{
  "id": 1715388,
  "name": "Jean DeFOURE v. MFA LIFE INSURANCE COMPANY",
  "name_abbreviation": "DeFoure v. MFA Life Insurance",
  "decision_date": "1980-03-12",
  "docket_number": "CA 79-75",
  "first_page": "829",
  "last_page": "835",
  "citations": [
    {
      "type": "official",
      "cite": "268 Ark. 829"
    },
    {
      "type": "parallel",
      "cite": "596 S.W.2d 7"
    }
  ],
  "court": {
    "name_abbreviation": "Ark. Ct. App.",
    "id": 13370,
    "name": "Arkansas Court of Appeals"
  },
  "jurisdiction": {
    "id": 34,
    "name_long": "Arkansas",
    "name": "Ark."
  },
  "cites_to": [
    {
      "cite": "149 Ark. 247",
      "category": "reporters:state",
      "reporter": "Ark.",
      "opinion_index": 0
    },
    {
      "cite": "83 S.W. 317",
      "category": "reporters:state_regional",
      "reporter": "S.W.",
      "opinion_index": 0
    },
    {
      "cite": "73 Ark. 118",
      "category": "reporters:state",
      "reporter": "Ark.",
      "opinion_index": 0
    },
    {
      "cite": "222 Ark. 968",
      "category": "reporters:state",
      "reporter": "Ark.",
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        1652957
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      "opinion_index": 0,
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    {
      "cite": "237 Ark. 643",
      "category": "reporters:state",
      "reporter": "Ark.",
      "case_ids": [
        1737959
      ],
      "weight": 2,
      "opinion_index": 0,
      "case_paths": [
        "/ark/237/0643-01"
      ]
    },
    {
      "cite": "229 Ark. 388",
      "category": "reporters:state",
      "reporter": "Ark.",
      "case_ids": [
        1702798
      ],
      "weight": 2,
      "opinion_index": 0,
      "case_paths": [
        "/ark/229/0388-01"
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  "analysis": {
    "cardinality": 446,
    "char_count": 9017,
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    "pagerank": {
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    "word_count": 1441
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  "last_updated": "2023-07-14T19:03:10.426772+00:00",
  "provenance": {
    "date_added": "2019-08-29",
    "source": "Harvard",
    "batch": "2018"
  },
  "casebody": {
    "judges": [],
    "parties": [
      "Jean DeFOURE v. MFA LIFE INSURANCE COMPANY"
    ],
    "opinions": [
      {
        "text": "George Howard, Jr., Judge.\nThe issue for determination is whether appellee is liable for medical expenses of $2,-780.95, under the terms of a \u201cConditions Precedent\u201d (a binding receipt), providing, among other things that \u201cno insurance shall be effective for any persons proposed for insurance in the application if [appellee] declines to insure any one of them.\u201d\nOn March 22, 1977, appellant made application for health insurance coverage for herself and her two minor children, Annetta, age 13, and Charles, age 15. Appellant paid two months\u2019 premium in advance of $88.14. Appellant received an instrument designated as \u201cConditions Precedent\u201d which provided conditional coverage.\nRelevant portions of the \u201cConditions Precedent\u201d are:\nCondition No. 1. Payment of Premium. Full payment of initial premium on selected mode must be made to an authorized agent of MFA Life Insurance Company on date of application.\nCondition No. 2. Insurability. MFA Life Insurance Company at its Home Office must determine to its satisfaction, according to its rules and practices, that as of the later date of the application or medical examination form, if required, the persons proposed for insurance were insurable for the plans and amounts applied for and at the rate of initial premium paid.\nEffective Date of Insurance. If the above conditions are met, insurance shall be effective, subject to the provisions in the policies applied for, as of the later date of the application or medical examination form, if required.\nMaximum Amount of Insurance which may be Effective before Policies are Issued. No insurance against death, including accidental death benefits, under this receipt shall be effective for more than $50,000.00 inclusive of all insurance now pending with MFA Life Insurance Company.\nCondition Not Met or Application Approved on Basis Other Than as Applied for: If above conditions are not met or if application is approved on a basis other than as applied for, insurance shall be effective only if: (a) a policy is delivered to the owner during the lifetime of all persons proposed for insurance, and (b) to the best of applicant\u2019s knowledge, there has been no material change in the answers contained in the application since the date of application or medical examination form, if required, and (c) full payment of any required additional premium is made. No insurance shall be effective for any persons proposed for insurance in the application if MFA Life Insurance Company declines to insure any one of them. If insurance is approved for any one of them other than as applied for, insurance shall be effective according to the paragraph immediately above.\nOn April 1, 1977, Charles fractured his left leg while riding a bicycle and incurred a medical expense of $2,780.95.\nOn April 12, 1977, appellee\u2019s agent delivered policy numbered D-026436 to appellant covering appellant and Charles, but appellee elected not to insure Annetta because she suffered from congenital Rubella Syndrome. On April 15, 1977, appellant, at the request of appellee, executed an amended application which contained only the names of appellant and Charles requesting insurance coverage. Appellee refunded to appellant a portion of the premium.\nAppellee denied appellant\u2019s claim for the medical expense in connection with Charles\u2019 injuries on the ground that the provision in the \u201cConditions Precedent\u201d which states: \u201cno insurance shall be effective for any person proposed for insurance in the application if MFA . . . declines to insure any one of them\u201d relieves appellee of any liability since it had declined to insure Annetta.\nThe trial judge, sitting without a jury, made the following findings:\n. \u201c(2) That Policy no. D-026436 issued by defendant was not in effect at the time Charles Rickey Willis suffered the injury for which claim under the policy was made.\n\u201cIT IS, THEREFORE, BY THE COURT CONSIDERED, ORDERED and ADJUDGED that the complaint be dismissed with prejudice. Defendant is awarded its costs.\nIt is settled law that ambiguities in insurance contracts will be construed against the insurer who prepared it. Binding or conditional receipts are subject to this rule of construction. Union Life Insurance Co. v. Rhinehart, 229 Ark. 388, 315 S.W. 2d 920; Ross v. Equitable Life Assurance Society, 237 Ark. 643, 375 S.W. 2d 222; Firemen\u2019s Insurance Company of Newark, N.J. v. Motley, 222 Ark. 968, 264 S.W. 2d 418.\nIn Firemen\u2019s Insurance Company of Newark, N.J. v. Motley, supra, the Arkansas Supreme Court said:\n\u2018Under well-settled principles, where the provisions of a policy are susceptible of two equally reasonable constructions, one favorable to the insurer and the other to the insured, the latter will be adopted. This is because the language is chosen by the insurer with the aid of experts employed for the purpose of writing the policy, and the insured has no voice in the matter. Therefore, where either of the two constructions may be adopted, it is fair that that which will sustain the claim and cover the loss will be chosen.\u2019\nIt is undisputed that appellant complied with Condition No. 1 by submitting a premium of $88.14 with her application. Condition No. 2 provided that appellee was required to determine to. its satisfaction that as of the later date of the application or medical examination form, if required, that appellant and her two children were insurable at the rate of the initial premium, under the plan desired as well as the amount of coverage sought. Appellee did not require a medical examination of either appellant or her children. Given this circumstance, Condtion No. 2 is subject to two interpretations: (a) Appellant and her children having been relieved of the requirement of a physical examination and having paid the necessary premium in advance would be justified in interpreting the provision as affording coverage effective March 22, 1977, the date of her application; (b) on the other hand, the same provision subjected to a strict construction supports the view that the binding receipt afforded no coverage until appellee had accepted and approved the application although physical examinations had been dispensed with.\nHad appellee, under the circumstances, intended the latter interpretation, appellee could have spelled this out to appellant who, obviously, was a person unfamiliar with insurance.\nAnother ambiguity is illustrated by the posture taken by both appellant and appellee with reference to the last two sentences in the final paragraph of the \u201cConditions Precedent.\u201d Appellee argues that only the first sentence is pertinent to the issue at hand; that it is clear that no insurance coverage shall be afforded \u201cany persons\u201d named in the application if appellee declines to insure \u201cany one of them.\u201d In other words, since Annetta was not accepted as a risk by appellee, Charles, under the binding receipt, was not covered on the date of his injury on April 2, 1977. On the other hand, appellant emphasizes that the final sentence which provides \u201cif insurance is approved for any one of them other than as applied for, insurance shall be effective according to the paragraph immediately above,\u201d relates to the provisions designated \u201cEffective Date of Insurance\u201d and \u201cMaximum Amount of Insurance;\u201d and that these provisions were intended to be considered together. \u201cOtherwise,\u201d argues appellant, \u201cthe final sentence of the \u2018conditions Precedent\u2019 makes no sense whatsoever.\u201d\nWe are persuaded that when all the terms and conditions of the \u201cConditions Precedent\u201d are considered, there is ambiguity as to when appellant and her children were insurable. We construe the provision against the appellee.\nWe are convinced that appellant did not waive any rights of coverage claimed under the \u201cConditions Precedent.\u201d The amendment to the original application was executed, at the request of the appellee, in order to delete the name of Annetta and not to make any material changes in the application affecting appellant or Charles. Moreover, it is settled law that the binding receipt, application and the policy itself are to be considered together as a whole in resolving an issue of the dimension here. Cooksey v. Mutual Life Insurance Co., 73 Ark. 118, 83 S.W. 317; Jenkins v. International Life Insurance Co., 149 Ark. 247.\nWe are not persuaded that appellant\u2019s appeal should be dismissed for failure to comply with Rule 9. While appellant did not abstract the exhibits and the testimony of the appellant and appellee\u2019s agent, appellant and appellee did set out the relevant portions of the record in their briefs.\nAccordingly, we revese the trial court and remand for proceedings not inconsistent with this opinion.\nReversed and remanded.",
        "type": "majority",
        "author": "George Howard, Jr., Judge."
      }
    ],
    "attorneys": [
      "Joseph Philip James and Larry Hartsfield; by Joseph Philip James, for appellant.",
      "Barrett, Wheatley, Smith & Deacon, by: Stephen M. Reasoner, for appellee."
    ],
    "corrections": "",
    "head_matter": "Jean DeFOURE v. MFA LIFE INSURANCE COMPANY\nCA 79-75\n596 S.W. 2d 7\nCourt of Appeals of Arkansas\nOpinion delivered March 12, 1980\nReleased for publication April 2, 1980\nJoseph Philip James and Larry Hartsfield; by Joseph Philip James, for appellant.\nBarrett, Wheatley, Smith & Deacon, by: Stephen M. Reasoner, for appellee."
  },
  "file_name": "0829-01",
  "first_page_order": 865,
  "last_page_order": 871
}