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Sippel v. Reliance Standard Life Insurance

United States Court of Appeals, Eighth Circuit
Nov 13, 1997
128 F.3d 1261 (8th Cir. 1997)

Summary

rejecting estoppel claim despite receipt of premiums

Summary of this case from KAUS v. STANDARD LIFE INSURANCE COMPANY

Opinion

No. 97-1504

Submitted October 20, 1997

Decided November 13, 1997

Diana L. Moro, James A. Young, Philadelphia, PA, for appellee.

Thomas Werner, Des Moines, IA, for appellant.

On Appeal from the United States District Court for the Southern District of Iowa.

Before RICHARD S. ARNOLD, Chief Judge, LOKEN and HANSEN, Circuit Judges.


This is an action under the Employee Retirement Income Security Act of 1974 (ERISA), 29 U.S.C. §(s) 1132(a)(1)(B), for denial of benefits claimed to be owed under policies insuring against accidental death. The plaintiff, Susan E. Sippel, is the surviving spouse of Larry Sippel, who had been a long-time employee of IBP, Inc. During his employment, Mr. Sippel was insured through two separate $100,000 accidental-death policies purchased by IBP from the defendant, Reliance Standard Insurance Company. Mr. Sippel left his employment with IBP and was killed in an automobile accident shortly thereafter. The District Court held that under the plain and unambiguous language of the policies, Mr. Sippel had no coverage at the time of his death. We affirm.

The Hon. Ronald E. Longstaff, United States District Judge for the Southern District of Iowa.

We summarize our reasons in brief compass. Mr. Sippel left IBP on February 25, 1993. He was killed on March 18, 1993, less than 31 days later. The question of coverage turns on the language of the policies, which grant to insured persons a privilege of conversion from group coverage to individual coverage under certain circumstances. A covered person's eligibility ceases when his employment ceases, but he has a right to convert his coverage to an individual policy. Conversion requires, however, that the covered person "apply for it within 31 days after his coverage ends." The policies provide further as follows, in language critical to the instant case:

The converted policy will:

(a) take effect on the date of termination of this insurance, or on the date of application for the converted policy, whichever is later; . . . .

Under this language, Mr. Sippel's coverage terminated when he left IBP, on February 25, 1993. He had 31 days, that is, until March 28, 1993, to apply for conversion. He never made such an application. Perhaps he intended to do so within the 31 days, and was prevented by his unexpected and untimely death, but the fact remains that no application for conversion was ever made. Accordingly, individual coverage never took effect, and the claim for benefits must fail. If Mr. Sippel had applied for conversion, it would have been granted, according to the plain language of the policy, and no additional evidence of insurability would have had to be furnished. The circumstances are unfortunate, but the language of the policies is clear.

Plaintiff also argues that the defendant is estopped to deny that an effective conversion took place. She states that a premium payment of $5.80 was made by way of a payroll deduction from Mr. Sippel's final paycheck. We assume that this payment represented the premium for the first month of what would have been converted individual coverage. This $5.80 was then, in combination with premiums deducted from the paychecks of other employees, forwarded by IBP to Reliance. In some circumstances receipt of a premium can work an estoppel against an insurance company, but we do not believe, at least in an ERISA case, that this can occur when the language of the policy is as clear as it is here. We therefore reject the estoppel argument.

Plaintiff argued in the District Court that a Nebraska statute, Neb. Rev. Stat. Section(s) 44-1607, applying by its terms to life insurance, also applies to these policies of insurance against accidental death, and that, under the statute, conversion to individual coverage was mandated. Plaintiff does not make this argument on appeal, so we have no occasion to address it.

Further details are contained in the well-reasoned opinion of the District Court. We do not believe the case requires further elaboration from us.

Affirmed.


Summaries of

Sippel v. Reliance Standard Life Insurance

United States Court of Appeals, Eighth Circuit
Nov 13, 1997
128 F.3d 1261 (8th Cir. 1997)

rejecting estoppel claim despite receipt of premiums

Summary of this case from KAUS v. STANDARD LIFE INSURANCE COMPANY

In Sippel, the Eighth Circuit affirmed the judgment of the district court without explaining the procedural posture of the case.

Summary of this case from Prassenos v. E.I. DuPont de Nemours & Co.

In Sippel, the deceased former employee had not retired, and the policy language stated that coverage ceased when employment ceased.

Summary of this case from Prassenos v. E.I. DuPont de Nemours & Co.

conducting no Rule 12(b) analysis

Summary of this case from Prassenos v. E.I. DuPont de Nemours & Co.

forwarding by employer to insurer of premium for employee's converted ERISA policy, together with premiums deducted from paychecks of other employees, did not work an estoppel against insurance company denying benefits under the converted policy to employee's widow when employee was prevented from applying for converted policy by unexpected death

Summary of this case from Silva v. Metro. Life Ins. Co.

implying that claim for benefits under accidental death conversion policy falls within ERISA

Summary of this case from Levine v. Transamerica Life Companies
Case details for

Sippel v. Reliance Standard Life Insurance

Case Details

Full title:Susan Sippel, Appellant, v. Reliance Standard Life Insurance Company…

Court:United States Court of Appeals, Eighth Circuit

Date published: Nov 13, 1997

Citations

128 F.3d 1261 (8th Cir. 1997)

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