United States District Court, N.D. California, San Jose Division
December 7, 2005.
Edward B. Foster, Plaintiff,
Metropolitan Life Insurance Company, Defendant.
The opinion of the court was delivered by: JAMES WARE, District Judge
ORDER GRANTING DEFENDANT'S MOTION FOR SUMMARY JUDGMENT
Edward B. Foster ("Foster" or "Plaintiff") initiated this suit
against Metropolitan Life Insurance Company ("MetLife") after
Plaintiff's life insurance policy "lapsed" due to non-payment of
premiums. Plaintiff contends that MetLife breached his life
insurance policy by failing to provide the requisite
Presently before this Court is MetLife's Motion for Summary
Judgment. MetLife contends that Foster's claim fails as a matter
of law because (1) Foster's claim is barred by the doctrine of
laches; (2) MetLife sent the requisite notices; (3) Foster's
policy lapsed due to non-payment of premiums; and (4) MetLife did
not waive its right to lapse and terminate Foster's policy. The
motion was heard of October 17, 2005. Based upon all papers filed
to date and the comments of counsel, the Court GRANTS MetLife's
Motion for Summary Judgment. II. BACKGROUND
In 1978, Foster was employed by Stanford Research Institute
("SRI"), and as part of the SRI employment benefits, Foster
acquired a Group Life Insurance Policy ("GUL"). The coverage
initially issued on November 11, 1989. At the time, Foster was
insured by Travelers. In 1995 or 1996, MetLife became Foster's
insurer. Marsh@Work Solutions ("Marsh") served as the third-party
administrator on Foster's policy.*fn1 Marsh administered and
processed claims according to MetLife's guidelines and all
records maintained by Marsh on behalf of MetLife are the property
On August 16, 1998, Foster retired from SRI and accordingly,
his GUL coverage transitioned from payroll deductions to
direct-bill status. At the time, Foster began making quarterly
premium payments towards his insurance policy. On August 23,
1999, Foster made an advance payment of $1,144.86, to cover the
months of August, September and October, 1999. Thereafter, Foster
made no payments in November or December 1999. MetLife's
insurance certificate contains a "Grace Period" provision, which
If you are not paying under the Payroll Deduction
Plan and if the Cash Value on any monthly anniversary
is less than the Monthly Deduction for that month,
there will be a Grace Period of 60 days after the
anniversary to pay an amount that will cover the
Monthly deduction. We will send you a notice of the
Grace period. If we do not receive a sufficient
amount by the end of the Grace period, this
certificate will then end without value.
Plaintiff's Opp'n. at 2. According to this provision, Foster's
60-day grace period expired on December 31, 1999. However,
MetLife did not cancel Foster's policy at the time. On January
26, 2000, Foster called Marsh, requesting that MetLife refrain
from declaring his policy as "lapsed," and accept a late payment
for the period November, December, 1999, and January 2000. On
February 1, 2000, Marsh received a payment for $1,021.91, which
was applied towards Foster's premium payments for November and
December 1999, and January 2000. Marsh failed to generate a
premium notice or billing notice for the months of January,
February and March 2000. On April 2, 2000, another 60-day grace
period lapsed. Again, MetLife took no action and failed to cancel
Foster's policy. MetLife claims that on April 7, 2000, it mailed to Foster, a
Notice of Payment Due for the February, March, April, 2000
premium period and the May, June, July, 2000 premium period. On
April 27, 2000, Marsh received a check from Foster in the amount
of $1,068.42, which was applied to the February, March, and April
2000 premium period. No other payments were received after April
On May 5, 2000, Marsh allegedly sent a billing notice to
Foster. MetLife claims that it also sent Foster a Notice of
Payment Due on May 5, 2000. This notice allegedly informed Foster
that his policy would lapse if payment was not received by July
1, 2000. MetLife also claims that it sent another Notice of
Payment Due to Foster on June 5, 2000, reminding him that his
policy would lapse if no payment was received by July 1, 2000.
Foster claims that he never received any of these notices. The
Notices of Payments Due were never returned to Marsh or to
MetLife. In the absence of any further payments, Marsh sent a
letter to Foster on July 9, 2000, stating that Foster's policy
had lapsed effective May 1, 2000.
On July 17, 2000, Foster contacted Marsh to inquire as to the
status of his policy. During this conversation, Marsh informed
him that his policy had lapsed due to non-payment of the premium.
Foster claimed that he had mailed a check for the required amount
and that he would contact his bank to ascertain if the check was
cashed. At this time, Marsh informed Foster that he could either
send a copy of the cancelled check to Marsh, or he could reapply
for reinstatement of his policy.
For the next two years and eight months, Foster made no contact
with Marsh or MetLife. Finally, on March 21, 2003, Foster called
Marsh requesting information on reinstatement of his policy.
Marsh informed Foster that he had six weeks remaining to complete
the necessary forms for reinstatement. Foster, however, chose not
to reapply for reinstatement and proceeded to file a complaint
against MetLife on April 23, 2003. MetLife removed the action to
Foster claims that MetLife breached its contractual agreement
by terminating his life insurance policy. Presently before this
Court is MetLife's motion for summary judgment. MetLife
essentially contends that Foster's policy lapsed due to
non-payment of premiums, and alternatively, that Foster's action is barred by laches.
Summary judgment is proper when there is no genuine issue of
material fact and the moving party is entitled to judgment as a
matter of law. FED. R. CIV. P. 56(c). The purpose of summary
judgment "is to isolate and dispose of factually unsupported
claims or defenses." Celotex v. Catrett, 477 U.S. 317, 323-24
A movant for summary judgment always "bears the initial
responsibility of informing the district court of the basis for
its motion, and identifying those portions of the `the pleadings,
depositions, answer to interrogatories, and admissions on file,
together with the affidavits, if any' which it believes
demonstrate the absence of a genuine issue of material fact."
Id. at 323. If the movant does not satisfy this initial burden,
the non-movant has no obligation to produce anything and summary
judgment must be denied. If, however, the movant meets this
initial burden, then the burden shifts to the non-movant to
"designate `specific facts showing that there is a genuine issue
for trial.'" Id. at 324. In other words, to preclude entry of
summary judgment, the non-movant must bring forth genuine issues
of material fact. An issue of fact is "genuine" if it can
reasonably be resolved in favor of either party. See Anderson
v. Liberty Lobby, Inc., 477 U.S. 242, 248 (1986). An issue of
fact is "material" if it "might affect the outcome of the suit
under the governing law. . . . Factual disputes that are
irrelevant or unnecessary will not be counted." Id. In short,
the non-movant "must do more than simply show that there is some
metaphysical doubt as to the material facts." Matsushita Elec.
Indus. Co. v. Zenith Radio, 475 U.S. 574, 586 (1986).
It is this court's responsibility "to determine whether the
`specific facts' set forth by the non-movant, coupled with
undisputed background or contextual facts, are such that a
rational or reasonable jury might return a verdict in its favor
based on that evidence." T.W. Elec. Service v. Pac. Elec.
Contractors, 809 F.2d 626, 631 (9th Cir. 1997). "Where the
record taken as a whole could not lead a rational trier of fact
to find for the non-moving party, there is no `genuine issue for
trial.'" Matsushita, 475 U.S. at 587. In conducting its
analysis, this court must draw all reasonable inferences in favor
of the non-movant. Masson v. New Yorker Magazine, Inc.,
501 U.S. 496, 520 (1991) (citing Anderson, 477 U.S. at 255). IV. DISCUSSION
I. Foster's Lawsuit is barred by the Doctrine of Laches.
MetLife contends that Foster's suit to reinstate his insurance
policy is barred by the doctrine of laches. Specifically, MetLife
contends that Foster contacted Marsh on July 17, 2000, to inquire
as to why his policy lapsed. Thereafter, Foster made no contact
with Marsh or MetLife until March 21, 2003, when he called Marsh,
requesting information on reinstatement of his policy.
To establish laches, a party must prove the following: (1) full
knowledge of all the facts by the claimant, (2) with a concurrent
unreasonable delay, (3) resulting in such substantial injury or
prejudice to defendant, (4) as to make enforcement of the claim
inequitable. Dillingham Corp. v. Employer's Mut. Liability Ins.
Co., 503 F.2d 1181 (9th Cir. 1974); Florio v. City of Ontario,
130 Cal. App. 4th 1462, 1468 (Cal.Ct.App. 2005). The defense of
laches requires unreasonable delay plus either acquiescence in
the act about which plaintiff complains or prejudice to the
defendant resulting from the delay. Utica Mut. Ins. Co. v.
Monarch Ins. Co., 250 Cal. App. 2d 538 (Cal.Ct.App. 1967).
Laches is an affirmative defense, the burden of pleading and
proving of which rests upon the party asserting it, unless laches
is disclosed from the face of the complaint. Id.
MetLife has clearly established the elements of laches based
upon the undisputed evidence. It is undisputed that on July 17,
2000, Foster contacted MetLife to inquire about the status of his
policy, and learned that MetLife considered his policy to have
lapsed due to non-payment of the premium. Despite being "highly
motivated to maintain life insurance,"*fn2 Foster did very
little to assert his rights, in apparent acceptance of MetLife's
determination to treat the policy as lapsed. On January 9, 2003,
he filed a complaint with the California Department of Insurance.
The status of this complaint is unknown. On March 21, 2003,
Foster he made a telephone call to Marsh. A telephone call,
however, is not a forceful assertion of one's rights. After the
telephone conversation, Foster again did nothing to seek legal
redress until April 23, 2003, when he filed the instant suit
against MetLife. In total, Foster waited from July 17, 2000 to
April 23, 2003, before bringing his dispute to court. Foster
offers various explanations for not taking legal action, however, none of them justifies a delay of
two years and nine months.
Moreover, Foster's unreasonable delay has resulted in
substantial prejudice against MetLife. Foster's claim rests on
his assertion that MetLife failed to provide him with the
requisite notices of cancellation in the year 2000. With the
passage of time, MetLife's access to key records and witnesses
regarding notices sent to Foster has been diminished. MetLife is
left to rely on exemplar copies of the notices. Therefore, the
Court finds that Foster's suit against MetLife is barred by the
doctrine of laches.
MetLife is entitled to summary judgment. The Court's ruling on
the doctrine of laches is sufficient to dispose of Foster's
entire suit. Nevertheless, the Court will address the remaining
arguments raised in the parties' briefs in the next two sections
of this Order.
II. Irrespective of the doctrine of laches, Foster's breach of
contract claim fails.
Irrespective of the doctrine of laches, the Court finds that
Foster's breach of contract claim fails as a matter of law. As a
preliminary matter, it is significant that MetLife did not
"cancel" Foster's policy. Rather, the policy lapsed due to
non-payment of quarterly premiums. "Lapse" is defined as the
termination of a policy's coverage at the end of a policy period,
resulting from the insured's failure to pay premiums or otherwise
manifest the intent to renew the policy. Scott v. Federal Life
Ins. Co., 200 Cal. App. 2d 384, 391-92 (1962). An express
provision of an insurance contract stipulating that a default in
payment causes it to lapse is valid, and a default in such
payment ordinarily forfeits the policy where statutory provisions
are not violated. Id.
Foster's payment history is undisputed. Starting November of
1999, Foster's payments were late. Indeed, Foster admits that he
"often delayed payment until well into the coverage period."
Decl. of Plaintiff in Support of Summary Judgment, par. 8. The
payment for the quarter November 1999 to January 2000 was
received 25 days after the sixty-day grace period allowed by
MetLife. Similarly, the payment for the quarter February, March,
and April 2000 was late. Foster's last payment was received on
April 27, 2000.
It is further undisputed that Foster's policy provided that his
policy would lapse upon failure to pay premiums. Notwithstanding
Foster's failure to make timely payments coupled with MetLife's
indisputable right to deem the policy lapsed for failure to pay
premiums, Foster contends that MetLife is not entitled to treat his policy as lapsed because he did not receive the
requisite notices. Foster asserts emphatically that "[w]hile
coverage was in force [he] never received any 60-day grace period
notices, nor did [he] receive any notices that [his] coverage
would be cancelled." Decl. of Plaintiff in Support of Summary
Judgment, par. 18. Foster's declaration constitutes
circumstantial evidence that the notices were not mailed.
MetLife, however, has submitted a computer generated log
identifying all communications sent to Foster. Further, Ms. Rita
Becconsall, an employee at MetLife states in her declaration,
that she has personal knowledge of the facts of Foster's case.
She testifies that on May 5, 2000, and June 5, 2000, "Notices of
Payments Due" were indeed mailed to Foster.
In the Court's view, the conflict in the evidence outlined
above is insufficient to defeat MetLife's motion for summary
judgment. This is because the conflict in the evidence does not
raise a "genuine" issue of material fact. That is, the conflict
in evidence cannot "reasonably be resolved in favor of either
party." See Anderson, supra. Foster, as the Plaintiff,
ultimately has the burden of establishing that MetLife failed to
send the requisite notices. There is no conceivable rational
basis for any jury to give Foster's declaration any more (or
less) credence than MetLife's computer generated log. The end
result, therefore, is that Foster can not possibly establish by a
preponderance of evidence that MetLife breached his life
insurance policy. Therefore, the Court finds that MetLife is
entitled to summary judgment on the additional ground that no
reasonable jury could find in Foster's favor.
III. Foster's assertion that MetLife waived its right to
terminate Foster's policy due to late payment of premiums is
Lastly, Foster attempts to defeat MetLife's summary judgment
motion by arguing that MetLife had a "track record" of accepting
late payments, and "either through waiver or estoppel suggested
Plaintiff could make payment at the end of the May-July 31, 2000
coverage period, to keep his policy in force." Plaintiff's
Opposition, p. 12.
In general, to prove waiver, there must be: (1) an existing
right, (2) knowledge of its existence, (3) an actual intention to
relinquish it, or, conduct so inconsistent with the intent to
enforce the right as to induce a reasonable belief that it had
been relinquished. Klotz v. Old Line Life Ins. Co. Of Am.,
955 F.Supp. 1183 (D. Cal. 1996). Whether a waiver has occurred is usually a
question of fact, the determination of which, if supported by
substantial evidence, will not be disturbed on appeal unless the
only inference which can be drawn from the evidence is to the
Four elements must generally be proved to establish equitable
estoppel: (1) the party to be estopped must know the facts, (2)
he must intend that his conduct shall be acted upon, or must so
act that the party asserting the estoppel had the right to
believe that it was so intended, (3) the party asserting the
estoppel must be ignorant of the true state of the facts, and (4)
he must rely upon the conduct to his injury. DRG/Beverly Hills,
30 Cal. App. 4th (Cal.Ct.App. 1994). The estoppel issue is a
non jury fact question to be determined by the trial court in
accordance with applicable law. Id.
"[A] past course of conduct of acceptance by the insurer of
payments of premiums after the grace period may establish a
waiver by the insurer of the right to declare a forfeiture for
failure to pay premiums exactly at the stipulated time." McCary
v. John Hancock Mut. Life Ins. Co., 236 Cal.App.2d 501, 508
(Cal.Ct.App. 1965). In McCary, the insurer accepted six out of
twelve premium payments after the expiration of the 31-day grace
periods. Id. at 505. In each of the instances, the insurer sent
a "late payment offer" to the insured, without availing itself of
the right to forfeit the policy or require the insured to make an
application for reinstatement. Id. Accordingly, the California
Court of Appeal concluded that the evidence was sufficient to
support a finding of waiver and estoppel to assert the right to
declare a policy lapse based upon the lateness of payment.
Unlike McCary, supra, MetLife accepted late payments from
Foster on only two occasions. Moreover, on one of these
occasions, MetLife accepted the late payment in January 2000,
only after Foster called and requested an extension for payment
of the premiums. By accepting just two late payments from Foster,
MetLife did not indulge in a pattern of conduct to support a
finding of waiver or estoppel.
Foster's claim is barred by the doctrine of laches. Further,
Foster's claim fails for lack of proof. Lastly, MetLife did not
waive, nor is it estopped, from treating Foster's policy as
lapsed. Accordingly, this Court GRANTS MetLife's Motion for Summary Judgment.
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