Court Opinion

ID: 9793374
Source: CourtListenerOpinion
Date Created: 2023-08-31 02:46:33.305261+00
Date Added: 2024-06-11T08:04:39.258975
License: Public Domain

OAKS, Justice
(dissenting):
I cannot agree that the insurance carrier is “estopped as a matter of law” from relying on the exclusions in its policy because a copy of the policy was not delivered to the debtor-insured. Although the Model Act directs that a copy be delivered to the debt- or-insured, U.C.A., 1953, § 31-34-6(1), nothing in that section or in the Act as a whole directs or indicates an intent to rescind the policy exclusions if this requirement is not met. That drastic result should not be decreed by this Court without explicit legislative direction.
The majority’s decision injects a new provision into insurance contracts, a provision whose effects are almost impossible to *503gauge but potentially far-reaching. An agent’s failure to deliver a policy or certificate would apparently rescind all policy exclusions, since the majority’s reasoning offers no basis to distinguish one exclusion from another. On this insurance contract, that would extend the policy coverage to disabilities resulting from intentionally self-inflicted injuries, flight in nonscheduled aircraft, war or military service, and normal pregnancy. As to life insurance, it would impose coverage for deaths caused by suicide.
The potential effects of the majority’s decision are even more far-reaching. The rationale that the insured “is entitled to be informed in writing of the essential terms of the insurance contract” apparently applies to terms of limitation, as well as to terms of exclusion. Consequently, the majority’s holding suggests that an insured who could convince a jury that he had not received a copy of the policy might enforce this policy without regard to its provisions on maximum age, gainful employment, limitation of one death benefit in the case of cosigners, and even to some unspecified point beyond the dollar limits of $15,000 on death benefits and disability payments. Other policy provisions, such as the critical definition of “total disability,” would also seem to come under the majority’s interdiction if sought to be applied against the insured.
The uncertainties introduced by the majority’s decision will provoke litigation and frustrate the kind of loss predictions that are essential to the stability of the insurance industry.
The district court’s judgment in favor of the insurance company on the basis of the policy exclusion should be affirmed.
HALL, C.J., concurs in the dissenting opinion of OAKS, J.