JAMES C. TURK, Senior District Judge.
Plaintiff Rebecca Smith ("Plaintiff or "Mrs. Smith") filed this action alleging that Protective Life Insurance Company ("Protective Life")
On October 1, 2004, Mr. Smith completed and signed a life insurance application for a $500,000 face value Preferred Non-Tobacco Policy with Zurich Life. The application was completed in the presence of Defendant's representative, a nurse, who conducted a medical examination required under the Policy. The annual premium quoted to Mr. Smith by Zurich Life for the Preferred Policy was $600.00. The application states that the Policy does not take effect unless during the lifetime of the Proposed Insured:
The application further states that "the first premium will not be deemed paid unless any check, draft, or other instrument of payment (given as premium) is paid in accordance with its terms."
Mr. Smith allegedly completed a Premium Payment Options form ("PPO form") as part of the application, including the section that provided for payment of the initial premium by credit card. Mrs. Smith has alleged that she "was present in the room" when her husband "completed and endorsed on October 1, 2004, a Premium Payment Options form . . . for the purpose of paying the initial premium." She has further alleged that "[i]t was the habit of Mr. Smith to either fax or mail documents he had signed on the same day of the endorsement." Defendant alleges they never received the PPO form. In support of this allegation Defendant states it was Zurich Life's routine practice to place an electronic copy of each endorsed PPO from in the policy file. Defendant has stated that Mr. Smith's file does not contain a PPO form.
The PPO form states:
With regard to temporary coverage, the application booklet states, "your new policy will become effective after you receive final underwriting approval and after your first premium is paid. However—prior to the approval and after the medical examination—if you have paid the initial premium you are covered for a special period of up to 60 days. . . ." Coverage under the Temporary Insurance Agreement is limited to $250,000.
Mr. Smith died on October 9, 2004, after experiencing a heart attack. On the same day, without knowledge of Mr. Smith's death, Zurich Life offered Decedent Smith coverage at the Select Non-Tobacco annual premium rate of $885.00. Zurich Life Account Executive Connie De Golian left messages on Decedent Smith and Plaintiffs home answering machine offering coverage at the higher Select Non-Tobacco premium rate on October 11 and 14, 2004. On October 20, 2004, Ms. De Golian spoke to someone at Decedent Smith and Plaintiffs home who informed her that Mrs. Smith would return her call; however, Ms. De Golian's call was not returned. Ms. De Golian called again on October 21, 2004, but was unable to speak to anyone. On October 26, 2004, Ms. De Golian called Decedent Smith's work number and left a message. On October 27, 2004, another Zurich Life representative left a message on Plaintiff and Decedent Smith's home answering machine.
On October 27, 2004, Plaintiff called Zurich Life, approved the higher premium rate being offered to Decedent Smith, and provided a credit card for his first premium payment. Plaintiff did not mention her husband's death 18 days earlier during this phone call. Decedent Smith's policy was issued on October 28, 2004. The first premium payment was credited by Zurich Life as paid on October 29, 2004.
Plaintiff did not notify Protective Life of Decedent Smith's death until almost two years later, on August 24, 2006. Plaintiff completed a claim for benefits under the Policy on February 9, 2007. Protective Life denied the claim for death benefits on March 21, 2008. After it denied the claim, Protective Life returned to Plaintiff all premiums paid with 3% interest.
In considering a summary judgment motion, the Court views the facts, and any inferences to be drawn from those facts, in the light most favorable to the nonmoving party.
Defendant's motion for summary judgment argues that because one of the conditions precedent—payment of the initial premium—under the Temporary Insurance Agreement was not fulfilled before Mr. Smith's death, coverage under the Temporary Insurance Agreement never took effect.
A contract of insurance is "`[a]n agreement by which one party for a consideration (which is usually paid in money, either in one sum, or at different times during the continuance of the risk), promises to make a certain payment of money upon the destruction or injury of something in which the other party has an interest.'"
In the present case the initial question is what the term "paid" means under the Temporary Insurance Agreement. Defendant argues under Virginia law "paid" means "received" and relies on
Contrary to Defendant's argument, Autumn Ridge does not control the outcome in this case because it does not resolve the factual dispute regarding whether the Defendant received the PPO form. Defendant's argument makes an unsupported intellectual leap from "received" meaning delivering the PPO form to "received" meaning charging the credit card. This Court can find no authority to support that proposition. Rather, Plaintiff has come forward with sufficient evidence that Decedent Smith sent the PPO form to the Defendant in accordance with his habit and thus the PPO form ought to have been received. Defendant states that there is no record of the PPO form in Mr. Smith's file. Thus, there is a disputed material fact as to whether Defendant received the PPO form. Based on Plaintiffs evidence it is possible that a reasonable jury could believe the Defendant received the PPO form, thereby entitling Mrs. Smith to death benefits under the Temporary Insurance Agreement.
The Court concludes that Plaintiff has shown that a disputed genuine issue of material fact exists as to whether the Defendant received the PPO form. Based on the Plaintiffs evidence a rational trier of fact could find for the Plaintiff, and thus summary judgment is inappropriate. Accordingly, Defendant's Motion for Summary Judgment must be