IN THE UNITED STATES COURT OF APPEALS
FOR THE FIFTH CIRCUIT
______________
No. 95-31220
Summary Calendar
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LIFE INVESTORS INSURANCE COMPANY OF AMERICA,
Plaintiff-Appellee,
versus
BARBARA F. MURPHY, Individually and as Administratrix on
behalf of Faydria Larae Murphy Estate; MICHELE L. CATO,
LATONYA CATO,
Defendants-Appellants.
_________________________________________________________________
Appeal from the United States District Court
for the Western District of Louisiana
(94-CV-2280)
_________________________________________________________________
April 30, 1996
Before SMITH, BENAVIDES and DENNIS, Circuit Judges.
PER CURIAM*:
Defendants-Appellants appeal the district court's grant of
Plaintiff-Appellee Life Investors Insurance Company of America's
("Life Investors") motion for summary judgment and denial of
Defendants-Appellants' summary judgment motion. Finding no
ambiguity in the termination and notice provisions of the
Certificate of Group Life Insurance and that Life Investors was not
at fault in the failure to notify, we affirm.
*
Pursuant to Local Rule 47.5, the court has determined
that this opinion should not be published and is not precedent
except under the limited circumstances set forth in Local Rule
47.5.4.
I.
In 1987, Defendant-Appellant Barbara Murphy ("Mrs. Murphy")
was solicited by her credit card company, American Express
("AMEX"), to purchase life insurance for herself and her family.
Mrs. Murphy and her husband, Alford Ray Murphy ("Mr. Murphy"), sent
in an application on April 5, 1987 and later received a Certificate
of Group Life Insurance ("Certificate") from AMEX insuring Mr.
Murphy for $50,000.1 The Murphys agreed to and authorized
quarterly billing and payment for the life insurance on Mrs.
Murphy's AMEX credit card.
The Murphys divorced on January 11, 1989. However, they
agreed to continue the life insurance for their children's benefit,
and Mrs. Murphy continued to pay the premiums after the divorce.
Life Investors purchased the group policy from AMEX in February
1993.
Mr. Murphy died on June 10, 1994. When Mrs. Murphy attempted
to collect the death benefits, Life Investors refused to pay
because Mr. Murphy, as an ex-spouse, was no longer covered.2
1
The Murphys never received a copy of the actual insurance
policy.
2
The provision of the Certificate of Group Insurance
excluding Mr. Murphy states:
The insurance of you and your Dependents, if any, who
are Covered Persons under the Policy will terminate on
the first to occur of the dates listed below:
. . . .
4. for your spouse only:
(C) the premium due date which next follows the
first to occur of: (1) the date you die; or (2) the
date your spouse ceases to be married to you.
2
The Murphys' Certificate did contain a provision by which a former
spouse could continue coverage.3 However, the Murphys never
applied for the continuation of coverage for Mr. Murphy, and never
notified AMEX or Life Investors that their marriage had terminated.
Life Investors filed suit for a declaratory judgment to ratify
its determination to deny coverage on Mrs. Murphy's Certificate.
Both sides to the litigation filed motions for summary judgment.
On October 26, 1995, the district court entered a memorandum ruling
granting summary judgment in favor of Life Investors, finding that
Mr. Murphy was not a "Covered Person" under the terms of the
Certificate at the time of his death, so that death benefits were
not owed by Life Investors. Judgment was entered in favor of Life
Investors that same day.
II.
We review the district court's summary judgment de novo. Aetna
Casualty & Surety Co. v. Iso-Tex, Inc., 75 F.3d 216, 219 (5th Cir.
3
The relevant provision states as follows:
Continuation of Insurance for Dependents: If the
Insurance of a Covered Person who is a Dependent of
yours would terminate:
. . . .
2. if the Dependent is your former spouse; due to such
person no longer being married to you;
. . . .
then such person may continue his or her insurance
under the Policy. The continuation will not be
automatic and will only occur if, within 31 days of the
date such person's insurance would otherwise terminate,
we receive both: (1) a written application to continue
that person's insurance under the Policy; and (2) the
required premium.
3
1996). Defendants-Appellants contend that continuation of coverage
provision of the Certificate, while clearly requiring notice, is
ambiguous because it does not provide instructions on how or where
to give notice of the divorce in order to continue coverage for the
divorced spouse. Such ambiguity, they argue, must be construed in
favor of the insureds. Borden v. Howard Trucking Co., Inc., 454
So.2d 1081, 1089 (La. 1983). In the alternative, Defendants-
Appellants argue that because the continuation of coverage
provision of the Certificate either intentionally or negligently
fails to provide notice instructions or advice, Article 1772 of the
Louisiana Civil Code applies4, so that the notice requirement is
deemed fulfilled and Life Investors must pay the death benefit for
Mr. Murphy.
Our review of the Certificate reveals no ambiguity in the
notice requirements of the continuation of coverage provision. As
Defendants-Appellants concede, the provision in question clearly
states that notice by written application must be given within
thirty-one days after divorce in order to continue coverage of the
ex-spouse. The "Additional Provisions" section of the Certificate
contains a "Notice of Claim" provision which provides the Home
Office address in California for notice to be given by or on behalf
of the claimant. Thus, we find that the unambiguous language of
4
Article 1772 provides:
A condition is regarded as fulfilled when it is not
fulfilled because of the fault of a party with an
interest contrary to the fulfillment.
LA. CIV. CODE ANN. art. 1772.
4
the Certificate provisions provided the Murphys with sufficient
information to notify the insurer of their intent to continue
coverage after their divorce.
In addition, Article 1772 does not apply in this case. The
Murphys' failure to notify the insurer after their divorce is not
due to any fault of the insurer, but rather, the Murphys' failure
to read the Certificate. The Murphys concede that they were not
aware of the notice requirement, and thus never attempted to give
notice to AMEX or Life Investors after they divorced. Therefore,
we find that the district court properly found that Life Investors
did not do anything to prevent the Murphys from following the
notice requirement in the continuation of coverage provision of the
Certificate.
III.
For the reasons articulated above, the judgment of the
district court is AFFIRMED.
5