Lead Opinion
Fulbright McNeill, Inc. (FMI) appeals the district court’s
I. Background
In February 2003, after an annual physical exam, McNeill’s personal physician pronounced McNeill healthy. On February 28, 2003, McNeill completed and signed an application for life insurance from PHL. The beneficiary of the policy was FMI, a rubber product manufacturing company located in Wynne, Arkansas in which McNeill owned a 50% interest. The dispute arises from the interpretation of two relevant policy clauses. First, under the heading “Limits on Our Rights to Contest This Policy,” the policy stated:
We rely on all statements made by or for the Insured in the written application or in any supplemental application for reinstatement. These statements are considered to be representations and not warranties. We can contest the validity of this policy for any material representation of fact. However, the misrepresentation must be contained in the written application and a copy of the application must be attached to this policy when issued.
Second, policy modifications had to be approved by PHL. According to the policy terms, “[a]ny change in the provisions of this policy must be signed by one of [PHL’s] executive officers to be in effect.”
On March 17, 2003, McNeill underwent a paramedic examination and completed and signed Part II of the PHL life insurance policy application. Based on the examination, the paramedic examiner also considered McNeill to be in good health and without heart problems. PHL relied upon the information and answers to the questions in Part II of the application in issuing the McNeill policy.
On April 2, 2003, McNeill voluntarily, submitted to a coronary test with a different physician. This test revealed McNeill’s total coronary artery calcium-score to be 431, placing him at a 90% likelihood of having a heart attack and a high risk of cardiovascular disease. McNeill was personally contacted by the doctor and informed of the results of his testing. Also, the hospital sent a letter with the results to McNeill on April 7, 2003.
On or shortly after June 15, 2003, PHL printed and issued the McNeill policy with an Issue Date of June 15, 2003. On July 11, 2003, the policy was delivered to McNeill. Craig Campbell, PHL’s insurance agent, told McNeill that he need not read the acceptance form because the form merely confirmed delivery of the policy. Campbell, however, was wrong. The policy acceptance form actually contained an express affirmation that McNeill’s representations regarding his health condition remained unchanged since he completed Part II of the application. The form also acknowledged that the policy acceptance had been incorporated into the policy application and the insurance contract. McNeill signed the acceptance form but did not disclose to PHL the results of the coronary test, which showed his high risk for cardiovascular disease.
McNeill died of a heart attack in January 2004. FMI filed a claim with PHL for payment of the $3,000,000 death benefits under the McNeill policy. After reviewing the claim, PHL refused to pay on the ground that McNeill had made a misrepresentation in his application for the insurance by not disclosing the results of his cardiac tests taken after submission of the insurance application.
II. Discussion
FMI appeals the grant of summary judgment in favor of PHL and argues that there was no material misrepresentation in the policy application. First, FMI argues that McNeill had no duty, either by operation of Arkansas law or under the language of the policy, to inform PHL of the results of his second medical examination; therefore, his failure to do so cannot be a basis to deny FMI benefits. Second, FMI asserts three reasons why PHL cannot rely on McNeill’s statements in the policy application to avoid paying FMI’s claim for benefits. These include: (1) McNeill’s signature was procured by fraud; (2) the acceptance form is not a part of the policy application as it was not' properly incorporated under the terms of the contract; and (3) the application was not attached to the policy when it was issued. Upon review, we conclude that McNeill had a duty to inform PHL of the substantial change in his health condition assessment that occurred after he completed the March application. Furthermore, we hold that McNeill’s failure to inform PHL of the results of the new coronary test resulted in a material misrepresentation of fact in the written application at the time the policy was issued; therefore, the district court properly granted PHL’s motion for summary judgment.
A district court’s grant of summary judgment is reviewed de novo. Palmer v. Arkansas Council on Econ. Educ.,
“Federal district courts sitting in diversity, as the district court in this case, must apply the forum state’s substantive law....” Guardian Fiberglass, Inc. v. Whit Davis Lumber Co.,
“We begin our analysis by stating the basic principle that an insurance company may retroactively rescind a policy because of fraud or misrepresentation of the insured.” Neill v. Nationwide Mut. Fire Ins. Co.,
Under Arkansas law, when interpreting the language of an insurance policy, “provisions contained in a policy of insurance must be construed most strongly against the insurance company which prepared it, and if a reasonable construction may be given to the contract which would justify recovery, it would be the duty of the court to do so.” U.S. Fidelity & Guar.
The policy issued to McNeill authorizes PHL to “contest the validity of this policy for any material representation of fact” as long as it is “contained in the written application.” It is undisputed that McNeill did not inform PHL of the substantial change in the assessment of his heart condition. Nor is it disputed that PHL’s willingness to insure McNeill’s life relied on medical opinion that McNeill had no heart condition. McNeill’s failure to inform PHL of the results of his April heart exam constituted a material representation in the policy application and is a sufficient ground on which to affirm the district court’s grant of summary judgment.
Arkansas recognizes the common law doctrine of uberrimae fidei — which states that, as a matter of utmost good faith and fair dealing, if an applicant for insurance discovers facts that make portions of his application no longer true while the company deliberates, he must make full disclosure of the newly discovered facts. See Dodds v. Hanover Ins. Co.,
McNeill’s representations in the policy application were continuing until the issuance of the policy. Once McNeill learned the true nature of his health, his statements in the application became false. He failed to modify that false representation before issuance of the policy. Consequently, PHL can assert these misrepresentations as its basis for denying FMI’s claim for benefits. McNeill’s duty to act in good faith during the pendency of his application preexisted and survived any alleged misrepresentation regarding the significance of the acceptance form made by PHL agent Campbell at delivery of the policy.
Based on the foregoing, we affirm the judgment of the district court.
Notes
. The Honorable James M. Moody, United States District Judge for the Eastern District of Arkansas.
. The dissent disagrees with our reading of Dodds and argues that the Arkansas courts have not explicitly adopted the doctrine of uberrimae fidei. Even if we were to agree with the dissent's reading of Dodds, however, Stipcich nonetheless still counsels that we take uberrimae fidei to be the law of Arkansas because there is an absence of an explicit rejection of this “generally recognized rule.” See Stipcich,
. The dissent argues that in failing to include a contractual duty for McNeill to supplement the representations in his application, PHL contracted away its protections under the common law duty of utmost good faith. We
Dissenting Opinion
dissenting.
I respectfully dissent. The majority’s opinion states, “McNeill’s representations in the policy application were continuing until the issuance of the policy. Once McNeill learned the true nature of his health, his statements in the application became false,” grounding this conclusion upon a common law duty of utmost good faith owed by McNeill. I disagree, because this approach uses the “duty of utmost good faith” to broaden the explicit policy language.
The PHL policy limited the ■ grounds upon which PHL could “contest the validity of this policy” to “any material representation of a fact,” as long as it is “contained in the written application” which is “attached to this policy when issued.” PHL and McNeill are fully within their rights to contract to limit the scope of misrepresentations which can be relied upon by PHL as grounds upon which to challenge the validity of the policy. See Pittman v. West American Ins. Co.,
The majority suggests we need to go beyond the plain language of the policy by superimposing the “duty of utmost good faith.” According to the majority, this duty overrides the specific agreed limitations on PHL’s rescission rights so that PHL can rescind this policy based on McNeill’s failure to inform PHL of a cardiac test done after McNeill truthfully completed the policy application, and after he was examined by a medical practitioner selected by PHL. I disagree. When a conflict exists between a general common law duty and the explicit language of a contract, the language of the contract should control. This is especially true when the contractual language is language which was unilaterally drafted by PHL, language PHL now wishes to avoid.
The only case in which the Arkansas courts address the issue of a duty of utmost good faith owed by an insured to an insurance company is Dodds v. Hanover Ins. Co.,
The district court also asserted the duty of utmost good faith rule had been adopted by the Eighth Circuit in Springfield Fire & Marine Ins. Co. v. National Fire Ins. Co.,
The Stipcich Court also acknowledged that “narrow and unreasonable interpretations of clauses in an insurance policy are not favored” and where “[t]hey are prepared by the insurer” and “open to two constructions, [the construction] most favorable to the insured will be adopted.” Id. at 322,
