ANDREW JACKSON LIFE INSURANCE COMPANY
v.
Willie L. Williams.
Supreme Court of Mississippi.
*1173 Christy D. Jones, Stevenson Ray, Butler Snow O'Mara Stevens & Cannada, Jackson, for appellant.
*1174 Michael B. McMahan, McMahan & McMahan, Hattiesburg, for appellee.
Before DAN M. LEE, P.J., and PRATHER and BLASS, JJ.
PRATHER, Justice, for the Court:
I. INTRODUCTION
[Once again, this Court is] called upon to redress grievances which [might have been] avoided by proper state regulation of insurance company practices.[1]
The primary issue addressed in the case sub judice is whether the insurer, Andrew Jackson Life Insurance Company, should be held accountable for its agents' allegedly "unauthorized" misrepresentations of insurance policy provisions and conditions. In the Hinds County Circuit Court, a jury answered the question in the affirmative and returned a verdict against the company in the amount of $28,000 in compensatory damages and $200,000 in punitive damages. The verdict is affirmed.
In Section I of this opinion, the events which preceded the filing of this appeal are delineated followed (in Section II) by an analysis of the issues presented. This analysis leads to the ultimate conclusion in Section III that the jury's verdict was proper.
Finally, no issues pertaining to the constitutionality of the punitive-damages award were raised at trial nor presented on appeal.[2] Accordingly, this Court's scope of review is limited.
A. Factual Background
In the fall of 1984, Al Page and David Smith, agents for Andrew Jackson Life Insurance Company ("Andrew Jackson"), met with numerous company officials at Universal Manufacturing Company ("Universal") in Mendenhall, Mississippi. The meetings with the officials were scheduled for the purpose of securing permission to offer interested Universal employees a "unique," "local" product contrived by Andrew Jackson. The agents explained that purchasers of the product would receive allegedly "better" coverage than that provided by American Income Insurance Company ("American Income"), which issued the policies then-held by many employees (including the appellee, Willie Williams).
More specifically, the agents explained that what they were offering was not an ordinary life insurance policy; rather, it was a "supplemental retirement program with a death benefit" and an "immediate cash benefit plan" containing a $1,000 "check"[3] which, in the event of an insured's death, could be cashed immediately to pay for such burdensome expenses as funeral arrangements. Of critical significance, the agents assured that employees who decide to enroll in Andrew Jackson's retirement program: (1) could allow their current policies to lapse, and (2) would be covered (insured) "immediately" and unconditionally upon completing an application and "upon signing ... the[ir] payroll deduction card." In essence, the agents guaranteed all-important "risk aversion"[4]*1175 and "peace of mind."[5] This was critical to those who were currently insured and were concerned about being without risk aversion and peace of mind once they allowed their policies to lapse.[6]
Based on the information the agents provided, permission to offer their retirement program was granted. With their "foot in Universal's door," the aggressive agents incurred no difficulty in persuading Universal employees to "lend an ear." As employees passed through clock alley,[7] their attention was captured by an array of alluring wares displayed on the table. These wares included televisions, radios, money, and teddy bears, and were provided as door prizes (i.e., "gimmicks") which anyone willing to stop and listen to the agents' offers could win. Basically, the offers included the same information conveyed during meetings with company officials.
Willie Williams, a forklift operator at Universal, was one of the many who were persuaded to sign his payroll-deduction card and to drop his American Income policy through guarantees of immediate "enrollment" in Andrew Jackson's "retirement program." Notably, the application was filled out by an agent as Willie and his wife, Jerlean responded to questions. Upon completing the transaction, the agents told Willie that he could "pick [his] policy up within two to three at the plant." But several weeks passed, and Willie had not received his policy as promised. On February 11, 1985, Jerlean died of a heart attack. Willie again inquired if his policy had arrived "because [he] needed the $1,000" check from the immediate cash benefit plan "to pay for funeral arrangements." And once again, the reply was: "[I]t [will] probably be in this week[; j]ust check back [later]."
The policy never arrived; instead, Andrew Jackson executives attempted to induce Willie to settle for $1,000 and to sign a release which would have relinquished his rights to receive the full amount of benefits due him under his policy. Willie refused to settle, to which one company executive admonished: "[I]f you don't take this, you might ... get nothing." But Willie, adamant in his refusal to settle, rationalized: "I'm in a bind, but, my God" "compared to the [death benefits I contracted for] this thousand dollars is nothing ... *1176 [and] I just as soon to do without it." Restated, Willie felt that Andrew Jackson was trying to take advantage of him and use his financial dire straits to compel him to settle. And in light of his heavy financial burdens, accepting the $1,000-settlement offer would hardly make a difference; therefore, he'd rather than "leave it" than "take it." It was simply a matter of principle.
On May 3, 1985, Andrew Jackson mailed Willie a letter officially denying his claim for the death benefits. Andrew Jackson provided the following logic for its denial: (1) Willie applied for a policy which expressly declares it "will not take effect until it has been delivered" and ... until the first premium has been paid ... while the ... Insureds are alive ... and ... prior to any change in health as shown in the application"; (2) The underwriting process was ongoing when Jerlean died, therefore, a contract had not been formed and an actual policy delivered; (3) The underwriting process nonetheless continued, and was eventually completed; and (4) Based on the information adduced during the underwriting process, Jerlean was determined to be "uninsurable" because she had a heart condition which was undisclosed. Andrew Jackson concluded its letter by noting: "Since we are unable to accept your application, we are returning [seven premiums in] the amount of $76.44 which ha[ve] been paid" by your employer through payroll deductions.
Willie attempted to avert litigation. He informed Andrew Jackson that, prior to Jerlean's death, its agents unequivocally formed a contract with him notwithstanding Jerlean's disclosure to the agents that she had a heart condition. In essence, Willie contended that Andrew Jackson was accountable for any misrepresentations which they may have made to him regarding policy conditions or to it their principal regarding Jerlean's health. Willie's attempt was to no avail.
B. The Suit
On August 26, 1986, Willie filed a complaint at the Hinds County Circuit Court, and contended that he contracted with authorized agents of Andrew Jackson for immediate enrollment in the "retirement program" and, that the insurer breached its "contractual obligations" by denying his claim and for "no logical, arguable reason." Willie also contended the breach was "prompted by willful and conscience [sic] wrong or by actual malice and fraud or by conduct so grossly negligent and inexcusable" that he is entitled to compensatory damages in the amount of $27,705, and to punitive damages "in the sum of $250,000" (punitive), in addition to costs and interest.
Andrew Jackson countered that conditions of insurability were not met in Willie's case, that it formed no contract with Willie, that its agents are limited to mere solicitation of applications, and that none of its agents is authorized to waive existent conditions or to form binding contracts on its behalf. Therefore, Andrew Jackson concluded that it cannot be held responsible for "any and all wrongful acts" of its agents.
During the course of the trial, Andrew Jackson twice moved for a directed verdict; the motions were denied. After three days of lengthy testimony, the jury returned a verdict in favor of Willie for $28,000 in compensatory damages and $200,000 in punitive damages. Andrew Jackson subsequently and unsuccessfully moved for j.n.o.v. and, alternatively, for a new trial. The motion was denied. Andrew Jackson appealed.
II. ANALYSIS
Eight issues were presented for resolution and are addressed, without specific reference, in the following sections.
A. Propriety of Compensatory-Damages Award
The propriety of the jury's award of $28,000 is determinable upon resolution of whether an actual contract was formed between Andrew Jackson's agents and Willie, and whether Andrew Jackson should be bound by the formed contract. Before addressing these issues, discussion of the *1177 standard applicable to this Court's review of the jury's finding is in order.
Formation of an insurance contract must be proved by clear and convincing evidence. Mississippi Farm Bureau Mut. Ins. Co. v. Todd,
Whe[n] a motion for j.n.o.v. has been made, the trial [judge] must consider all evidence in the light most favorable to the non-movant, who must also be given the benefit of all favorable inferences that may be reasonably drawn from the evidence; if the facts and inferences so considered point so overwhelmingly in favor of the movant that reasonable men [sh]ould not have arrived at [the] verdict [rendered in favor of the non-movant], granting the [motion for j.n.o.v.] is required; on the other hand, if there is substantial evidence opposed to the motion, i.e. evidence of such quality and weight that reasonable and fair-minded men in the exercise of impartial judgment might reach different conclusions, the motion should be denied and the jury's verdict allowed to stand.
Maxwell v. Illinois Cent. Gulf R.R.,
Presiding Judge Francis Bowling denied Andrew Jackson's motion. Andrew Jackson of course contends the denial was erroneous. In addressing the insurer's contention, this Court must bear in mind the guideline which a trial judge follows in denying or granting a j.n.o.v. or new-trial motion. In so doing, deference will be accorded the judge's determination of whether a jury issue was tendered. Deference will also be accorded the jury's fact-finding because of its position unlike this Court's to evaluate and weigh the truthfulness of a witness' testimony.
The demeanor or bearing of voice, the attitude and appearance of the witnesses, all are primarily for inspection and review by the jury. The jury not only has the right and duty to determine the truth or falsity of the witnesses, but also has the right to evaluate and determine what portions of the testimony of any witness it will accept or reject.
Traveler's Indemnity Co. v. Rawson,
1. Whether a Contract Was Formed: Overview of the Law
As a preliminary step to resolving the primary issue of whether a contract was formed, a cursory examination of the type of bargaining (or marketing) transaction which Andrew Jackson's agents employed is necessitated. The evidence is then scrutinized to determine whether the elements of a contract (i.e., offer, acceptance, and consideration) are present.
a. The Bargaining Transaction
Bargaining transactions with potential insureds are generally conducted by the insurer's agents. Through these transactions, the agent may invite the potential insured to make an offer (i.e., to become an applicant for coverage). See generally R. KEETON & A. WIDISS, INSURANCE LAW § 2.1(c) (1988) (hereinafter KEETON & WIDISS); 12 J. APPLEMAN & J. APPLEMAN, INSURANCE LAW AND PRACTICE §§ 7121 & 7151 (1981) (hereinafter APPLEMAN & APPLEMAN). The completed application may be forwarded to the insurer for assessment of the risks after which the insurer may decide to form a *1178 contract by accepting the applicant's offer. KEETON & WIDISS, supra, at § 2.1(c).
Through an alternative transaction, the insurer may initially make the offer, and the potential insured may form a contract by accepting. Completion of an application (or some other form) and remittance of the specified premium generally constitute an acceptance. See id. (citing numerous authorities).
Andrew Jackson contends that it employs the former type of transaction; that it never accepted Willie's offer and; consequently, that formation of a contract never occurred. The evidence, however, is otherwise indicative; the agents unequivocally employed the latter type of bargaining transaction.
b. Offer, Acceptance, and Consideration
From a technical standpoint, an offer, an acceptance, and consideration are manifested in the record. See generally 12A APPLEMAN & APPLEMAN, supra, § 7196, at 54-56.
The agents expressed their assent to specific and definite terms; that is, they extended Willie an offer to form a contract and thus become enrolled in Andrew Jackson's retirement program. More specifically, the offer was conditioned on completion of an application, remittance of a premium (or signing of a payroll deduction card), and assent to essential terms delineated in the application.[8] Formation of an insurance contract requires that these essential terms "be specific, either expressly or by implication, as to the subject matter, period, rate, and amount of insurance." Mississippi Farm Bureau Mut. Ins. Co.,
Acceptance of the offer (mutual assent or "meeting of the minds") was manifested through Willie's: (1) remittance of seven premiums deducted from his paycheck, and (2) completion of the application which contained the essential terms. See generally 1 A. CORBIN, CORBIN ON CONTRACTS §§ 11-108 (1963 & 1990 Supp.).
Consideration is also legally sufficient in light of both the benefit to Andrew Jackson and the detriment to Willie (i.e., detrimental reliance or promissory estoppel). Accord id. at §§ 109-209; KEETON & WIDISS, supra, at § 2.3(c)(6). On the one hand, Andrew Jackson received from Willie consideration in the form of seven premiums. Accord Pacific Mut. Life Ins. Co. v. Haslip,
Thus, Andrew Jackson's contention that no contract was formed (i.e., that no policy was issued) is simply contrary to the evidence adduced during discovery and trial. See also Ex.Vol., at 4 (document issued by Andrew Jackson containing the following clear and unambiguous statement: "This Entitles the Beneficiary of Policy No. 41296 to request our immediate cash benefit service for payment from the proceeds of the above numbered policy... . PAYABLE UPON THE DEATH OF Willie or Jerlean Williams.") (emphasis added); id. at 29 (A "claimant's statement," completed and filed by the agents on Willie's behalf, contains the following questions/answers: (1) "List all policy(s) numbers in this Company"/"41296," and (2) "If any policy in this Company was assigned, give particulars"/"[names of Williams-family members listed by the amount for which each is insured]"); id. at 3 (another document issued by Andrew Jackson containing number 41296 assigned to the Williams family policy).[10]
c. Summation
In sum, perusal of the recorded evidence leads this Court to conclude that "reasonable and fair-minded [jurors] in the exercise of impartial judgment might reach [the] conclusion[]" reached by the jurors in the case sub judice. Mississippi Farm Bureau Mut. Ins. Co.,
2. Whether Andrew Jackson Should Be Contractually Bound: Overview of the Law
Whether Andrew Jackson should be bound by the formed contract is dependent upon whether, as a matter of law, the evidence supports the conclusion that the *1180 agents were authorized to act on the insurer's behalf.
a. The Law of Agency
Mississippi recognizes the well-established principle that the general law of agency applies to insurers' relationships with their agents. See, e.g., Ford v. Lamar Life Ins. Co.,
Similarly, Mississippi statute provides, in pertinent part, that "every person [who performs certain actions] for or on behalf of any ... insur[er] ... shall be held to be the agent of the company ... as to all duties and liabilities imposed by law, whatever conditions or stipulations may be contained in the policy or contract. MISS CODE ANN. § 83-17-1 (1972) (emphasis added). "The purpose of this statute is to prevent insurers from operating through third persons [e.g., agents] and later denying responsibility for the acts of those persons." Lamar Life Ins. Co.,
b. An Agent's Scope of Authority
An agent's authority may be actual, or it may be apparent. If an agent had apparent authority to bind his or her principal, then the issue of actual authority need not be reached. Baxter Porter & Sons Well Servicing Co., Inc. v. Venture Oil Corp.,
[T]he principal is bound if the conduct of the principal is such that persons of reasonable prudence, ordinarily familiar with business practices, dealing with the agent might rightfully believe the agent to have the power he assumes to have. The agent's authority as to those with whom he deals is what it reasonably appears to be so far as third persons are *1181 concerned, the apparent powers of an agent are his real powers.
Steen,
To recover under the theory of apparent authority, a three-prong test must be met. Specifically, recovery requires a sufficient showing of: (1) acts or conduct on the part of the principal indicating the agent's authority, (2) reasonable reliance on those acts, and (3) a detrimental change in position as a result of such reliance. See Lamar Life Ins. Co.,
c. Evidence of Apparent Authority
Whether the evidence sufficiently meets the three-prong test of apparent authority is an issue for the fact-finder. Venture Oil Co.,
Evidence supportive of the jury's finding, vis-a-vis the first prong, involves the admissions during trial by an Andrew Jackson executive (Bethany) and agent (Page) as well as the blatant failure by the insurer to provide "notice of restrictions upon [the agents'] authority" to avert misleading or fraudulent representations. McPherson,
These admissions are additionally supportive of the second prong reasonable reliance stemming from the insurer's acts or failure to act. Indeed, if Andrew Jackson's own licensed agent, supposedly sophisticated in insurance practices, believed he was authorized then how could this Court conclude that an unsophisticated individual like Willie should have known otherwise? In other words, Willie's reliance cannot be deemed unreasonable under the circumstances.
And why shouldn't a Universal employee believe an agent who declares that immediate risk aversion and peace of mind are attainable so long as (1) he or she currently holds an American Income policy, (2) completes an application, and (3) remits the first premium? Virtually everyday, these intangibles are offered through television commercials, newspaper circulars, mailings, and even vending machines (e.g., "trip or traveller's insurance"). These offers are made seemingly guaranteeing prospective purchasers (1) that they can immediately enroll or receive coverage "for the lowest rates possible," (2) that "no physical examination is required" and "no medical questions will be asked; and (4) that they "will not be turned down regardless of *1182 health or for any reason." But these guarantees are sometimes misleading. See KEETON & WIDISS, supra, at § 2.7. A thorough investigation generally uncovers conditions which do exist like the proverbial "needle in a haystack" and which essentially amount to offers to negotiate rather than offers to accept. See, e.g., Riordan v. Motor Club of N.Y.,
The evidence adduced at depositions and at trial revealed that absolutely no oral or written notice of existent policy conditions or breadth of agents' authority was provided Willie or any Universal employee. Thus, Willie and other employees were not afforded an opportunity to become properly "informed" through inspection of sample policies, brochures, or anything, and discover that the agents' offers "wrongfully" contravened unrevealed policy conditions. As admitted by one agent: He "expected" the employees to "one hundred percent ... rely on what [he told] them about what they're getting" (or not getting). "[U]ntil the point a policy was actually put in [the employees'] hand[s], there wasn't any way for them to tell if [he] was [not informing] them [about attached conditions such as the date on which the policies became effective]." Employees "had to believe what [the agents] had to say," and "that's the way the people at Andrew Jackson [in Jackson] ... knew [the program] was set up." Vol. III, at 495-97 (testimony of Page); see also Vol. II, at 239 (Bethany admitting that he too expected the "customer [to] rely on what the agent says"); cf. Fritz v. Old Am. Ins. Co.,
Bethany added that the contract which limits the authority of its agents to mere solicitation of applications is not available for public inspection. Vol. IV, at 660. What is available for inspection is a certificate of authority issued by the Mississippi Department of Insurance declaring that Page and Smith are "duly licensed to transact insurance business" and that "Andrew Jackson ... has appointed [them] to be its ... general agent[s]" as opposed to mere "soliciting" agents. Ex.Vol., at 34 & 35 (emphasis added). This Court's holding in McPherson is especially pertinent in this regard:
A life insurance company is bound by the acts of its general agents within the scope of their real or apparent authority [and that] those dealing with such agents without notice of restrictions upon [the agents'] authority have a right to presume that [their] authority is co-extensive with [their] apparent scope and as broad as [their] title indicates.
Finally, the third and last prong of the apparent-authority test detrimental reliance was also met. As discussed in Section II(A)(1)(b), supra, Willie clearly relied on the agents' misrepresentations to his detriment.
d. Summation
In sum, the evidence supports the jury's verdict; Andrew Jackson was properly found to be bound by the contract formed by its apparently authorized agents.
B. Propriety of Punitive Damages
This subsection comprises discussions re propriety of: (1) submitting the punitive-damages issue to the jury; (2) imposing liability for punitive damages; and (3) awarding $200,000 in punitive damages an allegedly excessive amount.
1. Submission to the Jury
Whether a punitive-damages issue should be submitted to the jury is for the trial judge to decide in accordance with guidelines established by this Court. These guidelines will be examined shortly. But first, the trial judge's basis for submitting the issue will be discussed followed by a summary of Andrew Jackson's contention (i.e., that submission was erroneous).
*1183 a. Trial Judge's Basis
Judge Bowling submitted the punitive-damages issue to the jury on the basis of his interpretation of Blue Cross & Blue Shield of Miss., Inc. v. Campbell,
It can be argued with considerable persuasion that unless the trial judge grants a directed verdict to the insured plaintiff on the contract claim, then, as a matter of law, the insurance carrier has shown a reasonably arguable basis to deny the claim; and, therefore, the carrier should never be subjected to the possibility of punitive damages based upon "bad faith."
.....
Yet, the test is not infallible. Under some contrived or specious defense, an insurance carrier may be entitled to have the jury pass upon the issue of liability under the contract, yet not thereby insulate itself against a punitive damage claim based upon bad faith. There may be other reasons not yet encountered which may give an insurance carrier a defense on the contract itself, and yet nevertheless the carrier should be subjected to a bad faith claim.
Id. at 843 (Hawkins, J., denying petition for reh'g). Judge Bowling then cited the so-called "lying exception" to the general rule that a bad-faith issue should not be submitted to the jury if, upon presentation of all the evidence, the insured was not entitled to a directed verdict, peremptory instruction or the like, on the underlying contract or policy claim. Vol. V, at 790-95 (citing Blue Cross & Blue Shield of Miss.,
Basically, "[t]his exception to the general rule ... would be operative only where the jury is asked to reject on grounds of deliberate falsehood or fabrication [or misrepresentation] the insurer's defense to the underlying contract claim." Blue Cross & Blue Shield of Miss.,
The judge then applied the facts of the case sub judice to the law articulated in Blue Cross & Blue Shield of Miss.:
The testimony is ample from the general agents that the that it was their intention and their instruction to the employees and to the union and to all that they [c]ould ... change companies [and receive] automatic coverage... . I certainly don't disagree and find too much fault with Mr. Bethany for testifying that they had no such authority. But Mr. Page testified under oath that he did do so whether he was told by Mr. Bethany to do so or not.
Mr. Page was asked on two or three different occasions about lies that he told [and h]e admitted in his own words that he ... lie[d]... .
So I have no choice but to ... submit the question of punitive damages ... to the jury.
See generally Vol. V, at 793-95 (trial transcript).
b. Andrew Jackson's Contention
Andrew Jackson rejects the judge's logic and contends that the "lying exception" is not applicable to its case. Andrew Jackson's contention is based on the premise that "its defense does not require a resolution of the question of whether its agent lied." Rather, its "defense is that no contract of life insurance ever existed" and "that the conditions of the policy applied for were not fulfilled." Appellant's Brief at 31.
c. Overview of the Law
In an insurance-contract case such as the one sub judice, the trial judge is responsible for reviewing all the evidence before it in order to determine whether the issue of punitive damages should be submitted to the jury. Bankers Life & Cas. Co. v. Crenshaw,
Pursuant to this guideline, determination of whether to submit a punitive-damages issue to the jury generally will be contingent on a determination of whether the insurer denied the underlying policy or contract claim on an arguable basis.[11] The arguable-basis theory was pronounced in the seminal bad-faith case of Standard Life Ins. Co. of Ind. v. Veal: "[I]f an insur[er] has a legitimate ... or an arguable reason for failing to pay a claim, punitive damages will [generally] not lie."
Implicit in [Standard Life Ins. Co. of Ind.'s explanation] is the ... trial judge's ... responsibility of making the determination of whether there was an arguably reasonable basis, either legal or factual, for denying the claim. Indeed, only the trial judge could determine whether a legal basis asserted by the insur[er] for denying the claim was an "arguable reason," or "reasonably arguable."
Arguably-based denials are generally defined as those which were rendered upon dealing with the disputed claim fairly and in good faith. Cf. Southern United Life Ins. Co.,
*1185 In other cases, where the judge conclusively determines that an arguable basis for the denial or breach is not evidenced, the insurer may be deemed to have acted unfairly and in bad faith. In these cases, the punitive-damages issue generally should be submitted to the jury notwithstanding whether a directed verdict (or the like) was granted on the insured's policy or contract claim. Reserve Life Ins. Co. v. McGee,
And "in rare cases the defendant's denial of the plaintiff's allegations of bad faith leads to a sharp conflict in evidence necessitating jury resolution so that [determination of whether the insurer's denial or breach was unfair and in bad faith] is out of the question." State Farm Fire & Cas. Co. v. Simpson,
In the event the trial [judge] determines that as a matter of law it cannot hold that the insurer had a legitimate and arguable defensive position, but that the evidence constituted disputed facts as to whether or not such situation existed, then the trial [judge] should submit th[e arguable-basis and punitive-damages] issue[s] to the jury.
Some of the foregoing principles are not ironclad; that is, absence or presence of an arguable basis is not per se determinative of whether the punitive-damages issue should be submitted to the jury. See Aetna Cas. & Surety Co.,
Submission of the punitive-damages issue may not be warranted notwithstanding an absence of an arguable basis for the denial or breach. See Pioneer Life Ins. Co. of Ill.,
Conversely, Mississippi law has evolved to a point of recognition that submission of the punitive-damages issue may be submitted notwithstanding the presence of an arguable basis. Aetna Cas. & Surety Co.,
For example, an insurer who denies a claim on an arguable basis could conceivably be held liable for punitive damages if the insured's financial straits were used as a settlement leverage. Cf. Travelers Indem. Co. v. Wetherbee,
d. The Law and the Case Sub Judice
Applying the law to the evidence, this Court cannot conclude that the punitive-damages issue was erroneously submitted to the jury. This Court is not persuaded by Andrew Jackson's contention that, under the facts of the case sub judice, the so-called "lying exception" is inapplicable. To reiterate, the "lying exception" is "operative ... where the jury is asked to reject on *1187 grounds of deliberate falsehood or fabrication [or misrepresentation] the insurer's defense to the underlying contract claim." This is precisely what happened in this case.
Andrew Jackson based its denial of Willie's claim on Jerlean's allegedly undisclosed heart condition and an absence of a binding contract. Willie contended, however, that these bases should be rejected because the agents: (1) misrepresented Jerlean's disclosed heart condition to Andrew Jackson, and (2) misrepresented policy provisions to Willie and other Universal employees. Andrew Jackson knew (through Willie's pre-complaint information) or constructively knew (through imputation) or should have known (through diligent and thorough investigation) about its agents' misrepresentations. Such misrepresentations created a jury issue of whether Andrew Jackson's denial was arguable. See also Pioneer Life Ins. Co. of Ill.,
Assuming, arguendo, that Andrew Jackson denied Willie's claim on an arguable basis this case could be deemed an exception to the general rule that the punitive-damages issue should not be submitted to the jury under such circumstances. To reiterate, "under some contrived or specious defense, an insur[er] may be entitled to have the jury pass upon the issue of liability under the contract, yet not thereby insulate itself against [submission of] a punitive damage claim based upon bad faith." Aetna Cas. & Surety Co.,
2. Imposition of Liability
a. Overview of the Law
A fact-finder's assessment of punitive damages "is no different in `bad faith' cases than in other ... cases involving a request for punitive damages." State Farm Fire & Cas. Co.,
Restated, the law requires a finding of "bad faith-plus" based upon a preponderance of the evidence before punitive damages may be awarded. Accord Mutual Life Ins. Co. of N.Y.,
Through the years, explanations of what may constitute requisite "tortious" conduct have varied albeit minimally. See, e.g., Mutual Life Ins. Co. of N.Y.,
The theory supporting imposition of punitive-damages liability for commission of rarely-proven tortious conduct inheres the maxim "that every contract contains a[n implied] covenant of good faith and fair dealing." Note, Damage Measurements for Bad Faith Breach of Contract: An Economic Analysis, 39 STAN.L.REV. 161, 161 (1986) (citing numerous supportive authorities). This covenant applies to both insured and insurer albeit more so to the latter party. In short, the duty requires abstinence by all parties from commission of wrongful conduct which injures "the right of [the another] to receive the benefits of the agreement." Shipstead & Thomas, Comparative and Reverse Bad Faith: Insured's Breach of Implied Covenant of Good Faith and Fair Dealing as Affirmative Defense or Counterclaim, XXIII TORT & INS.L.J. 215, 218 (1987).
Recognition of an implied covenant and an evolving significant expansion of insurer liability stem from the recognition of *1189 "the `special relationship' existent between the insurer and insured, as well as the superior bargaining position of the insurer." Kornblum, The Current State of Bad Faith in the U.S., XXIII TORT & INS.L.J. 812, 813 (1988). In probably the seminal case inhering this recognition, the California Supreme Court opined:
It is a matter almost of common knowledge that a very small percentage of policy holders are actually cognizant of the provisions of their policies and many of them are ignorant of the names of the companies issuing the said policies. The policies are prepared by the experts of the companies, they are highly technical in their phraseology, they are complicated and voluminous ... and in their numerous conditions and stipulations furnishing what may be veritable traps for the unwary... . [C]ourts, while zealous to uphold legal contracts, should not sacrifice the spirit to the letter nor should they be slow to aid the confiding and innocent.
Raulet v. Northwestern Nat'l Ins. Co. of Milwaukee,
[W]e have recognized that a duty of good faith and fair dealing may arise as a result of a special relationship between the parties governed or created by a contract.
In the insurance context a special relationship arises out of the parties' unequal bargaining power and the nature of insurance contracts which would allow unscrupulous insurers to take advantage of their insureds' misfortunes in bargaining for settlement or resolution of claims. In addition, without such a cause of action insurers could arbitrarily deny coverage and delay payment of a claim with no more penalty than interest on the amount owed. An insurance company has exclusive control over evaluation, processing and denial of claims. For these reasons, a duty is imposed that "[an] indemnity company is held to that degree of care and diligence which a man of ordinary care and prudence would exercise in the management of his own business."
Arnold v. National County Mut. Fire Ins. Co.,
[O]ne of the benefits that flow [sic] from the insurance contract is the insured's expectation that his insurance company will not wrongfully deprive him of the very security for which he bargained or exposed him to the catastrophe from which he sought protection. Conduct by the insurer which does destroy the security or impair the protection purchased breaches the ... covenant of good faith and fair dealing implied in the contract.
Rawlings v. Apodaca,
The possibility of being held liable for punitive damages acts primarily to punish and deter. See Maas,
b. The Law and the Case Sub Judice
Applying the law to the case sub judice, this Court cannot conclude that imposition of liability was improper. The jury's finding is clearly supported by a preponderance of the evidence. The record is replete with evidence evincing "bad faith-plus."
For example, the record evinces: (1) egregious breach by both Andrew Jackson and its agents of the implied covenant of good faith and fair dealing; (2) attempted use of Willie's financial dire straits, lack of sophistication, and inferior bargaining position as a settlement leverage; (3) acts of fraud; and (4) general cavalier treatment of Willie.
In view of all the evidence, this Court holds that a reasonable jury could have found that the conduct of Andrew Jackson and its agents reached the heightened level of an independent tort which cannot be ignored nor go unredressed. The jury's awarding of punitive damages stands.
3. Amount of the Award
As noted, the jury awarded Willie $200,000 in punitive damages which Andrew Jackson contends is excessive because it "violates the rule that punitive damages are granted in the nature of punishment, but not to destroy the defendant's financial status." Appellant's Brief at 40.
a. Overview of the Law
Under current Mississippi law, the "quantum" of a punitive-damages award is measured upon consideration of certain general factors. First, the amount awarded should serve to punish the insurer and to deter it from committing similar offenses in the future. Second, the amount should serve as an example set to deter others from committing similar offenses. Third, the amount awarded should account for the insurer's pecuniary ability and financial worth. And fourth, the amount constitutes compensation for the plaintiff for his or her "public service" in bringing the action. See, e.g., Mutual Life Ins. Co. of N.Y.,
Measurement of the amount is a matter solely committed to the jury's fettered discretion. Id. at 540 (Punitive-damages "awards are most properly submitted to the `discretion, sound judgment and combined wisdom of jurors drawn indiscriminately from every walk of life.'") (Anderson, J., dissenting); see also Bankers Life & Cas. Co.,
On appeal, this Court is essentially asked to review the trial judge's decision in response to a motion for a remittitur, additur, new trial, or the like. Bankers Life & Cas. Co.,
b. The Law and the Case Sub Judice
Andrew Jackson's contention that the award is grossly excessive because it "destroy[s its] financial status" is merely conclusory and virtually devoid of substantiation. That is, Andrew Jackson reached its conclusion without specific application of the standard discussed in the preceding subsection albeit the various factors which compose the standard are mentioned in its brief. For example, Andrew Jackson correctly notes that measurement of a punitive-damages award requires consideration of: "(1) an amount necessary to punish ... and ... deter; (2) an amount ... necessary to make an example of the defendant ...; and (3) the financial worth of the defendant." Id. See Appellant's Brief at 40. But Andrew Jackson does not explain how the amount awarded constitutes a breach of these requisite considerations. Andrew Jackson's sole premise for its "grossly-excessive" conclusion is a comparison of percentages:
The present award of 5 1/4% of the net worth of defendant is not justified. In [Mutual Life Ins. Co. v. Wesson, this] Court noted that the "net assets" of the defendant there were $8 billion. Thus, the punitive damages award of $8 million was equivalent to one-tenth of one percent of the net worth of the defendant. The amount of punitive damages allowed after the remittitur in Wesson was equivalent to less than two hundredths of one percent of the net worth of the defendant. These numbers illustrate the absurdity of the punitive damages award against Andrew Jackson in this case. Under the rule in Wesson, the punitive damages award against Andrew Jackson is excessive as a matter of law.
Id. at 41. Thus, Andrew Jackson seems to believe that this Court has pronounced a "hard and fast" rule of percentages to be applied in cases involving punitive damages. This is clearly not the case. As most aptly stated by Justice Sullivan in Bankers Life & Cas. Co.: "[N]o hard and fast rule may be laid down with regard to the maximum amount of punitive damages which may be awarded in a given case."
Upon perusing Andrew Jackson's contention and applying the standard to the facts of the case sub judice, this Court concludes that the award is not grossly excessive and that the trial judge committed no discretionary abuse.
C. Propriety of the Jury Instructions
Finally, Andrew Jackson presented issues pertaining to the substantive propriety *1192 of the jury instructions. The record and briefs have been perused. This Court concludes that no reversible error was made by the trial judge.
III. CONCLUSION
Before concluding this opinion, an afterword is in order. This case involved a seemingly pervasive and problematic insurance practice described and poignantly criticized by Justices Hawkins and Sullivan in a specially concurring opinion:
[The] sole source of [agents'] income from [the insurer] was on commission... .
If the policy was issued following [completion of] the application, they kept the commission. If the policy was not issued, the premium had to be refunded.
When the soliciting agent, rather than the applicant fills in the application, it is naive to assume that there is not a strong temptation on his part to ignore an answer the applicant gives which would prevent the company's issuing a policy, which would "knock out" a sale.
The insurance companies surely know this. Yet, they permit their agents to be put in such conflict of interest positions, only to assert later, with a presumably straight face, that precisely what happened in this case should never occur.
... [H]aving approved a system or practice which encourages giving false answers (by their own agents) to questions on their application forms, they use the deceit of their own employees as a weapon to deny a claim.
... The question then follows, why don't insurance companies [remedy the situation]?
National Life & Accident Ins. Co.,
In the case sub judice, Page testified that "out of each one of these policies down there at Universal, [he] get[s] fifty percent of the premium." "If you don't produce you don't get paid." Vol. III, at 525. Thus, an incentive existed for overzealous agents to misrepresent the facts. See Lamar Life Ins. Co.,
In addition, Andrew Jackson could have provided such information in the application a practice common in the insurance industry.
Some insurers have designed simple, easily understood application[s] ... with prominently displayed explanations of both the limitations as to when coverage will commence... . [I]nsurers employing this approach have adopted specific measures designed to assure either that the applicant has the same . .. expectations.
Id. § 2.3(d); see id. § 2.1(c) ("[A]pplication[s] used by many insurers provide that the insurer's acceptance ... of an applicant's offer will not occur until the ... policy is [issued or] literally delivered to *1193 the applicant."); Lamar Life Ins. Co.,
Insurers are admonished to exercise "more careful selection and supervision of their agents." State Farm Fire & Cas. Co.,
Regrettably for Andrew Jackson, no compunctious feelings about the inexcusable mishandling of Willie's case can be gleaned from the record or briefs. The insurer can continue to "play the odds" through usage of risky practices which motivates agents to make misrepresentations; they can then deny a claim; flippantly "absolve" itself of any responsibility for such misrepresentations; and it can lose. In this case, the insurer "played the odds and lost." National Life & Accident Ins. Co.,
AFFIRMED.
ROY NOBLE LEE, C.J., HAWKINS and DAN M. LEE, P.JJ., and ROBERTSON, SULLIVAN and ANDERSON, JJ., concur.
BLASS, J., concurs by separate written opinion, joined by ROY NOBLE LEE, C.J., and PITTMAN, J.
BLASS, Justice, concurring:
I concur in the result reached by the majority. While my respect for the writer of the majority opinion is great and unfeigned, and while I hold the learned Justice in high esteem, I protest that the opinion is too long and will be seriously burdensome to the Bar. It would be an excellent journal article, but it is difficult to tell how much of it is law. In my opinion, the case is properly decided and could have been readily and adequately treated in five to six pages. It is an important case but its precedential usefulness is diminished by the length and complexity of the discussion. It is difficult to separate the academic discussion and incidental comment, obiter dicta, from those parts of the opinion which set out the facts and the law which led the Court to the conclusion which it reached.
My impression is that the Court is saying in this case that the defendant clothed its agents with apparent authority to solicit insurance business and to close contracts with prospective insureds on the spot; that the agents, designated in posted writings from the defendant as "general" agents, promised people instant coverage, induced them to sign payroll deductions; induced them to drop insurance which they then had in effect by representing that they were instantly covered by new policies upon signing a payroll deduction slip; that the plaintiff was so induced by the agent to drop his current insurance and to sign with the defendant; did so to his detriment; lost his insurance which was then in effect only to have defendant deny him coverage, claiming that his wife was uninsurable, and that the application forms, filled out by its "general agent", did not make full disclosures. After the wife died (before the policy was issued) the evidence showed that the company attempted to induce the plaintiff to sign a settlement, amounting to a release of his benefits under the policy without advising him what it was, by offering him "his check" for a thousand dollars but nothing more. The sales pitch had promised that a thousand dollars would be immediately available in the event of a death claim, with the remainder to be paid in course.
The company, in effect, set up its agents to contract with individuals such as the plaintiff, irresponsibly inducing them to give up the insurance then in effect, allowing the agents to hold themselves out as general agents, and then walked away leaving the grossly mistreated "insured" with no protection of any kind. The jury found that the defendant was bound by the acts of its agents and that the gross misconduct of the defendant justified punitive *1194 damages. We agree on all points. There is no new law in this decision.
Respectfully.
ROY NOBLE LEE, C.J., and PITTMAN, J., join this opinion.
NOTES
Notes
[1] National Life & Accident Ins. Co. v. Miller,
[2] Whether an allegedly excessive punitive-damages award is violative of rights embodied in the United States Constitution is an issue presently before the United States Supreme Court on certiorari. See Pacific Mutual Life Ins. Co. v. Haslip,
[3] The so-called $1,000 "check" is not actually a check which can be taken to a bank and cashed. The only purpose it seems to serve is as a misleading gimmick to promote sales of Andrew Jackson's policies. Vol. IV, at 628-29; Ex. Vol., at 4.
[4] "Risk aversion" may be understood through the following illustration.
An individual has a choice: (1) of receiving $5.00, or (2) of receiving a 5% chance of winning $100.00. Both choices are the same to the extent that $5.00 "is the expected benefit" of a 5% chance of winning $100.00. Some individuals may, some of the time, be indifferent when faced with the option of choosing to receive a "certain amount" (i.e., $5.00) or its "uncertain or expected equivalent" (i.e., 5% chance of winning $100.00); these individuals are so-called "risk neutral." Many individuals are "risk adverse"; they would choose the certain amount. And those who are "risk preferring" would choose the uncertain or expected equivalent. Law-and-economic theorists generally contend that, by definition, insurers are risk neutral (though their risks are "infinitesimal"); insureds are risk adverse; and gamblers are risk preferring. R. POSNER, TORT LAW: CASES AND ECONOMIC ANALYSIS 3 (1982); see R. POSNER, ECONOMIC ANALYSIS OF LAW 91-96 (providing further illustrations and explanations"); see also Note, Damage Measurements for Bad Faith Breach of Contract: and Economic Analysis," 39 STAN.L. REV. 170-71 (1986).
[5] The "peace of mind" concept was poignantly described by Justice Lent of the Oregon Supreme Court:
That insurers sell their product as being not only an agreement to indemnify the insured for certain kinds of loss but also to relieve the purchaser from anxiety concerning all aspects of claims is readily apparent in our society. One cannot watch televised entertainment for very long without being exposed to commercials for the sale of insurance which, for example, indicate that the purchaser will be in "good hands," that he will have the assistance of a troop of mounted cavalry, that he [will have] "a piece of the rock," or that "like a good neighbor" the insurer will be there. As such advertisements reflect, the relationship between insurer and insured does not merely concern indemnity for monetary loss [risk aversion].
Farris v. United States Fidelity & Guar. Co.,
[6] "Universal's computerized payroll system had only one position or `slot' for the deduction of life insurance premiums." Appellant's Main Brief at 4 n. 2. If an employee decided to purchase Andrew Jackson's product (i.e., the "retirement plan with death benefits"), they would have to sign the deduction card. This would result in: (1) cessation of premium payments to, for example, American Income and (2) commencement of payments to Andrew Jackson. Employees were concerned that coverage under their current policies (e.g., under their American Income policies) would consequently lapse, and they would be without insurance unless Andrew Jackson's plan was effectuated immediately upon signing the deduction card. Vol. IV, at 607-08.
[7] "Clock alley" is an area inside Universal through which employees pass daily on their way to and from work and lunch. Vol. III, at 494.
[8] Another condition seems to be reflected in the record. The agents seem to have extended their offer of immediate coverage to those, who at the time, held American Income policies. Whatever the case may be, the agents knew Willie held an American Income policy when they extended an offer to him. And a notation was made on the application indicating that the coverage being purchased would replace coverage under an American Income policy. Ex. Vol., at 1-2.
[9] Were Mississippi an adherent to the "traditional" view with regard to measurement of damages for breach of contract intangible losses would be an irrelevant factor in the detrimental-reliance analysis. That is, Mississippi recognizes that an insured bargains for more than mere eventual monetary proceeds of a policy; insureds bargain for such intangibles as risk aversion, peace of mind, and certain and prompt payment of the policy proceeds upon submission of a valid claim.
More specifically, under the restrictive "traditional" approach to determining damages for breach of contract, no extra-contractual recovery is permitted (i.e., an insurer may be held liable only for the amount of the policy, plus interest.). See D. DOBBS, HANDBOOK ON THE LAW OF REMEDIES § 12.1, at 788-90 (1976) (discussing "expectation" damages); R. POSNER, ECONOMIC ANALYSIS OF LAW 105-17, 124 & 491 (1986) (general discussion on damages for breach of contract); see, e.g., Casson v. Nationwide Ins. Co.,
[10] Neither Willie nor Andrew Jackson differentiated between interim and long-term contracts. See KEETON & WIDISS, supra, at §§ 2.1 & 2.3(a). Because the evidence in the case sub judice supports the conclusion that a long-term contract was formed, this Court need not decide whether an interim contract was formed.
[11] Various phrases have been used by this Court to describe the basis upon which an insurer may deny a claim and avoid, in most cases, punitive-damages liability. Compare Reserve Life Ins. Co. v. McGee,
In this opinion, the basis must be "arguable" since the term inheres "reasonableness." See, e.g., BLACK'S LAW DICTIONARY 98-99 (5th ed. 1979); THE AMERICAN HERITAGE DICTIONARY 126-27 (2d ed. 1985).
[12] Accord Northwestern Nat'l Ins. Co. v. Pope,
[13] Conceivably, upon presentation of sufficient proof, consequential or extra-contractual damages (e.g., reasonable attorney fees, court costs, and other economic losses) may be awarded in cases involving a lack of a reasonably arguable basis notwithstanding that the insurer is not liable for punitive damages. Cf. Maas,
