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Martha Lind, As Authorized Representative, Etc v. David Maxwell-Jolly

July 28, 2011

MARTHA LIND, AS AUTHORIZED REPRESENTATIVE, ETC., PLAINTIFF AND APPELLANT,
v.
DAVID MAXWELL-JOLLY, AS DIRECTOR, ETC., DEFENDANT AND RESPONDENT.



(Super. Ct. No. 39-2008-00185514-CU-WM-STK)

The opinion of the court was delivered by: Butz , J.

Lind v. Maxwell-Jolly

CA3

NOT TO BE PUBLISHED

California Rules of Court, rule 8.1115(a), prohibits courts and parties from citing or relying on opinions not certified for publication or ordered published, except as specified by rule 8.1115(b). This opinion has not been certified for publication or ordered published for purposes of rule 8.1115.

Appellant Martha Lind, the legal representative of Mary G. Lind,*fn1 appeals from a judgment denying Martha's petition for writ of administrative mandate. (Code Civ. Proc., § 1094.5.) Mary sought a judgment overturning an order of the director of the State Department of Health Care Services that denied her application for Medi-Cal benefits. At issue is whether a single-premium endowment life insurance policy, for which Mary paid $92,000, should be counted as an available asset, thereby disqualifying her from California Medical Assistance Program (Medi-Cal) eligibility.

We shall uphold the determination of the director and the trial court that Mary did not meet Medi-Cal's eligibility requirements.

FACTUAL BACKGROUND

The Parties

Martha is the daughter and authorized representative of Mary, who, at all times pertinent, was a 91-year-old resident of a long-term care facility.

Defendant and respondent David Maxwell-Jolly is the Director (the Director) of the State Department of Health Care Services (the Department). (Sandra Shrewry was named as defendant in the trial court because she occupied the director's position at that time.)

On March 22, 2007,*fn2 Mary applied for Medi-Cal benefits. Effective May 1, she purchased a policy entitled "Single Premium Pure Endowment Life Insurance Contract" (hereafter the policy or Endowment Contract) from Employees Life Company (Mutual) (hereafter ELCO) for $92,000. The policy application listed Mary's two daughters as equal, primary beneficiaries and her granddaughter as the contingent beneficiary.

The policy states that a "maturity benefit" will be paid on the maturity date, provided the insured is then living. "No benefit is payable at death prior to the maturity date other than accrued dividends." (Boldface in original.) The "MATURITY DATE" is May 1, 2012, or five years after the date of issue. Mary is listed as the "INSURED," and the "MATURITY BENEFIT" is shown as $92,463. If Mary were to die before the maturity date, "a post-mortem dividend is anticipated to be payable" to the beneficiaries. The contract does not identify a specific post-mortem dividend amount.

On June 20, the San Joaquin County Human Services Agency denied Mary's Medi-Cal application, finding that her assets exceeded the $2,000 Medi-Cal resource limit. In making this determination, the county considered the Endowment Contract to be "countable property" for purposes of determining Medi-Cal eligibility. ...


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