Court Opinion

ID: 9446883
Source: CourtListenerOpinion
Date Created: 2023-08-03 22:20:33.704742+00
Date Added: 2024-06-11T17:30:48.965267
License: Public Domain

HAMLIN, Circuit Judge.
I respectfully dissent. The Ransom case cited in the opinion was based on different language in the application than the language found in the instant case. In Ransom, the California court held that the language used was ambiguous and that “the ambiguity must be resolved against defendant.”
In the instant case I see no ambiguity.
The application contained Parts A, B, and C. Part A was signed by the applicant, in which he made application for a certain type of insurance and in which he gave his occupation as an airplane crop duster and answered other questions asked by the Company. Part B is to be filled out by the applicant in the presence of the medical examiner. It is designated at the top “Applicant’s Statements to the Medical Examiner.” Part C is entitled “Medical Examiner’s Report on ..........” and is to be signed by the medical examiner at the completion of the applicant’s medical* examination. These three parts of one document comprise “the application.” They are all portions of one piece of paper, which piece of paper was exhibited to the Court.
In the instant case there was no evidence of any statement by the agent that the applicant was covered when he signed Part A. He was told to arrange for a medical examination. No medical examination was had, the applicant having been killed in an airplane accident in the course of his occupation on the morning of the day on which an appointment for a medical examination had been scheduled.
Parts B and C of the application thus were never filled out. Part A of the application, which had been signed by the applicant, stated:
“4. The Company shall incur no liability under this application until a policy has been delivered and the full first premium specified in the policy has actually been paid to and accepted by the Company during the lifetime and continued insurability of the applicant, in which case such policy shall be deemed to have taken effect as of the date of issue as recited therein, except as follows: If an amount equal to the full first premium on the policy applied for is paid to and accepted by the Com*312pany at the time Part A of this application is signed and if this application is approved at the Company’s Home Office for the class, plan and amount of insurance herein applied for, then the insurance in accordance with the terms of the policy applied for shall be in force from the date hereof.” [Italics mine.]
The receipt, given by the agent at the time Part A was signed by the applicant, stated:
“If the sum collected at the time Part A of this application is signed is at least equal to the full first premium on the policy applied for and if such application is approved at the Company’s Home Office for the class, plan, and amount of insurance therein applied for, then the insurance in accordance with the terms of the policy applied for shall be in force from this date, but otherwise no insurance shall be in force under said application unless and until a policy has been delivered, and the full first premium specified in the policy has actually been paid to and accepted by the Company during the lifetime and continued in-surability of the applicant.” [Italics mine.]
In addition to the fact that no medical examination was ever had, the application (which consists of Parts A, B, and C) was never “approved at the Company’s Home Office for the class, plan, and amount of insurance * * * applied for * * In fact, the application never qyen reached the Home Office.
To me, the language in Part A and in the receipt is clear and explicit. It provides for certain conditions to be fulfilled before the policy is in effect. These conditions were not fulfilled.
The Ransom ease, supra, cites and relies on Gaunt v. John Hancock Mut. Life Ins. Co., 2 Cir., 1947, 160 F.2d 599. While the language in the Gaunt application differs somewhat from the Ransom case, it also differs from the language in this case. The Court said, in Gaunt, “The important words were: ‘if the Company is satisfied that on the date of the completion of Part B of this application I was insurable * * * and if this application * * * is, prior to my death, approved by the Company at its Home Office, the insurance applied for shall be in force as of the date of completion of said Part B.’ ”
Also, the facts in the Gaunt case are far different from this case. In Gaunt, a medical examination was had, which Gaunt passed. A second medical examination was taken by Gaunt, which Gaunt again passed. A medical examiner at the Home Office “approved the ‘application.’ ” Apparently the Company was-, satisfied that Gaunt was “insurable.”' The judge found that if Gaunt had lived,, the “Home Office” would have approved the “application.” It appeared that nothing further need be done but the ministerial act of issuing the policy.
The Court said in Gaunt: “The important question is how far the condition of subsequent approval shall prevail over the promise of immediate coverage as-, soon as the insured has paid his premium and has passed his physical examination.” [Emphasis added.]
The ease turned on the belief of the-applicant “who has paid his first premium and had successfully passed his. physical examination” that he had immediate coverage.
These are not the facts in the instant case, nor is the language used by the-Company the same in this case.
In this case there was no promise of' immediate coverage (as there was in Gaunt); no physical examination was ever taken (as there was in Gaunt and Ransom); the application was not completed (as it was in Gaunt and Ransom) ; and, the application never reached the-Home Office (as it did in Gaunt and Ransom).
Granting that ambiguities should be-construed in favor of the insured, I feel, that the California cases hold that
“Where there is no ambiguity, however, courts will indulge in no *313forced construction against the insurer, and the insurance policy, like any other contract, is to be interpreted according to the intention of the parties as expressed in the in.strument in the light of the circumstances surrounding its execution.” Blackburn v. Home Life Ins. Co., 19 Cal.2d 226, 229, 120 P.2d 31, 32; Rankin v. Amazon Ins. Co., 89 Cal. 203, 26 P. 872, 23 Am.St.Rep. 460; Maryland Casualty Co. v. Industrial Acc. Comm., 209 Cal. 394, 287 P. 468; Metts v. Central Standard Life Ins. Co. of Illinois, 142 Cal.App.2d 445, 298 P.2d 621. I would reverse.