itself is sufficient to put the insured on notice that the policy will terminate without further payments. The grace notice comes in addition to annual policy reports, as required under Regulation 36, that inform the insured of the policy's net cash surrender value and alert the insured if that value "will not maintain insurance in force until the end of the next reporting period unless further premium payments are made." La. Admin. Code tit. 37, § 8515(A)(2)(h). The Policy at issue entered the grace period twenty-two times, and J & J made the necessary payment to maintain coverage twenty-one times. The fact that J & J failed to do so once is not reason enough to graft an additional reporting requirement onto § 22:905 and Regulation 36.
Additionally, we consider the reasoning of the New York State Insurance Department (NYSID) in reconciling nearly identical statutory and regulatory notice requirements in the flexible premium context, because we find it the type of "persuasive data" that the Louisiana Supreme Court might consider.
Finally, we conclude that the Policy did not enter a second grace period following the February 11, 2011 termination date, contrary to the district court's suggestion in its ruling on Conseco's Rule 59(e) motion. Regulation 36 does require flexible premium policies to provide a thirty-day grace period after lapse, where "lapse,"
For the aforementioned reasons, we REVERSE the judgment against Conseco and REMAND for entry of judgment in its favor.
La.Rev.Stat. Ann § 22:844(C).
Id. § 22:1667(D). See also 11 Oxford English Dictionary 378 (2d ed.1989) ("Of a sum of money ... falling due (at or on a specified date ... ).").