MacDonald v. Penn Mut. Life Ins. Co.
| Decision Date | 18 April 1973 |
| Docket Number | No. 71--865,71--865 |
| Parties | Howard Layton MacDONALD, Appellant, v. The PENN MUTUAL LIFE INSURANCE COMPANY, an insurance corporation, et al., Appellees. |
| Court | Florida District Court of Appeals |
James E. Thompson, of Fowler, White, Gillen, Humkey, Kinney & Boggs, Tampa, for appellant.
Vernon W. Evans, Jr., of Shackleford, Farrior, Stallings & Evans, Tampa, for appellees.
Appellant appeals an adverse final judgment and assigns as error the trial court's ruling in dismissing, with prejudice, the first count of the original complaint and the sixth count of the amended complaint.
Appellee issued a group insurance policy to a bank where appellant was employed. Appellant thereafter terminated his employment and sought to convert his coverage under the group policy to an individual policy and to thereby obtain major medical insurance coverage on an individual basis. The appellee issued an individual policy for hospital and surgical benefits but refused to issue an individual major medical insurance policy to appellant without further proof of insurability. In Count I the appellant sought specific performance to compel appellee to issue an individual major medical insurance policy and on appellee's motion to dismiss the lower court held that the conversion privilege set forth in the policy did not require the appellee to issue individual major medical insurance or coverage to appellant under the terms of the conversion privilege of the group contract.
The pertinent part of the contract read in part:
'Conversion Privilege If an employee's Hospital, Surgical or Major Medical Expense Insurance has been in force for three months and thereafter terminates because his employment terminates for any reason, he shall have the privilege of converting that insurance without submission of evidence of insurability to an individual policy of hospital and surgical insurance.'
Appellant contends that the language of the quoted portion of the policy was ambiguous, and that such ambiguity should be resolved in favor of the insured. We think that the conversion privilege paragraph clearly states, without ambiguity, that upon termination of his employment the insured shall have the privilege of converting his insurance coverage while an employee into an individual policy of hospital and surgical insurance without submission of evidence of insurability, but that the privilege of conversion was not extended to major medical insurance.
We hold that the lower court correctly dismissed Count I of the original complaint.
The lower court also correctly dismissed Count 6 of the amended complaint for failure to state a cause of action. In said count appell...
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