(O'hares Petition)
IN THE CIRCUIT COURT OF ST. LOUIS COUNTY STATE OF MISSOURI
MICHELLE A. O'HARE,
Plaintiff,
v.
FARM BUREAU LIFE INSURANCE COMPANY OF MISSOURI, INC.,
Serve at:
Dan Cassidy Registered Agent
701 S. Country Club Dr. Jefferson City, MO 65102
Defendant.
Case No.: 2105CC-00155
PETITION
COMES NOW, Plaintiff, Michelle A. O'Hare ("Plaintiff'), by and through her
attorneys, Teasdale, Murphy & O'Grady, LLP, and for her claim against Defendant Farm Bureau
Life Insurance Company of Missouri, Inc. ("Farm Bureau") states to the Court as follows:
BACKGROUND
1. At all times relevant, Plaintiff was and is a resident of the State of Missouri,
currently residing in St. Louis County. At all times relevant, Plaintiff was married to Thomas P.
O'Hare, III (the "Insured") until his death on June 2,2003.
2. Defendant Farm Bureau is a Missouri corporation licensed to do business as an
insurance company with offices in St. Louis County, Missouri.
3. Venue is proper in the St. Louis County, Missouri under §480.040.R.S.Mo. 2000
as Defendant sells policies and has offices in St. Louis County.
4. On or about November, 2000, Farm Bureau issued a policy oflife insurance to
Thomas P. O'Hare, III, the Insured, Policy No. 0205864 (the "Policy"). Plaintiff was designated
as the sole beneficiary under the Policy, which has Policy Proceeds of FIVE HUNDRED THOUSAND DOLLARS AND NO CENTS ($500,000.00) (the "Policy Proceeds "). A copy of said Policy is attached and incorporated hereto as Exhibit A.
5. From November, 2000 to the present, Plaintiff and Insured paid all premiums due
on the Policy and met all conditions of continuing insurability.
6. On or about December, 2002, Defendant returned to Plaintiff and the Insured their
previously sent premium payment as required by the policy, and stated that the Insured must complete a reinstatement application.
7. Upon information and belief, Defendant alleges that the Policy lapsed.
8. That in April, 2003 and again in May, 2003, prior to Insured's death, Plaintiff and
Insured met all the express conditions precedent to reinstate the Policy if the Policy had lapsed, which Plaintiff expressly denies, in that Insured submitted a written application for reinstatement and provided: a) evidence of insurability; and b) a check for all premiums due.
9. According to the express language of the Policy, reinstatement may occur "at any
time" once the insured provides: a) evidence of insurability satisfactory to Farm Bureau; and b) payment of past premiums with interest. (See, Section Reinstatement of the Policy.)
10. In fact, Defendant did reinstate the Policy, notifying Plaintiff and the Insured by
letter that the policy had been reinstated.
II. While the Policy was in full force and effect, Plaintiff's husband, the Insured, died
suddenly at Mineral Area Regional Medical Center in Farmington, Missouri, on June 2, 2003
12. Shortly thereafter, Plaintiff informed Defendant of the death of the Insured.
13. Plaintiff, as the sole beneficiary under the Policy, filed a Proof of Death Claimant
Statement in order to receive the Policy Proceeds.
COUNT I - EQUITY - DECLARATORY JUDGMENT
COMES NOW, Plaintiff and for Count I of her Petition against Defendant, states to the Court as follows:
14. Plaintiff realleges and reasserts all of the allegations contained in Paragraphs 1-13
above as if fully set forth herein.
15. That Plaintiff is the sole beneficiary under the Policy issued by Defendant to
Plaintiff's husband. Further, that the Plaintiff and her husband met all the conditions of insurability, and paid all premiums due under the terms of the Policy.
16. That the Policy was in full force and effect at the time the Insured died, and
Plaintiff, as sole beneficiary, under the Policy is entitled to the Policy Proceeds plus interest.
17. That even if the Policy had lapsed, which Plaintiff expressly denies, that Insured
met all the conditions precedent to reinstatement as set forth in the Policy, such that the Defendant had to reinstate the Policy.
18. According to the express language ofthe Policy, reinstatement may occur "at any
time" once the insured provides: a) evidence of insurability satisfactory to Farm Bureau; and b) payment of past premiums with interest. (See, Section Reinstatement of the Policy.)
19. In fact, the Insured did provide both 1) evidence of insurability and 2) payment of
past premiums and Defendant did reinstate the Policy, notifying Plaintiff and the Insured by letter that the policy had been reinstated (the "Letter"). A copy of said Letter is attached and incorporated hereto as Exhibit B.
20. While the Policy was in full force and effect, Plaintiff's husband, the Insured, died
suddenly at Mineral Area Regional Medical Center in Farmington, Missouri, on June 2, 2003
21. Plaintiff, as the sole beneficiary under the Policy, filed a Proof of Death Claimant
Statement in order to receive the Policy Proceeds.
22. Representatives from Defendant, Mr. Thomas Ittner and Ms. Fay Hartwick
contacted Plaintiff regarding adjusting the claim. In response to e-mails from these representatives, Plaintiff provided additional information on the death of her husband, including a certified death certificate, a copy of the Policy, a W-9 withholding form, a social security verification form and a copy of the autopsy report from the Coroner's Office of S1. Francois County.
23. On or about August 29, 2003, over three (3) months after reinstating the Policy
and over five (5) months after the initial receipt of the reinstatement application, Defendant denied Plaintiff's claim for Policy Proceeds.
24. That pursuant to §527.010 R.S.Mo. 2000, Plaintiff requests that this Court
determine Plaintiff's rights to the Policy Proceeds, and that there was coverage under the terms of the Policy at the time the Insured died.
25. That pursuant to §527.010 R.S.Mo. 2000, this Court has jurisdiction to determine
the rights of the Plaintiff and Defendant with respect to the Policy.
WHEREFORE, Plaintiff respectfully requests that this Court enter a Judgment on Count I of her Petition and Order that the Policy was in full force and effect at the time ofthe Insured's death, enter Judgment for Plaintiff and against Defendant for the Policy Proceeds, for interest at the highest legal rate, as well as attorneys' fees and for such other and further relief as this Court deems just and proper.
COUNT II - WAIVER AND ESTOPPEL
COMES NOW, Plaintiff and for Count II of her Petition against Defendant, states to the Court as follows:
26. Plaintiff realleges and reasserts all the allegations contained in Paragraphs 1-25
above as if fully set forth herein.
27. That Defendant through its actions and statements is estopped to deny coverage
under the Policy, because as set forth in Paragraphs 18 & 19 above, Plaintiff and Insured met all the conditions precedent set forth in the Policy to maintain the Policy or to reinstate the Policy and Defendant either properly reinstated the Policy, or the Policy had never lapsed.
28. That Defendant waived all defenses to the claim other than the one asserted in
Defendant's August 29,2003 denial letter, and that Defendant is estopped to deny the defense of coverage as Plaintiff and Insured met all the conditions precedent to coverage and Defendant's subsequent conduct was manifestation of acceptance of reinstatement or continuation of the existence of the Policy.
29. That Defendant is estopped to deny coverage under the Policy, by one or more of the following actions in that:
a) Defendant reinstated the Policy and notified Plaintiff ofthe reinstatement; and/or
b.) Defendants kept the premiums for an unreasonable amount of time after
acknowledging the reinstatement, and even after Plaintiff had informed Defendant of the death of the Insured; and/or


c) Defendant initiated the adjustment of the claim, requesting items from
Plaintiff including the autopsy and tax information, while failing to acknowledge or assert issues of coverage; and/or
d) Defendant acknowledged receipt of the reinstatement application in April,
2003, and requesting only that Defendant sign and date the reinstatement application caused Plaintiff and Insured to detrimentally rely on Defendant's statements; and/or
e) Defendant, by indicating to Plaintiff and the Insured, that if the Policy had
lapsed, which Plaintiff expressly denies, that Insured only need to sign and return the reinstatement application without additional evidence of insurability, that the Policy would be reinstated, which then occurred; and/or
f) Defendant failed to provide written notification of its failure to renew as
provided in §375.004.1 R.S.Mo. 2000 and is estopped to do it retroactively.
30. That Plaintiff and Insured reasonably relied upon the actions and representations
of Defendant in not procuring additional insurance and relied upon Defendant's action in initiating adjustment of the claim and retaining the premiums.
31. That Plaintiff would be injured if Defendant were permitted to deny coverage under the Policy.
WHEREFORE, Plaintiff respectfully requests that this Court enter a Judgment on Count II of her Petition against Defendant holding that the Policy was in full force and effect at the time of the Insured's death, enter Judgment for Plaintiff and against Defendant for the Policy Proceeds, for interest at the highest legal rate, as well as reasonable attorneys' fees and for such other and further relief as this Court deems just and proper.
COUNT III - BREACH OF CONTRACT
COMES NOW, Plaintiff and Requests a Jury Trial for Count III of her Petition against Defendant, states to the Court as follows:
32. Plaintiff realleges and reasserts all the allegations contained in Paragraphs 1-31
above as if fully set forth herein.
33. Farm Bureau issued a policy oflife insurance to Thomas P. O'Hare, III, the
Insured, Policy No. 0205864 and Plaintiff was designated as the sole beneficiary under the Policy, which has Policy Proceeds of FIVE HUNDRED THOUSAND DOLLARS AND NOnOO CENTS ($500,000.00). (See, Exhibit A.)
34. From November, 2000 to the present, Plaintiff and Insured paid all premiums due
on the Policy and met all conditions of continuing insurability.
35. On or about December, 2002, Defendant returned to Plaintiff and the Insured their
previously sent premium payment and stated that the Insured must complete a reinstatement application.
36. Upon information and belief, Defendant alleges that the Policy lapsed.
37. That in April, 2003 and again in May, 2003, prior to Insured's death, Plaintiff and
Insured met all the express conditions precedent to reinstate the Policy if the Policy had lapsed, which Plaintiff expressly denies, in that Insured submitted a written application for reinstatement and provided:
a) evidence of insurability; and b) a check for all premiums the due.
38. According to the express language of the Policy, reinstatement may occur "at any
time" once the insured provides: a) evidence of insurability satisfactory to Farm Bureau; and b) payment of past premiums with interest. (See, Section Reinstatement of the Policy.)
39. In fact, Defendant did reinstate the Policy, notifying Plaintiff and the Insured by
letter that the policy had been reinstated. (See, Letter, attached as Exhibit B.)
40. While the Policy was in full force and effect, Plaintiffs husband, the Insured, died
suddenly at Mineral Area Regional Medical Center in Farmington, Missouri, on June 2, 2003
41. Shortly thereafter, Plaintiff informed Defendant of the death of the Insured.
42. Plaintiff, as the sole beneficiary under the Policy, filed a Proof of Death Claimant
Statement in order to receive the Policy Proceeds.
43. On or about August 29,2003, over three (3) months after reinstating the Policy
and over five (5) months after the initial receipt of the reinstatement application, Defendant denied Plaintiff s claim for Policy Proceeds.
44. On or about October 1,2003, Plaintiff sent Defendant a certified demand letter for
the Policy Proceeds to which Defendant refused to even respond.
45. Defendant has breached the terms ofthe Policy by refusing to pay Plaintiffthe
Policy Proceeds of FIVE HUNDRED THOUSAND DOLLARS AND NOnOO CENTS ($500,000.00) due under the Policy, along with interest from June 2, 2003
46. Plaintiff has complied with all the conditions in the Policy.
47. That pursuant to the Policy, Plaintiff is entitled to the FIVE HUNDRED
THOUSAND DOLLARS AND NO/IOO CENTS ($500,000.00) Policy Proceeds and interest at EIGHT PERCENT (8%) for the first year and for statutory interest thereafter on the Policy Proceeds from the date of the Insured's death, until payment is made.
WHEREFORE, Plaintiff, respectfully request Judgment on Count III in her favor and against Defendant in the amount of the Policy Proceeds of $500,000, plus interest at the highest legal rate, for costs and attorneys' fees, and for such other and further relief as this Court deems just and proper.
COUNT IV - VEXATIOUS REFUSAL
COMES NOW, Plaintiff and Requests a Jury Trial for Count IV of her Petition against Defendant, states to the Court as follows:
48. Plaintiff realleges and reasserts all the allegations contained in Paragraphs 1-47
above as if fully set forth herein.
49. That Plaintiff is entitled to Policy Proceeds under the Policy issued to Insured,
that the Policy was in full force and effect at the time of the death ofInsured, and Plaintiff has made demand to Defendant who, without excuse or justification, has refused to pay.
50. Under §375.420 R.S.MO. 2000, Defendant's refusal to pay the Policy Proceeds to
Plaintiff is vexatious, without merit and is without reasonable cause or delay. The actions of the representatives of Defendant were vexatious in that they delayed paying the Policy Proceeds by asking Plaintiff such irrelevant questions as "if her husband knew whether he was going to die." In addition, later actions by representatives of Defendant were also vexatious such as Defendant's refusal to even acknowledge a certified demand letter for the Policy Proceeds.
51. That Defendant's sole basis for denial of the Claim, that there was no coverage,
was not asserted until August, 2003, almost three (3) months after reinstating the Policy.
52. That under §375.420 R.S.Mo. 2000, because of Defendant's actions, Plaintiff is
entitled to vexatious damages, all relevant penalties, interest at the highest legal rate, costs and attorneys' fees on the Policy Proceeds.
WHEREFORE, Plaintiff respectfully request that this Court enter a Judgment on Count IV of her Petition and enter Judgment for Plaintiff against Defendant for the Policy Proceeds and for vexatious refusal to pay, for all the statutory damages permitted under §375.420 R.S.Mo. 2000, including penalties, as well as attorneys' fees, interest at the highest legal rate, and for such
other and further relief as this Court deems just and proper under the circumstances.
Respectfully Submitted,
TEASDALE, MURPHY & OGRADY, LLP
Matthew P. O'Grady,
DouglAs S. Teasdale
1001 Washington Ave., Suite 360 St. Louis, MO 63101
Telephone: 314/725-5353
Facsimile 314/621-1906
Attorney for Plaintiff