DocketNumber: M-117
Judges: Crawford Martin
Filed Date: 7/2/1967
Status: Precedential
Modified Date: 2/18/2017
Honorable Clay Cotten Opinion No. M-117 Commissioner of Insurance State Board of Insurance Austin, Texas 78701 Re: Whether under Article 3.50, Section 2, Texas Insurance Code, the State Board of Insurance is authorized to approve group life insurance forms, containing pro- visions for reduction or denial of death claims In cases where death is caused by suicide after the master policy has been In force for two Dear Mr. Cotten:” years or more. You have requested ourLoplnlon a8 to whether you may approve group life insurance forms which contain provisions for denying or reducing death claims in cases where death results from suicide after the master poIlcy has been In force for two (2) years or longer. Article 3.50, Section 2, Texas Insurance Code, reads in part as follows: II nor shall any policy of group life insurance be delivered in this State unless It contains In substances the following provlslons, or provisions which In the opinion of the Com- missioner are more favorable to the persons ln- sured, or at least as favorable, to the persons insured and more favorable to the policyholder. . . “(2) A provision that the validity of the policy shall not be conte,sted, except for non- payment of premiums, after’ it has been ln force for two (2) years from its date of Issue; Andy that no statement made by any person ,lnsused ,.,I,? ;y. ’ , Honorable Clay Cotten, page 2, Opinion No. M-117 under the policy relating to his Insurability shall be used in contesting the validity of the Insurance with respect to whlcrh such state- ment was made after such ineuranoe has been In force prior to the aonte’st for a period of two (2) years,durlng suoh peEson’s lifetime nor unless~ it Is contained in a.wrl$ten Instrument signed by him. “( 3) A provision that a copy of the appll- cat.lon, IS any, of the policyholder shall be attached to the policy when Issued, that all statements made by the, policyholder orby the persons Insured ehall be deemed representtitlons .and not warranties, and~.that no statement made by any person Insured shall be ueed in any oon- test unless a copy of the Instrument containing the statement Is or has been furnished to such person or to his beneflciarl-” Article 3.50, Section 2(2, &ontalns exactly the same wording as the former Artlole b,764a, Se&ion l(l), Vernon’s Annotated Civil Statutes (1948), about whlah a portion of AttorneY General Opinion Ho. O-5060 was written. Thet opinion dlacussed cases construing the slmllar lncontest- ability requirement of former Artlole 47 2, V.A.C.S. (1948), {currently Aktlole 3.44, .Insu.rance Code. f The queatlon before ua Is whether the two ,year contest- ability period under Article 3.50, Section 2(2) begins running from the date when the master p&Icy Is lssutid, or from the various dates when Individuals beoome Insured under the master policy. Attorney General Opinion lo. O-5060 holds as follows; “In our oplnlon the aviation clause violates the Incontestable requirements of Artlcl&s 4764s and &‘64b, ‘VernonUs Annotated Civil Statutes, lnso- far as it ,purports to provide a defense after the expiration of the contestable peslods therein set out, and sueh clause sl;tould not be approved by the Board for that r?ason, The above mentioned “aviation clause’ Is similar to .the suicide clause now inlquestion, for,such @auses. purport to reduce or deny ,beneflts In case of death from the specified Honorable Clay Cotten, page ‘3, Opinion No.N-117 " causes after the two (2) year period specified In Article 3.50, Section 2(2). The above Opinion No. 0-5060, together with Article 3.50, Section 2, in effect dictates that the suicide clause should not be approved by the Board if such clause purports to be effective after the contestability period. The first,part of Article 3.50; Section 2(2) specifies that a policy must contain 'a provision that the validity of the olicy shall not be contested, except for non-payment of prem urns,after it has been in force for two years from the date of its issuq . . .' (emphasis added). The word "policy" can onlyTan the master policy, for an individual covered by group insurance Is Issued a certificate rather than a policy. However, the remaining portion of Article 3.50, Section 2(2) provides as follows: I, and that no statement made by any person'insured under the policy relating to his insurability shall be used In contesting the validity of-the Insurance with respect to which such statement .was made after such insurance has been in force prior to the contest for a period of two (2) years during such'person's lifetime nor unless it is contained In a written lnstru- ment signed by him." (emphasis added). The above language refers to the period of time for which the individual has been Insured, and lsln conflict with the first quoted portion of Article 3.50, Section 2(2). The first portion, if interpreted and ,applied literally, will render the second portion inoperative, for the,time at which the in- dividual becomes insured will then be Irrelevant. In resolvlnm the.conflict we must consider public policy and the reasons fo: which the statute was passed, See Newsom v. State, ,372 S.W.2d 681
, 682-683 (Tex. Crim. 1963); 53 Tex.~Jur. 2d 229-234, Statutes, Sections 1.60and 161. Article 3.52, Section 2(c) and~sectlon 4(a), Texas In- surance Code, illustrate application of the rule to individual policies that was intended to be applied to group policies under Article 3-50, Section 2(2). That rule allows contest- ability through suicide clauses for a period of two years after the individual becomes insured. The same rule is applied by Article 22.13, Section l(2) and Section 5, Texas Insurance Code. .. Honorable Clay Cotten; page 4; Opinion No. M-117 Article 3.50, Section 2(s) and the latter portion of Article 3.50; Section2(2), supra
, both show that the Legls- lature contemplated a.contestablllty period based,on the date of the lndlvldualts Insurance'rather than the,date of the master'pollcy. It is our opinion that the contestability period consists of the two years followlng the date when the Individual becomes Insured under the master policy. S U M.M A R Y ------- The lnsuranoe Issued to an Individual under a group policy does,not become.incontestable under Article 3.50, Section 2, Texas Insurance Code until two years from the date when that Individual becomes insured under the master policy. Y&r0 very truly, orney General of Texas Prepared.by Fielding Early Assistant Attorney General APPROVED: OPINION CONMITTEE A. J. Carubbi, Jr., Chairman Staff Legal Assistant W. 0. Shults, Co-Chairman John Reeves Tom Rack Robert Flowers Tom Thurmund -540-~