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Bethea v. Metropolitan Life Insurance Co.

March 18, 2009

CINDY J. BETHEA, ON BEHALF OF HERSELF AND ALL OTHERS SIMILARLY SITUATED, PLAINTIFF-APPELLANT,
v.
METROPOLITAN LIFE INSURANCE COMPANY, A NEW YORK CORPORATION, DEFENDANT-RESPONDENT.



On appeal from the Superior Court of New Jersey, Law Division, Middlesex County, Docket No. L-3499-08.

Per curiam.

NOT FOR PUBLICATION WITHOUT THE APPROVAL OF THE APPELLATE DIVISION

Argued February 2, 2009

Before Judges Sabatino and Simonelli.

Plaintiff appeals the Law Division's dismissal of her consumer fraud complaint against defendant under Rule 4:6-2(e) for failure to state a claim upon which relief may be granted. Because the trial court did not sufficiently treat the complaint with the indulgence required under the Rule and also hinged its ruling upon a mistaken legal premise, we vacate the dismissal and remand for further proceedings.

We summarize the facts alleged in the detailed complaint, which contains fifty-two paragraphs and numerous attachments, in a light most favorable to plaintiff. Printing Mart v. Sharp Electronics Corp., 116 N.J. 739, 772 (1989).

Plaintiff Cindy J. Bethea resides in Edison. At the time of the events in question, plaintiff and her granddaughter, Shikera Bethea ("Shikera"), both resided in Maplewood.

In February 2002, plaintiff completed an application for whole life insurance with defendant, Metropolitan Life Insurance Company ("MetLife"), seeking $10,000 in coverage on Shikera's life. Plaintiff was the proposed owner and beneficiary of the life policy to insure her granddaughter's life.*fn1

As part of MetLife's standard application form, a copy of which is attached to the complaint, plaintiff (and, apparently, Shikera) answered several inquiries. Both plaintiff and Shikera signed the application's last page. The form included inquiries about whether the proposed insured, i.e., Shikera, had used tobacco. In particular, Question 13 on the form asked them to indicate the dates on which Shikera had last smoked or used (1) cigarettes, (2) cigars, (3) a pipe, or (4) smokeless tobacco. The response "never" was checked as to each of these four inquiries.

The form also requested several disclosures about Shikera's health and activities, seeking responses to such things as the name of her family physician, whether she is regularly taking medication, whether she is engaged in certain dangerous forms of recreation, and whether she has been diagnosed with various specified illnesses, including lung disorders or allergies. Plaintiff and Shikera supplied the requested information, including the contact information for Shikera's doctor. Their responses also stated that Shikera had passed a physical examination for school sports within the past year, and that Shikera had not been treated for any of the listed illnesses or conditions.

Based upon the information supplied, MetLife quoted plaintiff a monthly premium of $11.80 for $10,000 in coverage. The policy was issued effective August 1, 2002. The policy listed the insured's age and gender as "15 Female," and the policy classification as "Standard." The plan was designated as a "Life Paid Up at Age 98."

In connection with the transaction, MetLife provided plaintiff with a separate document, which is also attached to the complaint, containing a series of policy illustrations. Each of the illustrations specified, in the upper right-hand corner, the "Risk Class" applicable to Shikera as "Female Standard Nonsmoker Age: 15." (Emphasis added).

The document further stated:

The Premiums are based on the proposed insured's age, sex, risk class and premium payment mode shown above. If you apply for this policy and the actual age, sex, risk class or premium payment mode as shown in the policy (if issued) are different than those shown above, your MetLife representative will provide you with a revised illustration and can explain any differences to you. This illustration was designed to ...


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