Cadez v. General Casualty Co.
Cadez v. General Casualty Co.
Opinion of the Court
This appeal challenges a judgment entered on a verdict directed in favor of the appellee insurance companies (General) in a tort action claiming that General negligently failed to provide the appellants-plaintiffs (insureds) with workmen’s compensation protection. Jurisdiction is based on diversity.
As the ease was withdrawn from the jury, we view the evidence and the reasonable inferences therefrom in the manner most favorable to the insureds. In 1949 Cadez, Sr., the father of the insureds, and a partner named Rader acquired a wholesale distributing business at Grand Junction, Colorado. One Coe, whose testimony was not available at the trial because of his death, was a
Cadez, Sr., bought out his partner in 1951 and in 1953 sold the business to his two sons, the insureds. In 1958, during the life of the 1955 renewal policy and at a time when there were more than 4 people employed in the business, an employee named Hugenot was injured and filed a claim with the Colorado Industrial Commission for workmen’s compensation under the state law. The insureds notified General which denied liability on the basis of the policy exclusionary clause. The insureds were required to pay a compensation award to Hugenot plus certain expenses and seek to recover from General the $21,646.25 so paid.
Shortly after the issuance of the first policy in 1949 and thereafter during all the times involved herein, except the fourth quarter of 1955 and the first quarter of 1957, the business had 4 or more employees. On at least one occasion Cadez, Sr., told Coe the business had more than 4 employees and inquired about his protection. Coe replied that he had full coverage. There is no evidence that Cadez, Sr., or the insureds, ever expressly requested insurance against workmen’s compensation liability or that Coe ever told either Cadez, Sr., or the insureds that the policy as issued specifically covered
From the evidence the jury could have found that Coe made wrongful representations as to the insurance coverage or erroneously interpreted that coverage. The question is whether such finding would have justified a recovery in tort against General.
The question of the liability of an> insurance company for negligent representations of an agent in an interpretation of a policy was considered in Union Life Insurance Co. v. Burk, 10 Cir., 169 F.2d 235, 239. We held that such representations “would not bind the company unless they were made within the scope-of his authority, or, if not warranted by the scope of his authority, they nevertheless came to the notice of the company,, and by its subsequent conduct it estopped: itself to repudiate them.” Although this-principle was announced in a case arising-in New Mexico, our attention is directed to no Colorado statute or decision which, negates the applicability of the rule in Colorado.
The parties differ as to the meaning- and applicability of the Colorado statute
As to the first, we have no doubt that negligent representations as to policy coverage when made by a general agent or by a policy-writing agent are binding upon the agent’s principal. But this case does not present such a situation. The agency agreement of General authorized Coe “to receive and accept proposals” for contracts of insurance. Coe, a soliciting or local agent, had no power to bind General on any risk or to write a policy of insurance.
As to the second, there is no claim that the statements of Coe ever came to the attention of General. It may be that some insurance agents in their enthusiasm to produce business make reckless or negligent statements concerning policy coverage. The complexity of modern insurance contracts is such that persons desiring protection understandably place great reliance on the agent who handles their insurance business. If untrained or over-zealous agents malee negligent or reckless representations as to policy coverage and it can be shown that the company had actual knowledge thereof or that knowledge may be implied from the circumstances of a particular situation, the company must accept the responsibility. Such is not the case here. There is no evidence that General had actual knowledge of Coe’s statements and no evidence from which knowledge may be implied.
The insureds point out that representatives of General audited the insureds’ books to determine premium amounts and that such audits disclosed the existence of more than 4 employees. This might have been pertinent had there been any notice to General that the insureds desired or* thought they were getting protection against workmen’s compensation liability but the record shows no such notice.
Reliance is also placed on the payment of a $15 claim on account of an injury to an employee named Provo in 1957. If is without persuasive effect as the evidence is that the payment was for medical expense within the medical payment coverage and that no compensation claim was asserted by Provo.
Affirmed.
. The Colorado law, Colo.Rev.Stat.Ann. § 81-2-6 (1953), applies to an employer of 4 or more.
. Colo.Rev.Stat.Ann. § 72-1-25 (1953).
. Constitution Life Ins. Co. v. Rogerson, 130 Colo. 26, 273 P.2d 1019, 1022; New York Life Ins. Co. v. Haru Fukushima, 74 Colo. 236, 220 P. 994; Northwestern Mut. Life Ins. Co. v. Farnsworth, 60
. Benson v. Bankers Life and Casualty Co., Colo., 362 P.2d 1039 (misstatement by agent as to requirements of company for disclosure of prior illnesses); Warner v. Farmers’ Automobile Inter-Insurance Exchange, 104 Colo. 359, 90 P.2d 965 (attempted waiver of forfeiture clause by agent); and Commonwealth Casualty Ins. Co. v. Kuhrt, 75 Colo. 175, 225 P. 251 (authority of agent to bind company as to effective date of insurance).
. Cf. Smith v. Orion Insurance Company, 10 Cir., 298 F.2d 528, decided November 3, 1961.
. United Pacific Ins. Co. v. Northwestern Nat. Ins. Co., 10 Cir., 185 F.2d 443, 447-448.
Reference
- Full Case Name
- John CADEZ, Jr. and James Cadez, a partnership, doing business as Central Distributing Company v. GENERAL CASUALTY COMPANY OF AMERICA, and General Insurance Company of America
- Cited By
- 6 cases
- Status
- Published