OPINION OF THE COURT
Huu Nam Tran appeals from the District Court’s grant of summary judgment in favor of Metropolitan Life Insurance Company (“MetLife”), in connection with a complaint filed by Tran alleging that he was misled by MetLife’s agent as to the number of years he was obligated to pay premiums on a life insurance policy he purchased. We affirm in part and reverse in part.
I. Factual Background and Procedural History
Tran was born in Vietnam and came to the United States in 1979. He alleged in his complaint that he does not speak or read English well, and he testified through an interpreter at his deposition in this case. In 1993, Tran met Kwok Lam, a MetLife agent, when Lam came into the Chinese restaurant where Tran worked. 1 Lam spoke with Tran about purchasing a life insurance policy. The communications between Lam and Tran took place in Chinese. 2
Lam eventually sold Tran what is commonly known as a “vanishing premiums” policy. Tran testified that Lam told him that he would only have to pay premiums
Lam testified that he drew the line on the illustration to demonstrate that Tran could use his dividends to pay the premiums on his policy “after 14 [fourteen] years 3 if the current dividend scale had not been changed” from what it was at the time Tran purchased the policy. After the table illustrating the dividend payment plan, the document states:
The cash outlay illustrated shows the result if the current dividend scale continues without change. Dividends are not guaranteed and may increase or decrease in the future. If the future dividends decrease, it is possible that the cash value of additional insurance may not be sufficient in some future years to pay the full current premium and some cash outlay may be required.
Tran signed an application for a MetLife life insurance policy on September 7, 1993. MetLife issued a whole life policy to him on September 16, 1993. Lam testified at his deposition that he personally delivered the policy to Tran and went over its terms with Tran in Chinese. Lam -stated that “[he] just told [Tran] that if he dies, how much money would be payable to his beneficiary, and that- he has to pay the premium lifetime, but after a certain number of years, if the current dividend scale is okay, he could start using the dividend to pay for the premium. That’s about it.” Tran agreed only that he received the policy.
The front page of Tran’s policy included a provision titled “10-Day Right to Examine Policy” that stated:
Please read this policy. You may return the policy to Metropolitan or to the sales representative through whom you bought it within 10 days from the date you receive it. If you return it within the 10-day period, the policy will be void from the beginning. We will refund any premium paid.
The front page of the policy also stated that “[p]remiums [were] payable for a stated period.” The premium schedule, on the third page of the policy, showed that premiums were payable for fifty-nine years. On the fifth page of the policy, a section titled “Payments During Insured’s Lifetime” specified how insureds could use the annual dividends they received from Met-Life. One way was to apply the dividends toward premium payments.
Finally, the policy, included an integration clause as well as. a clause limiting the sales representative’s authority. The integration clause stated that the policy “includefd] all riders and, with the application attached when the policy [was] issued, ma[de] up the entire contract. All statements in the application [were] representa
According to Tran, he only realized that the terms of his policy were not what he believed them to be in 1999, when he received notice of a class action against Met-Life. Tran later opted out of the class action and filed a complaint against Met-Life and Lam on January 8, 2001, asserting causes of action for negligence, common law fraud and deceit, violations of Pennsylvania’s Unfair Trade Practice and Consumer Protection Law (“UTPCPL”), 73 Pa. Stat. § 201-1, et seq., breach of the implied covenant of good faith and fan* dealing, bad faith, breach of fiduciary duty, and negligent supervision. At its base is the claim that Lam misrepresented the terms of the policy to Tran by telling him that his premium payments on the policy would cease after a period of time and that Tran, particularly in light of his difficulty with English, justifiably relied on Lam’s representations.
The District Court dismissed Tran’s claims for breach of the implied covenant of good faith and fair dealing, bad faith, and breach of fiduciary duty, for failure to state a claim pursuant to Federal Rule of Civil Procedure 12(b)(6). MetLife and Lam subsequently filed a motion for summary judgment with respect to Tran’s remaining claims. The District Court granted this motion in May 2004. In doing so, it rejected MetLife’s argument that Tran’s claims were barred by the applicable statutes of limitation. However, the Court ruled that MetLife was entitled to summary judgment because Tran could not, as a matter of law, establish reasonable reliance 5 on Lam’s oral representations, as was required to succeed on his fraud, negligent misrepresentation 6 , and UTPCPL claims. The District Court, citing the provisions stating that premiums were payable for fifty-nine years, that the cash value of the policy when Tran reached retirement age was specific, and that sales agents could not alter the terms of the policy through oral promises, concluded that the nature of Tran’s policy was presented on the specification page of that policy in “clear, plain language.” The Court acknowledged that “Pennsylvania law permits the 'reasonable expectations’ of the insured to prevail over the express language of an insurance policy where the insurance company creates a reasonable expectation of coverage[,]” but determined that Tran could not “challenge the unambiguous provisions of a policy which he made no attempt to read” or to have read to him.
Tran filed a timely notice of appeal, and the propriety of the District Court’s grant of summary judgment to MetLife on Tran’s fraud, negligent misrepresentation, and UTPCPL claims is now before us. 7
The District Court had diversity jurisdiction over this action pursuant to 28 U.S.C. § 1332, and we have appellate jurisdiction over the District Court’s final order pursuant to 28 U.S.C. § 1291. Our review of orders granting summary judgment is plenary, and we apply the same test as the District Court.
Med. Protective Co. v. Watkins,
III. Discussion
Tran argues that the District Court erred in granting MetLife summary judgment because a reasonable jury could find that he justifiably relied on Lam’s representations about the nature of the policy. Complementing this argument is Tran’s contention that, as a matter of law, he had no duty either to read the policy or have it read to him. Tran also contends that the District Court erred in determining that he was required to prove justifiable reliance, rather than mere ordinary reliance, with regard to his UTPCPL claims. We address each of these arguments in turn.
A. Tran’s Reliance on Lam’s Representations
Justifiable reliance on an alleged misrepresentation is an element of both fraudulent representation and negligent misrepresentation causes of action in Pennsylvania.
8
Courts must consider “the relationship of the parties involved and the nature of the transaction” when determining whether one party’s reliance on the allegedly fraudulent representations of another is justifiable.
Rempel v. Nationwide Life Ins. Co., Inc.,
The general rule in Pennsylvania, as elsewhere, is that courts are required to give effect to the language of contracts, including insurance policies, if that language is clear and unambiguous.
See Bensalem Township v. Int’l Surplus Lines Ins. Co.,
In
Bensalem Township,
we canvassed the Pennsylvania Supreme Court’s decisions on the doctrine of reasonable expectations and concluded that “we [were] unable to draw any categorical distinction between the types of cases in which the Pennsylvania courts will allow the reasonable expectations of the insured to defeat the unambiguous language of an insurance policy and those in which the courts will follow the general rule of adhering to the precise terms of the policy.”
[o]ne theme that emerges from all the cases ... is that courts are to be chary about allowing insurance companies to abuse their position vis-a-vis their customers. Thus we are confident that where the insurer or its agent creates in the insured a reasonable expectation of coverage that is not supported by the terms of the policyf,] that expectation will prevail over the language of the policy.
Id.; see also W. Am. Ins. Co. v. Park,
Here, the District Court agreed with Tran that his reasonable expectations regarding the terms of his policy must be viewed in light of his limited understanding of English. The Court proceeded to hold, however, that Tran had a duty under Pennsylvania law to read the policy or to have it read to him (obviously in a language he understands) and that, because he failed to fulfill that duty, he could not claim justifiable reliance on Lam’s representations and his expectations thus could not defeat the clear policy language. This conclusion was incorrect because Pennsylvania does not impose a duty to read insurance policies when insureds allege fraud.
The Pennsylvania Supreme Court has stated that “[t]he idea that people do not read or are under no duty to read a written insurance policy is not novel.”
Rempel,
Standard Venetian Blind,
cited by the District Court and relied on heavily by MetLife, is not to the contrary. The Pennsylvania Supreme Court stated in that case that
“[i]n the absence of proof of fraud,
failure to read [the contract] is an unavailing excuse or defense and cannot justify an avoidance, modification or nullification of the contract or any provision thereof.”
In
Tonkovic v. State Farm Mut. Auto. Ins. Co.,
a crucial distinction between cases where one applies for a specific type of coverage and the insurer unilaterally limits that coverage, resulting in a policy quite different from what the insured requested, and cases where the insured received precisely the coverage that he requested but failed to read the policy to discover clauses that are the usual incident of the coverage applied for.
Id. Rempel
applies to the first type of case, and
Standard Venetian Blind
applies to the second.
Id.; accord Pressley v. Travelers Prop. Cas. Corp.,
Although our case does not involve coverage issues, we nonetheless believe that the
Tonkovic
distinction is useful, as Tran did not receive the premium structure he anticipated just as the policyholders in
Tonkovic
and
Pressley
did not receive the coverage they anticipated. This brings our case within
Rempel
and its progeny rather than
Standard Venetian Blind,
and the rule that an insured has no duty to read a policy unless it would be unreason
We also disagree with the District Court’s determination that the terms of Tran’s policy were clear and unambiguous. “Interpretation of the language of an insurance policy is generally the role of the court, rather than the jury.”
Williams v. Nationwide Mut. Ins. Co.,
However, as the Court of Appeals for the Eighth Circuit recently noted, a policy provision stating that premiums are payable for a certain number of years “could be read by a reasonable unsophisticated insured as being completely consistent with the agents’ alleged representations that the premiums paid by plaintiffs for a limited time, in combination with policy interest and dividends paid, would be sufficient to cover future premiums.”
Knouse v. Gen. Am. Life Ins. Co.,
“Where a provision of an insurance policy is ambiguous, it will be construed in favor of the insured.”
Williams,
Accordingly, summary judgment was not called for on the ground that Tran could not demonstrate justifiable reliance. We stress, as have the Pennsylvania courts, that the issue of whether reliance on a representation is reasonable (or justifiable) is generally a question of fact that should be presented to the jury.
See, e.g., Silverman,
Having determined that the District Court erred in concluding that Tran could not establish justifiable reliance as a matter of law, we turn to Tran’s argument that the District Court also erred in determining that he was required to prove justifiable reliance at all as to his UTPCPL claims.
B. Justifiable Reliance and the UTPCPL
Tran alleged that MetLife violated the following provisions of Pennsylvania’s
The “underlying foundation” of the UTPCPL “is fraud prevention.”
Weinberg v. Sun Co., Inc.,
In addition, the Pennsylvania Superior Court, which had previously agreed with Tran’s position that plaintiffs were not required to prove the elements of common law fraud with regard to certain sections of the UTPCPL,
see DiLucido v. Terminix Int’l, Inc.,
Upon our review of the [Pennsylvania] Supreme Court’s decision in Weinberg, we must conclude that every plaintiff asserting a private cause of action under the UTPCPL must demonstrate his/her justifiable reliance on the misrepresentation or wrongful conduct. As the decision in Weinberg emphasized that the UTPCPL was designed to prevent fraud and that the legislature did not intend to remove the common law elements of reliance and causation that attend a fraud action, plaintiffs must demonstrate the level of reliance that accompanies a common law fraud claim.
Id. at 11 (emphasis added).
We are not bound by Toy’s holding (as it is not a Pennsylvania Supreme Court decision), but we are persuaded by its reasoning, which we are obliged to consider.
Gruber v. Owens-Illinois Inc.,
IV. Conclusion
In sum, the District Court was correct that Tran must establish justifiable reliance to prevail on all of his remaining claims, including those brought under the UTPCPL. It erred, however, in concluding that Pennsylvania law imposed upon Tran a duty to read his insurance policy or to have it read to him. Its conclusion that the pertinent policy provisions were clear and unambiguous was similarly in error. This case, like most others raising the issue of justifiable reliance, presents disputed issues of material fact that are simply more appropriate for resolution by a jury than by a judge. We therefore affirm in part, reverse in part, and remand for further proceedings consistent with this opinion. 13
Notes
. According to Tran's brief and evidence submitted in his appendix, MetLife at that time encouraged its agents to target people in Asian-American communities.
. At his deposition, Tran stated that he communicated at work in Chinese but that he was not fluent in that language. (His conversations with Lam were in the Cantonese dialect.) He also testified that he studied English while in high school in Vietnam and for a period of time after coming to the United States but that he did not remember the English he had learned in school.
. Looking at Lam's deposition testimony in context, we surmise what he meant was that Tran could begin using his dividends to pay premiums in the fourteenth year of the policy's life.
. The policy application contained essentially the same language as well.
. The District Court used the terms "reasonable reliance” and "justifiable reliance” interchangeably.
. The District Court characterized Tran's negligence cause of action as stating a negligent misrepresentation claim, and Tran does not dispute that characterization.
. The District Court also granted summary judgment in favor of MetLife on Tran's negligent supervision claim because he had pre
. The parties do not dispute that Pennsylvania law applies to this diversity action. To succeed on a fraudulent misrepresentation claim under Pennsylvania law, a plaintiff must prove the following elements by clear and convincing evidence: "(1) a misrepresentation; (2) a fraudulent utterance; (3) an intention by the maker that the recipient will be induced to act; (4)
justifiable reliance on the misrepresentation;
and (5) damage to the recipient as a proximate result.”
Tunis Bros. Co., Inc.
v.
Ford Motor Co.,
. In concluding otherwise, the District Court, while referring to
Standard Venetian Blind,
did not discuss
Rempel.
Instead, the Court relied mainly on
Fried v. Feola,
. Tran asserts that the Eighth Circuit’s decision in
Knouse
should prevent MetLife from relitigating the issue of Tran’s justifiable reliance in this case under the issue preclusion doctrine. "Under Pennsylvania law, issue preclusion applies where: (1) the issue decided in the prior adjudication was identical with the one presented in the later action; (2) there was a final judgment on the merits; (3) the party against whom the plea was asserted was a party or in privity with a party to the prior adjudication; and (4) the party against whom it is asserted has had a full and fair opportunity to litigate the issue in question in a prior action."
Greenleaf v. Garlock,
. Although we believe that the District Court erred in determining that the policy language was clear, reasonable jurors in any event could find that, despite Tran’s failure to read the policy, his reasonable expectations (based on Lam's representations) that his policy premiums would "vanish” after a period of time prevailed even if the District Court had been correct that those expectations contradicted unambiguous policy language.
See, e.g., UPMC Health Sys. v. Metro. Life Ins. Co.,
. As the Pennsylvania courts have spoken on this issue, we need not address Tran's argument that we should look to decisions of the Federal Trade Commission (''FTC”) for guidance in interpreting the UTPCPL, nor need we address MetLife's contention that Tran waived his argument that we should consider FTC decisions by not raising it below.
. Because we have determined that we must reverse the District Court for the reasons stated above, we need not reach Tran’s other arguments in favor of reversal.
