Fortis Benefits Ins. Co. v. Pinkley
Fortis Benefits Ins. Co. v. Pinkley
Opinion of the Court
Fortis Benefits Insurance Company and Fortis Insurance Company (hereinafter collectively referred to as "Fortis") appeal by permission, pursuant to Rule 5, Ala. R.App. P., from the denial of their motion for a summary judgment in an action commenced by Bertha Bernice Pinkley, individually and as executrix of the estate of her deceased husband, Jay Donald Pinkley, to recover life-insurance benefits. We reverse and remand.
For the purpose of this appeal, we treat the following facts as undisputed. In 1991, Jay Pinkley purchased a $100,000 life-insurance policy, the obligations of which were subsequently assumed by Fortis. The policy application listed Bertha Pinkley as the primary beneficiary, and Paul Sanford, Bertha's son and Jay's stepson, as the contingent beneficiary. The policy provided, in pertinent part:
"CHANGE OF BENEFICIARY: The beneficiary designation contained in the application will remain in effect until changed. The Owner may change the beneficiary at any time during your lifetime. A satisfactory written notice must be filed at the Home Office. The change will take effect only upon being recorded by [Fortis]."
(Emphasis added.)
In January 2000, someone identifying himself as Jay D. Pinkley telephoned Fortis's office. During that telephone call, which Fortis recorded, the caller requested a change-of-beneficiary application form ("the request form"). The caller provided a Fortis representative with the policy number and Jay D. Pinkley's Social Security number. Fortis sent a request form to Pinkley's address as reflected in its records, and, in February 2000, received the completed request form designating Dianne Sanford, the wife of Paul Sanford, as the primary beneficiary. The request form designated "Bernice Pinkley" as the contingent beneficiary. The name "Jay D. Pinkley" was handwritten on the line immediately above the words "Policyowner's signature." The request form contained *Page 983 the Social Security numbers of both Pinkleys and purported to be witnessed by Paul Sanford. The telephone number given on the request form matched the telephone number on Jay Pinkley's policy-application form. On February 28, 2000, Fortis stamped the request form with acknowledgment of receipt and agreement to the requested change. Fortis then mailed a copy of the stamped request form to Jay Pinkley's address of record. Fortis received no objection to the change from Jay Pinkley.
Jay Pinkley died on April 26, 2001. On or about May 15, 2001, Dianne Sanford filed a claim for the policy benefits. Fortis paid her the proceeds of the policy on May 22, 2001.
In March 2003, Bertha Pinkley, through her attorney, also filed a claim for the benefits of Jay Pinkley's life-insurance policy, alleging that Jay Pinkley's signature on the request form was forged.1 Fortis denied Pinkley's claim, saying that it had discharged its contractual obligations by paying the policy benefits to Dianne Sanford in reliance on the request form.
On March 25, 2003, Pinkley sued Fortis, alleging various theories arising out of its refusal to pay her the proceeds of the policy on Jay Pinkley's life, including (1) negligence, (2) wantonness, (3) breach of contract, and (4) bad-faith failure to pay a claim. Fortis and Pinkley filed cross-motions for a summary judgment. In an order denying both motions, the trial judge certified a controlling question of law, thereby laying the predicate for a permissive appeal from an interlocutory order, pursuant to Rule 5. The order stated, in pertinent part:
"[T]he court finds and hereby CERTIFIES that this order involves a controlling question of law as to which there is substantial ground for difference of opinion, that an immediate appeal from this order would materially advance the ultimate termination of this litigation, and that an appeal would avoid protracted and expensive litigation.
"In this case, [Pinkley] has sued Fortis because she claims Fortis improperly paid the death benefits of her late husband's life insurance policy to [Pinkley's] daughter-in-law, who, according to Fortis' records, was the beneficiary of record at the time of the decedent's death. [Pinkley], however, claims that she was the proper beneficiary and that the change of beneficiary form that substituted her daughter-in-law as the beneficiary was forged. It is undisputed that the benefits were paid to the daughter-in-law without any notice of a competing claim by [Pinkley]. The controlling question of law presented in this matter is whether [Ala. Code 1975, §]
27-14-24 , bars [Pinkley's] claims. Section27-14-24 provides . . . as follows:"`Whenever the proceeds of, or payments under, a life or disability insurance policy or annuity contract, heretofore or hereafter issued, become payable in accordance with the terms of such policy or contract, or the exercise of any right or privilege thereunder, and the insurer makes payment thereof in accordance with the terms of the policy or contract or in accordance with any written assignment thereof, the person then designated in the policy or contract, or by such assignment, as being entitled thereto shall be entitled to receive such proceeds or payments and to give full acquittance therefor; and such payments shall fully discharge the insurer from all claims under the policy or contract, unless, before payment *Page 984 is made, the insurer has received at its home office written notice by, or on behalf of, some other person that such other person claims to be entitled to such payment or some interest in the policy or contract.'"
This Court granted Fortis's petition for permission to appeal to consider a question of first impression in Alabama: whether §
"`It is the general rule that when the insurer makes payment of the proceeds of insurance to the person who by the policy is the proper recipient, such payment is a discharge of the liability of the insurer.'" Alfa Life Ins. Corp. v.Culverhouse,
"Where an insurer, acting in good faith without any actual knowledge of the insured's mental incompetency, has recognized an apparently duly executed change of beneficiary and has paid the proceeds of the insurance to the substituted beneficiary, it is not liable to the original beneficiary when sued by him or her even though it is established that the insured was in fact incompetent and lacked the capacity to make the change of beneficiary. That is, the insurer is not under any duty to investigate the mental competency of the insured to change the beneficiary unless it knows of circumstances reasonably suggesting the probability of his or her mental incompetency.
"Similarly, an insurer is not required to investigate to determine whether a change of beneficiary had been procured by undue influence in the absence of knowledge of facts which would indicate that the change might have been so procured."
4 Lee R. Russ and Thomas F. Segalla, Couch on Insurance 3d § 60:77 (1997) (emphasis added). See also Demerath v. Knights ofColumbus,
Section
Such statutes are aptly described as "narrowly drawn" facility-of-payment clauses that frequently appeared in certain types of insurance contracts. 15 William S. McKenzie H. Alston Johnson III, Louisiana Civil Law Treatise: Insurance Law Practice § 256 (2d ed. 1996). Facility-of-payment clauses typically appeared in "the so-called `industrial' life insurance" or "burial policy." Id. "It was generally held that the clause was for the protection of the insurer, affording it protection against later claims from others who might arguably have a superior right to the proceeds." Id. It was sometimes said that "payment of the policy proceeds to a person entitled thereunderabsolutely discharg[ed] the insurer of all liability." 2A John Appleman Jean Appleman, Insurance Law and Practice § 1163, at 306 (1966) (emphasis added). At other times, it was held that payments must be "made by the insurer in good faith to a person entitled to the benefits thereunder." Id. See Dorsey v.Metropolitan Life Ins. Co.,
The good-faith element that characterizes the general rule and the typical facility-of-payment clause was written into §
"(1) claims that named beneficiaries are not eligible to receive benefits because of `Slayer's Statute' issues that arise after payment, (2) receipt of a change of beneficiary application after the benefits have been paid, (3) claims that the owner of the policy was unduly influenced or incompetent at the time he or she signed the beneficiary designation or change of beneficiary application that arise after payment of the benefits, (4) claims that the owner was contractually obligated to name someone else as the beneficiary that arise after payment, (5) claims that a creditor has a lien against the benefits that arise after payment, and (6) other claims that attempt to collaterally attack payment to the beneficiary named by the owner in the insurer's records after payment to the named beneficiary."
Pinkley's brief, at 37-38 (emphasis added).
Pinkley contends, however, that forgery presents a situation that differs fundamentally from these situations because, she argues, §
For this proposition, Pinkley cites Bigley v. Pacific StandardLife Insurance *Page 986 Co.,
"Unless the insurer has reason to believe that the beneficiary named by the policyholder is not entitled to receive the policy proceeds, payment to the policyholder's designated beneficiary discharges the insurer from liability under the policy.
"Payment of the policy proceeds to a person fraudulently substituted as beneficiary, however, does not relieve the insurer of its contractual obligation to pay the beneficiary actually designated by the policyholder. Western Southern Life Ins. Co. v. Whiston,
30 Ill. App.3d 844 ,333 N.E.2d 72 (1975); Stavros v. Western Southern Life Ins. Co.,486 S.W.2d 712 (Ky.App. 1972); Union Labor Life Ins. Co. v. Parmely,270 Md. 146 ,311 A.2d 24 (1973); . . . cf. McNabb v. Kentucky Central Life Ins. Co.,631 S.W.2d 253 (Tex.App. 1982). . . ."This conclusion is consistent with the general rule that a change of beneficiary of an insurance policy can be effected only by following the procedure prescribed by the policy. . . . The life insurance policy . . . sets forth only one method by which a change of beneficiary may be effected: `[T]he owner [of the policy] may change the Beneficiary . . . by filing a satisfactory written request with us at our Executive office. . . .' (Emphasis added.) Because [the forger], rather than the owner of the policy, signed the change of beneficiary form and submitted it to the defendant . . ., the request did not comply with the terms of the contract and, therefore, did not effect a change of beneficiary."
We find Bigley unpersuasive. The four cases cited by that Court afford little support for its holding or its rationale. Two of the cases — Stavros v. Western Southern Life InsuranceCo.,
"`Whenever the proceeds of or payments under a life . . . insurance policy . . . become payable in accordance with the terms of such policy . . . and the insurer makes payment thereof in accordance with the terms of the policy . . ., the person then designated in the policy . . . as being entitled thereto shall be entitled to receive such proceeds or payments and to give full acquittance therefor, and such payments shall fully discharge the insurer from all claims under the policy . . . unless, before payment is made, the insurer has received . . . [notice] . . . that such other person claims to be entitled to such payment or some interest in the policy or contract.'"
After the insured's death, the insurer paid the benefits to Dorothy, who, it was *Page 987
ultimately determined, "had not been validly married to [the insured]."
"The statute is nothing more than an attempted codification of the rule applied in the cases cited earlier. As we have already intimated, had Dorothy been designated by name in the policies, [the insurer] would have been discharged upon making payment to her, unless it had received prior notice of Francina's claim. In other words, since Dorothy had not been validly married to Clyde, she was not his `widow' under the policies. Hence, payment to her did not discharge [the insurer] from its obligations. On the other hand, Francina, as the `widow,' is entitled to payment."
Stavros is similarly inapposite. There, the insurer paid benefits to the sister of an insured 11-year-old minor in reliance on a change-of-beneficiary request form that required the "Signature of Life Insured if 15 years or older, otherwise of Parent or Guardian."
Although McNabb v. Kentucky Central Life Insurance Co.,
The only other case cited in Bigley actually involving a forgery is Western Southern Life Insurance Co. v. Whiston,
In addition to citing only unpersuasive authority, Bigley
does not attempt to explain why forgery is outside the generalrule. Thus, neither Pinkley, nor any case she cites, explains why the insurer has a *Page 988
duty to discover forgeries but not to discover other irregularities, such as undue influence. As we noted earlier in this opinion, Pinkley admits that an insurer has no duty to discover whether "the owner of the policy was unduly influenced
or incompetent at the time he or she signed the beneficiary designation or change of beneficiary application." Pinkley's brief, at 37-38 (emphasis added). She attempts to distinguish between forgery and undue influence on the ground that "[a] forged instrument is void," Ex parte Floyd,
Forgery is a species of fraud, Life Insurance Co. of Georgiav. Smith,
This is especially so in the case of fraud in the factum, that is, where a signatory is "`deceived into signing the instruments in ignorance of their true character.'" Sheffield v.Andrews,
Clearly, §
In that connection, Pinkley contends that "Fortis could have easily detected the irregularity by reviewing the signature samples of Mr. Pinkley in its records." Pinkley's brief, at 32. We disagree. The forged signature is not markedly different from the samples of Pinkley's bona fide signature contained in the record.2 To *Page 989 charge the insurer with liability in the case of a forgery but not in the case of undue influence would place form over substance, and such an approach is not authorized by the statute.
The phrase "payment . . . in accordance with the terms of the policy" refers primarily to the time the proceeds become payable. Specifically, it refers back to the first word of the statute, namely, "[w]henever," that is, "whenever," pursuant to the policy, "the proceeds of [the policy] . . . become payable." Thus, "whenever" an event triggers the insurer's duty to pay and payment is made to "the person" whose name appears on the faceof the policy or any change to the policy in regular form as the proper beneficiary, payment has been made "in accordance with the terms of [the] policy."
Any other construction defeats the purpose of the statute. Thus, we agree with Fortis, which states: "[Section
Under the undisputed facts of this case, a Fortis representative spoke by telephone with an individual purporting to be Jay Pinkley. The caller supplied Fortis with Jay D. Pinkley's Social Security number and the policy number of Jay Pinkley's life-insurance policy. Fortis sent the request form to Jay Pinkley's address of record. In addition to the witnessed signature purporting to be that of the policy owner, the completed request form Fortis received contained Jay Pinkley's address and the telephone number that was listed on his policy application. The request form bearing Fortis's stamped acceptance was mailed to Jay Pinkley's address of record. Before it paid the proceeds, Fortis had received no notice, actual or otherwise, of a competing claim or interest in the policy. The statute requires no more of an insurer than Fortis did in this case.
In summary, we hold that §
REVERSED AND REMANDED.
NABERS, C.J., and SEE, STUART, SMITH, BOLIN, and PARKER, JJ., concur.
HARWOOD, J., concurs specially.
LYONS, J., dissents.
Dissenting Opinion
I must respectfully dissent.
The main opinion, relying upon §
Section
"Whenever the proceeds of, or payments under, a life or disability insurance policy or annuity contract, heretofore or hereafter issued, become payable in accordance with the terms of such policy or contract, or the exercise of any right or privilege thereunder, and the insurer makes payment thereof in accordance with the terms of the policy or contract or in accordance with any written assignment thereof, the person then designated in the policy or contract, or by such assignment, as being entitled thereto shall be entitled to receive such proceeds or payments and to give full acquittance therefor; and such payments shall fully discharge the insurer from all claims under the policy or contract, unless, before payment is made, the insurer has received at its home office written notice by, or on behalf of, some other person that such other person claims to be entitled to such payment or some interest in the policy or contract."
(Emphasis added.)
The terms of the policy here provide as follows:
"CHANGE OF BENEFICIARY: The beneficiary designation contained in *Page 991 the application will remain in effect until changed. The Owner may change the beneficiary any time during your lifetime. A satisfactory written notice must be filed at the home office. The change would take effect only upon being recorded by [Fortis]."
(Emphasis added.) The policy therefore quite plainly provides that only the owner can change the beneficiary designation. For purposes of this appeal we have assumed that the owner — Jay Pinkley — never changed the designation of the beneficiary and that the change-of-beneficiary form was a forgery.
The main opinion treats §
"Whenever the proceeds of, or payments under, a life or disability insurance policy or annuity contract, heretofore or hereafter issued, appear to have become payable in accordance with the terms of such policy or contract, or the exercise of any right or privilege thereunder, and the insurer makes payment thereof in apparent accordance with the terms of the policy or contract or in apparent accordance with any written assignment thereof, the person then designated in the policy or contract, or by such assignment, as being apparently entitled thereto shall be entitled to receive such proceeds or payments and to give full acquittance therefor; and such payments shall fully discharge the insurer from all claims under the policy or contract, unless, before payment is made, the insurer has received at its home office written notice by, or on behalf of, some other person that such other person claims to be entitled to such payment or some interest in the policy or contract."
(Changed language emphasized.)
Section
Nevertheless, as written, §
Concurring Opinion
I concur. I write specially only to make one further point.
The case upon which Bertha Bernice Pinkley most heavily relies,Bigley v. Pacific Standard Life Insurance Co.,
"`[R]ights of creditors of insured against beneficiary. (a) The beneficiary of any life insurance policy, being a person other than the insured, whether named as beneficiary in the original policy or subsequently named as beneficiary in accordance with the terms of the policy, shall be entitled to the proceeds of the policy as against the representatives or creditors of the insured, unless the policy was procured or the designation of a beneficiary was made with intent, express or implied, to defraud creditors. . . .
"`(c) The company issuing the policy shall be discharged of all liability thereunder by payment of the proceeds in accordance with the terms of the policy, unless, before such payment, the company has received written notice, from a creditor, executor or administrator of the insured, that the policy was procured or premiums were paid thereon with intent to defraud creditors. That notice may be disregarded by the company unless proper legal proceedings to enforce the claim are begun within three months from the giving of the notice.'"
The Court pointed out that "§ 38a-453(c) applies where the `policy was procured or the premiums were paid thereon with intent to defraud creditors' of the insured, circumstances not alleged in this case. Section 38a-453(c) is therefore inapposite."
Reference
- Full Case Name
- Fortis Benefits Insurance Company and Fortis Insurance Company v. Bertha Bernice Pinkley, Individually and as for the Estate of Jay Donald Pinkley
- Cited By
- 12 cases
- Status
- Published