American National Insurance Company, Petitioner, v. Bertha Arce, Individually and as Representative of All Others Similarly Situated, Respondent
No. 21-0843
Supreme Court of Texas
April 28, 2023
Argued January 12, 2023
Argued January 12, 2023
JUSTICE DEVINE delivered the opinion of the Court.
JUSTICE YOUNG filed a concurring opinion.
For more than a century, Texas courts have applied the settled rule that insurers may not avoid liability under an insurance policy based on a misrepresentation in an insurance application unless, among other things, the insurer pleads and proves the insured intended to deceive or induce the insurer to issue the policy. The primary issue before us is whether the common-law scienter requirement is repugnant to the plain language of
We hold that
I
During a chance encounter with an insurance agent at a motorcycle shop, Sergio Arce, Jr. spontaneously applied for a $25,000 life insurance policy with American National Insurance Co. (ANIC). The application
One month later, ANIC issued a life insurance policy to Arce but, for undisclosed reasons, declined accidental-death coverage and required payment of an additional premium on delivery. As required by statute, the policy would become incontestable two years after issuance, but in a tragic turn of events, Arce died a mere thirteen days later from injuries sustained in an automobile accident.1
Arce‘s mother, Bertha, submitted a claim under the policy as his designated beneficiary, but ANIC denied the claim and refunded the premium. During the claims-investigation process, ANIC reviewed Arce‘s medical records and determined that he had incorrectly answered “no” to an application question inquiring about diagnoses, treatment, or medical advice for “any disease or abnormality of the stomach, intestines, rectum, pancreas, or liver, including cirrhosis, hepatitis and colitis.” In refusing to pay the claim, ANIC informed Bertha that it would not have issued the policy if the application questions had been answered correctly.
Bertha sued ANIC for policy benefits, statutory penalties, and attorney‘s fees, alleging breach of contract and related violations of the
In a traditional summary-judgment motion limited to the claims in Bertha‘s previous filing, ANIC argued that the breach-of-contract and statutory claims were fatally infirm because ANIC was entitled to rescind the policy. Relying principally on
ANIC acknowledged the common-law rule requiring proof of intent to deceive
ANIC did not take the alternative position that intent to deceive was conclusively established. However, it argued that even if proof of intent is required to avoid paying on the policy, Bertha‘s claims under
Bertha‘s summary-judgment response, filed months later, joined issue on the necessity of pleading and proving intent to deceive before an insurer may decline to pay benefits based on a misrepresentation in the insurance application. She argued that
Bertha further asserted that ANIC had forfeited any misrepresentation defense by failing to timely notify her about its intent to rescind the policy, as required by
The trial court granted ANIC‘s motion and rendered a final take-nothing judgment rescinding Arce‘s life insurance policy. No grounds were stated. On motion for rehearing, which was denied, the trial court expressly overruled Bertha‘s objections to ANIC‘s summary-judgment evidence.
The court of appeals affirmed the trial court‘s ruling on Bertha‘s objections, but otherwise reversed and remanded.5 After rejecting ANIC‘s argument that the common-law scienter requirement did not survive
in
II
ANIC‘s petition for review presents three issues: (1) whether
We granted ANIC‘s petition to resolve an incipient conflict between Texas state cases, which consistently apply the common-law rule, and a handful of federal district court cases that have recently departed from it.11 But before beginning our analysis of that issue, we address, as a preliminary matter, the effect of the 2003 nonsubstantive recodification of the
In the courts below, ANIC argued that the 2003 recodification rendered the common-law intent requirement inoperative because the Legislature substantively changed
Having lost on that argument in the court of appeals, ANIC changed tack in this Court, asserting that
this Court, ANIC now acknowledges—quite correctly—that the Legislature not only declared that the 2003 recodification was nonsubstantive, it also left
This brings us to the main issue on appeal: whether
III
“[A]n insurance policy is a contract that establishes the respective rights and obligations to which an insurer and its insured have mutually agreed.”15 Insurance policies are construed as contracts and enforced as contracts.16 Under our
Whether ANIC is correct depends on the proper interpretation of the statute, which is a question of law we consider de novo according to
established principles.20 As always, our primary objective is to give effect to the Legislature‘s intent as manifested in the enacted language, which we apply according to its plain and grammatical meaning unless doing so would produce absurd results or a different meaning is contextually apparent.21 While “we must never ‘rewrite [a]
A
Subchapter A is composed of
respectively, misrepresentations in proofs of loss and misrepresentations in insurance applications. As a precondition to invoking a misrepresentation defense at trial,
Subchapter B contains a single “special” provision,
The principal provision at issue here,
§ 705.051. Immaterial Misrepresentation in Life, Accident, or Health Insurance Application
A misrepresentation in an application for a life, accident, or health insurance policy does not defeat recovery under the policy unless the misrepresentation:
- is of a material fact; and
- affects the risks assumed.26
ANIC views this provision as effectively encompassing all the common-law rescission elements, except intent to deceive,27
Both the statutory and the common-law elements govern an insurer‘s misrepresentation defense because, grammatically,
As written,
satisfied; it only guarantees that recovery cannot be defeated if one or the other is not. Consistent with its status as a consumer-protection statute,
ANIC‘s contrary construction works only if the statute is rewritten to change “does not defeat” to “does defeat” and “unless” to “if“. We might consider ANIC‘s point well taken if that were what the statute actually said, but it does not. Even taking “unless” to mean “except if“, as ANIC urged in post-submission briefing, does not alter the plain meaning of
ANIC argues we must conclude differently because the Legislature knows how to impose an intent requirement and conspicuously did so in
an insurer‘s ability to avoid an insurance obligation based on a misrepresentation in an insurance application, but the minimum conditions the statute imposes are different:
§ 705.104. Misrepresentation in Application for Life Insurance
A defense based on a misrepresentation in the application for, or in obtaining, a life insurance policy on the life of a
conflict with language in
person in or residing in this state is not valid or enforceable in a suit brought on the policy on or after the second anniversary of the date of issuance of the policy if premiums due on the policy during the two years have been paid to and received by the insurer, unless:
(1) the insurer has notified the insured of the insurer‘s intention to rescind the policy because of the misrepresentation; or
(2) it is shown at the trial that the misrepresentation was:
(A) material to the risk; and
(B) intentionally made.29
ANIC contends that the intent element in
First, making intent a statutory requisite to rescission when a life insurance policy is otherwise incontestable is not inconsistent with leaving it to the common law to impose an intent condition, or not, for other types of policies (like accident or health insurance) or before a life insurance policy is incontestable.
Second, a review of the common law when
changing the standard to permit cancellation if (among other things) the misrepresentation was intentionally made, the Legislature effectively made the standard after incontestability equivalent to the standard Texas followed under the common law during the contestability period.
For either reason, our construction of
B
ANIC nonetheless urges us to abandon the scienter requirement, bemoaning the common-law rule as a product of “judicial drift” that has placed Texas in the minority.34 ANIC‘s proffered reasons are
the application); Franklin Life Ins. Co. v. Villeneuve, 60 S.W. 1014, 1015 (Tex. Civ. App. 1901, no writ) (same);.
insufficiently compelling to warrant destabilizing a body of jurisprudence that is not in conflict with the statutory scheme.
It is true, as ANIC says, that some of the earliest authority declaring the law “settled” is more conclusory than explanatory,35 but brevity is not unusual for
jurisdictions in requiring intent to deceive, we are neither newly nor unwittingly so.37
We conclude that principles of efficiency, fairness, and legitimacy counsel against unsettling that which has been settled so long and with such clarity. “Adherence to precedent remains the touchstone of a neutral legal system that provides stability and reliability,” so “[d]epartures from precedent must be carefully considered and should be rare.”38 But while stare decisis is “not an inexorable command,” it has its “greatest force” in areas where the Legislature may rightfully flex its constitutional power, like enactment of the
Adhering to our precedent, we therefore hold that insurers must plead and prove intent to deceive to avoid contractual liability based on a misrepresentation in an application for life insurance, whether the policy is contestable or not. Proof of a material inaccuracy is not enough. We express no opinion as to whether the record bears legally sufficient evidence of intent because ANIC‘s summary-judgment motion did not argue that intent was conclusively established.
C
We do not reach the third issue—whether ANIC‘s denial of benefits was proper as a matter of law—because, as presented in this Court, success on that issue is premised on the common-law rule‘s invalidity. But to the extent ANIC contends Arce‘s statutory bad-faith claims are not viable based on a bona fide dispute about that matter, we hold that summary
However, the court of appeals erred in reversing summary judgment based on ANIC‘s alleged failure to give timely notice under
been duly paid.42 ANIC submitted affidavit evidence that the premiums were paid; the court of appeals upheld the trial court‘s decision overruling Bertha‘s objections to that evidence;43 and Bertha has not appealed the adverse appellate ruling. Accordingly, we reverse and render judgment that
IV
For the reasons stated, we reverse and render judgment that
John P. Devine
Justice
OPINION DELIVERED: April 28, 2023
