Court Opinion

ID: 9702853
Source: CourtListenerOpinion
Date Created: 2023-08-25 23:27:32.580692+00
Date Added: 2024-06-11T18:21:42.152721
License: Public Domain

Morse, J.,
dissenting. The August 1993 Order of Commissioner Costle should be reversed because the findings do not support the commissioner’s decision that the proposed life insurance policy violates 8 V.S.A. § 3542(2). Accordingly, I respectfully dissent.
I agree with the Court that the language of the policy was not ambiguous or misleading but disagree that the exclusion deceptively affects the risk that UNUM purports to assume. Under the second prong of § 3542(2), the commissioner determined that the condition deceptively affects the risk that UNUM purports to assume because the exclusion will bar recovery on more than half of claims made during the first two years of the policy. Apparently, this is based upon the commissioner’s finding that consumers of life insurance policies expect to be covered as long as they do not commit suicide. For two reasons, I fail to understand how this finding supports the commissioner’s conclusion.
First, the condition will be placed in the policy itself and brochures will be mailed to every Credit Union member to explain what the *209exclusion is and how it will work. If informed, a consumer would not think the policy would pay out in all circumstances. Furthermore, the exclusion is limited to persons who have been diagnosed as suffering from one of the exclusion conditions and who receive medical treatment for the condition in the six month period prior to the effective date of the policy’s coverage. Consequently, there is little risk that a prospective insured will not be aware that he has an excluded condition.
Next, the commissioner describes UNUM’s promise to assume an individual risk as “illusory” in more than half of all cases arising during the first two years of the policy. On the effective date of the policy, however, UNUM assumes the risk that the individual will live beyond the two year limit. Moreover, UNUM accepts all risk in the event that the insured dies from a cause unrelated to the excluded condition. These risks are not illusory. The condition simply does not deceptively affect the risk that UNUM purports to assume.
I would reverse. Chief Justice Allen joins in this dissent.