FRANK J. GAIDON, &C., ET AL., APPELLANTS, v. THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA, RESPONDENT.
94 N.Y.2d 330 (1999).
December 20, 1999
1 No. 173
[99 NY Int. 0179]
Decided
PAUL A. GOSHEN, &C., APPELLANT, v. THE MUTUAL LIFE INSURANCE COMPANY OF NEW YORK ET AL., RESPONDENTS.
99 N.Y. Int. 0179.
December 20, 1999
1 No. 174 [99 NY Int. 0179]
Decided
This opinion is uncorrected and subject to revision before publication in the New York Reports.
Case No. 173
Melvyn I. Weiss, for appellants.
Thomas J. Dougherty, for respondent.
Attorney General of the State of New York; Business
Council of New York State, Inc.; American Council of Life
Insurance, amici curiae.
Case No. 174
Melvyn I. Weiss, for appellant.
Harvey Kurzweil, for respondents.
Attorney General of the State of New York; Business
Council of New York State, Inc.; American Council of Life
Insurance, amici curiae.
In both appeals before us, plaintiffs are policyholders who have brought actions against insurance companies in connection with "vanishing premium" life insurance policies. They allege, in essence, that they purchased their insurancepolicies based on defendants' false representations that outofpocket premium payments would vanish within a stated period of time. Plaintiffs have asserted several theories of liability, two of which merit our review. One is based on plaintiffs' claims that defendants violated General Business Law § 349 by engaging in deceptive marketing and sales practices; the other is based on common law fraud.
I.
Facts and Procedural History
A.
The GaidonGuardian Action
In the mid1980s, plaintiff representatives of a purported class each purchased a life insurance policy from defendant Guardian Life Insurance Company of America. [n.1] Each policy was a "Whole Life Policy With Specified Premium Period." The policies contained provisions setting forth the periods for which premiums were to be paid. These periods varied from policy to policy and ranged from ten years to life.
Plaintiffs allege that they bought their policies onthe strength of false representations made to them by a Guardian sales agent. They assert that as part of the company's standard marketing presentation, the agent prepared a personalized "vanishing premium" illustration for each plaintiff. Using this device, the agent allegedly represented to each plaintiff that he or she would have to pay annual premiums outofpocket for only the first eight years of the policy, assuring each of them that the policy's dividends would thereafter cover the premium costs. Plaintiffs contend that the illustrations were premised on dividend projections that Guardian knew or should have known were untenable. Specifically, they allege that Guardian, in the mid1980s, artificially inflated its current dividend rates despite waning profits because it wanted to continue depicting competitive vanishing dates.
On a separate page, accompanying each illustration, however, limitations such as the following appeared:
"Figures depending on dividends are neither estimated nor guaranteed, but are based on the [current year's] dividend scale."
"The [current year's] dividend scale reflects current company claims, expense and investment experience * * * and taxes under current laws. Actual future dividends may be higher or lower than those illustrated depending on the company's actual future experience."After deciding to purchase the policy each plaintiff signed an application. Several weeks later Guardian deliveredthe policies. Each policy contained the following provisions:
(1) "[a] participating policy shares in Guardian's divisible surplus. The policy's share, if any, is determined yearly by Guardian"; and
(2) "[t]he dividend will reflect Guardian's mortality, expense, and investment experience."
Moreover, the policies contained several integration or merger clauses stating, in words or substance, that only the actual policy provisions controlled. [n.2]
In 1995, eight years after the sale of the policies, Guardian informed each plaintiff that his or her premiums would, in fact, not vanish and that if the policies were to remain in force, plaintiffs would have to continue outofpocket premium payments. [n.3] Plaintiffs brought this purported class action suit against Guardian in 1996. [n.4]
In its preanswer motion, Guardian moved to dismiss. Supreme Court granted the motion and dismissed the complaint forreasons that varied with the particular plaintiff. [n.5] The Appellate Division affirmed but made no distinction among plaintiffs, holding that, among others, the fraudulent inducement and General Business Law § 349 claims failed as a matter of law ( Gaidon v Guardian Life Ins. Co. of America, 255 AD2d 101, 10102).
B. The GoshenMONY Action
Plaintiffs' assertions against defendants Mutual Life Insurance Company of New York and MONY Life Insurance Company of America (collectively "MONY") mirror those in the Gaidon/Guardian case. In essence, they allege fraudulent representations and a deceptive marketing scheme, both based on untenable dividend projections.
Plaintiffs (members of certified class) purchased whole and universal life insurance policies in the mid1980s from MONY. The MONY policies, like Guardian's, set forth premium payment schedules covering a stated number of years. MONY presale illustrations were accompanied by "Limitations" pages similar to those in Guardian:
"This illustration shows the surrender of values dependent in whole or in part on dividends paid by the Company. These values are not guaranteed."
"Dividends shown and amounts dependent on them are based on the current illustrative formula. They are neither guarantees nor estimates of future results."Each prospective policyholder submitted an application and, several weeks later, received a policy containing generally worded integration clauses. [n.6]
In 1995, MONY began informing plaintiffs that if they wished to keep their policies in force they would be required to pay additional premium payments beyond the depicted vanishing date. Employing theories similar to those in the companion case, plaintiffs commenced this action against MONY. [n.7]
Supreme Court certified the class to include
"all persons or entities * * * who have, or at the time of the policy's termination had, an ownership interest in one or more whole life or universal life insurance policies issued by [MONY] * * * and were harmed due to [MONY's] alleged wrongful conduct with respect to the sale of Policies on an alleged 'vanishing premium' basis * * * during the period from January 1, 1982 through and including December 31, 1995."[n.8]
Following discovery, Supreme Court granted MONY summary judgment on all claims, including those for fraudulent inducement and violation of General Business Law § 349. The Appellate Division, citing its decision in Gaidon, affirmed without opinion.
II.
Vanishing Premium Life Insurance: The Background
The cases before us are not unique . They involve allegations and practices of a national scope that have generated industrywide litigation ( see, 7 Holmes, Appleman on Insurance 2d § 49.19 ). In resolving this case, we consider the various types of cash value life insurance that are marketed, and the import of "vanishing premiums" in that setting.
All the policies in the appeals before us provide"whole life" or "universal life" insurance each a form of "cash value" life insurance. Cash value life insurance combines "pure" life insurance with an investment component that creates a potential accumulation of money in the policy (Downes & Goodman, Dictionary of Finance and Investment Terms at 81 [4th ed]; see also, Black & Skipper, Life Insurance at 17778 [12th ed] [discussing "dual nature" of cash value life insurance]). In a cash value policy, the carrier typically invests accumulated money and pays returns to the policyholder in the form of dividends or interest (Downes & Goodman, supra, at 81).
When cash value insurance first emerged, insurance
companies invested accumulated money exclusively in conservative
securities with fixed interest rates, such as municipal and
corporate bonds ( see, Fischel & Stillman, The Law and Economics
of Vanishing Premium Life Insurance, 22 Del J Corp L 1, 4
[1997]). Commentators point out that because interest rates
"soared" in the late 1970s and early 1980s, the economics of
these cash value life insurance policies became unattractive to
investors who sought to take advantage of the high interest rates
( see, Fischel & Stillman, op. cit., at 5; MultiState Life
Insurance Task Force and MultiState Market Conduct Examination
of The Prudential Insurance Company of America, Executive
Summary, http://www.naic.org/presum.htm ). In the mid1980s, the
life insurance industry reacted to its diminishing market share
by designing policies, like the ones here at issue, in whichpolicyholders' accumulated money is tied to the current rate of
interest ( see, Fischel & Stillman, op. cit., at 5).
Carriers marketed interest ratesensitive insurance
under a host of premium payment options, including the "vanishing
premium" plan (Fischel & Stillman, op. cit., at 6).
Under this
plan, the policyholder pays higherthannormal premiums in the
early years of the policy, resulting in a quicker accumulation of
premium dollars for investment purposes (Fischel & Stillman, op.
cit., at 67; Black & Skipper, op. cit., at 112). These policies
are marketed on the premise that enough cash value will
accumulate so that at a fixed date future administrative and
insurance costs will be covered and the policyholder relieved of
any further outofpocket premium obligations (Fischel &
Stillman, op. cit., at 67).
In the late 1980s, however, sharply declining interest
rates "upset the economics" of these widely marketed policies
(Fischel & Stillman, op. cit., at 7). Accumulated cash values
became insufficient to pay expected future insurance and
administrative costs. By the early 1990s, many consumers who
purchased such policies were required to continue outofpocket
payments to keep their policies in force (Fischel & Stillman,
op. cit., at 7). And the lawsuits followed.
III.
General Business Law § 349 As Compared With Common Law Fraudulent
Inducement
In addressing the primary issues in these appeals, we
must examine the components of both General Business Law § 349
and common law fraudulent inducement. Although a person's
actions may at once implicate both, General Business Law § 349
contemplates actionable conduct that does not necessarily rise to
the level of fraud. In contrast to common law fraud, General Business Law § 349 is a creature of statute based on broad
consumerprotection concerns ( see, Oswego Laborers Local 214
Pension Fund v Marine Midland Bank, NA, 85 NY2d 20, 2425)
.
Although General Business Law § 349 claims have been aptly
characterized as similar to fraud claims, ( e.g., Dornberger v
Metropolitan Life Ins. Co., 961 F Supp 506, 549 [SDNY 1997]),
they are critically different in ways illustrated by the cases at
bar.
As this Court noted in Oswego ( supra, 85 NY2d, at 24 ),
General Business Law § 349 was enacted initially to give the
Attorney General enforcement power to curtail deceptive acts and
practices willful or otherwise directed at the consuming
public. Owing to the "everchanging types of false and deceptive
business practices which plague consumers in our State," theGovernor signed the measure into law ( NY Dept of Law, Mem to
Governor, Bill Jacket, L 1963, ch 813). In 1980, the Legislature
took a significant step to expand the statute's enforcement
scheme by allowing a private cause of action (General Business Law § 349[h]).
As a threshold matter, plaintiffs' claims under
General Business Law § 349 must be predicated on a deceptive act
or practice that is "consumer oriented" ( Oswego, supra, 85 NY2d at 2425). We hold that they are. In contrast to a private
contract dispute as to policy coverage ( e.g., New York Univ. v
Continental Ins. Co., 83 NY2d 308), the practices before us
involved an extensive marketing scheme that "had a broader impact
on consumers at large" ( e.g., Oswego, supra, at 25).
Turning to the other components of § 349, "a plaintiff
must allege that defendant has engaged 'in an act or practice
that is deceptive or misleading in a material way and that
plaintiff has been injured by reason thereof'" ( Small v Lorillard
Tobacco Co, NY2d , No 154, 1999 NY LEXIS 3441, at *12 [Oct
26, 1999] [quoting Oswego, supra, at 25] ). This Court has
defined a "deceptive act or practice" as a representation or
omission "'likely to mislead a reasonable consumer acting
reasonably under the circumstances'" ( Karlin v IVF America, Inc., 93 NY2d 282, 294 [quoting Oswego, supra, at 26]). We hold that
plaintiffs have adequately alleged that defendants violated the
statute.
Plaintiffs have alleged, in essence, that defendants
lured them into purchasing policies by using illustrations that
created unrealistic expectations as to the prospects of premium
disappearance upon a strategically chosen "vanishing date." This
vanishing date, plaintiffs allege, was misleading, as based on
the premise that interest rates would continue at a high,
unprecedented rate for, in some cases, twenty or more years a
premise that defendants allegedly knew to be unlikely.
Plaintiffs' argument is supported by the Attorney
General, who has submitted an amicus brief asserting that the
lower courts' interpretation of section 349 was too restrictive.
He urges that a matteroflaw finding that the practices were not
deceptive or misleading would undermine the State's power to
redress consumer practices that do not rise to the level of
common law fraud.
In seeking to uphold the dismissal of the section 349
claims, defendants argue, in substance, that the illustrated
vanishing dates were not deceptive. They have directed our
attention to the policies' merger clauses, which seek to confine
their representations to the four corners of the policies. They
also point to the abovequoted disclaimer language stating that
illustrated dividend/interest rates "are neither guarantees nor
estimates of future results" or that such rates may be "higher or
lower * * * depending on the company's actual future experience."
Defendants' contentions are compelling when resisting plaintiffs'claims of fraud, but they cannot, on this record, justify
dismissal of plaintiffs' section 349 claims.
To begin with, the merger provisions for whatever
other importance they may carry are not determinative of
plaintiffs' § 349 claims, which are based on deceptive business
practices, not on deceptive contracts. Moreover, the
disclaimers, though more particularized than the merger
provisions, do not speak to the true, unrevealed relationship
between dividend/interest rates and the vanishing dates as
represented. Consumers vary in their level of sophistication and
their ability to perceive the connection between a fluctuation in
dividend/interest rates and a vanishing date, or to make the
necessary arithmetic adjustments. The issue before us is not
whether, as a matter of law, reasonable consumers would be misled
in a material way, but whether that prospect is enough to create
a question of fact in the Goshen appeal, or to state a claim in
Gaidon. It is, in both cases, for a number of reasons.
Defendants made vanishing dates the centerpiece of
their sales presentations. They allegedly marketed vanishing
premium policies by tying depicted vanishing dates to a milestone
in the policyholder's near future (such as the policyholder's
proposed retirement age or the year when a child was expected to
go to college), and thereby created the expectation of a firm,
personalized timetable. The very goal of the marketing scheme
was to convince prospective purchasers that the vanishing datewould in fact conform to the individualized projections.
Plaintiffs allege that the defendants were aware that the
premiums were unlikely to vanish as projected because they
allegedly knew or should have known that the opposite was true:
dividend/interest rates were not sustainable at the illustrated
level. In the face of that unlikelihood, defendants created
these expectations with illustrations that were based on the
unrealistic dividend/interest forecasts and no disclosure or
disclaimer revealing that fact.
[n.9]
Further, and in spite of this alleged knowledge,
defendants allegedly trained sales agents to make presentations
in ways that would arguably deceive and mislead prospective
policyholders. The record contains a sales training videotape
that is revealing. It instructs agents how to "cause the vanish
to occur whenever your client wants to see it." Also, vanishing
premium policies were marketed with slogans such as "Pay one and
done," "4 Pay/No Pay," "Pay One Vanish," "Accelerated Vanish,"
and "How to get lifetime insurance protection with payments that
are . . . GOING, GOING, GONE."
The Gaidon action was determined solely on the
pleadings. Plaintiffs have alleged that Guardian was aware of
the unlikelihood that the then current dividend rate could be
maintained. This awareness, plaintiff alleges, was based not
only on the general state of the economy, but on Guardian's
transactions and on its heightened knowledge of its own financial
condition.
In Goshen, plaintiffs also have produced affidavits
averring that the company's current dividend rate, as depicted at
the time of the illustration, was based in part on nonrecurring
transactions that skewed any projection of MONY's ability to
maintain the then current dividend/interest rates.
Insisting that they have engaged in no deceptive
conduct, defendants have challenged plaintiffs' allegations.
Defendant MONY, for example, asserts that "[t]he regulatory * * *
repercussions of engaging in the sort of pervasive misconduct to
which plaintiffs allude would be swift and severe." In this
context we note that in 1997 and 1998 the New York State
Superintendent of Insurance issued several regulations aimed
directly at the marketing scheme before us. One regulation
banned outright the use of "vanishing premium" language:
Further, subpart 533.3(13) provides that where presale illustrations depict reinvestment of nonguaranteed
dividend/interest to pay off premiums,
Most pointedly, the Superintendent of Insurance has
required carriers to dispel any false impression that
dividend/interest rates would continue for all the years shown in
a life insurance illustration. The regulation is designed to
insure that prospective purchasers, during high interest eras,
will no longer be led or misled to believe that their outofpocket obligations will be reduced or eliminated. Subpart 533.3(b)(5) thus requires presale illustrations to include the
following statement:
Contrary to the suggestions of our dissenting
colleague, the actions of the Superintendent of Insurance are
independent of our conclusion that plaintiffs have pleaded a
valid § 349 claim.
[n.11]
They merely match and fortify our
determination.
In all, we conclude that plaintiffs in the Gaidon
action have adequately pleaded a General Business Law § 349 cause
of action and that plaintiffs in Goshen have presented swornassertions sufficient to raise a question of fact as to a General Business Law § 349 deceptive practice.
B. Common Law Fraudulent Inducement
A practice may carry the capacity to mislead or deceive
a reasonable person but not be fraudulent. That distinction
separates plaintiffs' fraud claims from their § 349 claims.
Fraud is wrongful enough to occupy a civil classification just
short of criminal conduct, and over the years has generally been
defined by behavior involving intentional, false representations
and other connotations of scienter such as willfulness,
knowledge, design and bad faith ( see, e.g,
Channel Master Corp. v
Aluminum Ltd. Sales, Inc., 4 NY2d 403, 40708; Reno v Bull, 226
NY 144, 145
).
To state a claim for fraudulent inducement in an
insurance context, plaintiffs must allege a "misrepresentation or
material omission" by defendants that induced plaintiffs to
purchase the policies, as well as scienter, reliance and injury
( New York Univ. v Continental Ins. Co., supra, 83 NY2d 308, 318;
see also Small v Lorillard Tobacco Co, supra, __ NY2d __, No 154,
1999 NY LEXIS 3441, at *9 [Oct 26, 1999]).
The parties' arguments for and against plaintiffs'
fraud claims mirror those made in connection with section 349.
Notably, plaintiffs stress that the illustrations were onesidedmisrepresentations designed to deceive and mislead purchasers by
projecting only the brighter prospects while concealing
predictably bleaker ones. They assert that they have met the
"misrepresentation or material omission" threshold for fraud,
alleging that the illustrations painted a purposefully distorted
landscape using false, untenable interest rate projections and
further, that defendants intentionally diverted funds to conceal
the artificially inflated nature of the dividend picture.
Defendants argue that plaintiffs' assertion that they
intentionally and artificially inflated dividends is largely
conclusory and incompatible with the constraints of a highly
regulated industry.
Contending further that there was no
misrepresentation or falsification that could give rise to a
fraud claim, defendants submit that the dividend/interest rates
projected in the illustration tables were, in fact, those being
paid out to policyholders at the time of the sales presentations.
Additionally, defendants claim that the projections were
illustrations only, that they were based on the continuation of
an existing state of affairs and cannot be construed or
characterized as guarantees. They also argue, in substance, that
any claim of fraudulent concealment or omission is necessarily
defeated by the disclaimer language in the illustrations.
We recognize that a number of courts have gone so far
as to sustain fraud charges as adequately pleaded in vanishing
premium cases ( see, e.g., Greenberg v Life Ins. Co. of Virginia,177 F3d 507 [6th Cir 1999]; Myers v Guardian Life Ins. Co. of
Am., 5 F Supp2d 423 [ND Miss 1998]; Nepomoceno v Knights of
Columbus, supra, No 96 C 4789, 1999 US Dist LEXIS 1366 [ND Ill
Feb 8, 1999]; Grove v Principal Mutual Life Ins. Co., 14 F Supp2d
1101 [SD Iowa 1998]; Force v ITT Hartford Life & Annuity Ins.
Co., supra, 4 F Supp2d 843 [D Minn 1998]; Chain v General Am.
Life Ins. Co., No 4:96CV96BB, 1996 US Dist LEXIS 21505 [ND Miss
Sept 30, 1996]; In re Prudential Ins. Co. of Am. Sales Practices
Litig., 975 F Supp 584 [DNJ 1996] ; Mentis v Delaware Am. Life
Ins. Co., CA No 98C12023 WTQ, 1999 Del Super LEXIS 419 [July
28, 1999]; but see, Frith v Guardian Life Ins. Co. of Am., 9 F
Supp2d 744 [SD Tex 1998]; Solomon v Guardian Life Ins. Co. of
Am., No 961597, 1996 US Dist LEXIS 18342 [ED Pa Dec 11, 1996],
aff'd 162 F3d 1152 [3d Cir 1998] [unpublished table decision]).
We conclude, however, that defendants' disclaimers,
although insufficient to defeat plaintiffs' § 349 claims, are
sufficient to absolve them of fraud. Defendants are correct in
asserting that plaintiffs have not met the threshold element to
support a fraud claim "misrepresentation or material
omission." The elements for fraud are narrowly defined,
requiring proof by clear and convincing evidence ( cf., Vermeer
Owners, Inc. v Guterman, 78 NY2d 1114, 1116). Not every
misrepresentation or omission rises to the level of fraud.
[n.12]
Anomission or misrepresentation may be so trifling as to be legally
inconsequential or so egregious as to be fraudulent, or even
criminal. Or it may fall somewhere in between, as it does here.
By stating that the illustrated dividend/interest rates
are not guaranteed and that they may be higher or lower than
depicted, defendants made a partial disclosure. They revealed
the possibility of a dividend/interest rate decline, but did not
reveal its practical implications to the policyholder. Although
they did not guarantee that interest rates would remain constant,
they failed to reveal that the illustrated vanishing dates were
wholly unrealistic.
We conclude that although defendants' sales practice,
as pleaded, falls within the purview of General Business Law § 349, it does not constitute a "misrepresentation or material
omission" necessary to sustain a cause of action for fraud.
Because the Appellate Division dismissed the entire
Gaidon/Guardian complaint on the merits, it is now necessary for
that court to consider which plaintiffs would be legally entitled
to bring a claim under General Business Law § 349. Accordingly,
in Gaidon, the order of the Appellate Division should be
modified, without costs, by reinstating the General Business Law § 349 cause of action, and remitting the case to that court for
consideration of issues raised but not determined on the appeal
to that court. As so modified, the order should be affirmed.
In Goshen, the order of the Appellate Division should
be modified, without costs, by reinstating the General Business Law § 349 cause of action and remitting the case to Supreme Court
for further proceedings consistent with this opinion and, as so
modified, affirmed.
Gaidon v Guardian Life Ins. Co. of America
Goshen v Mutual Life Insurance Co. of New York
No. 173 & 174
BELLACOSA, J. (dissenting in part).
My dissent is respectfully tendered solely with regard to
the revival and reinstatement of the General Business Law § 349
claims. I agree with the lower courts, including their rulings
that these particular claims are no more sustainable or
cognizable on these records than any of the other standard
claims.
I dissent also because the precedential implications of the
Majority holding, as proposed, are beyond the intent, enactment
and interpretation of this remedial statute. In particular, I
conclude that no deceptive act or practice, which would mislead a
reasonable consumer, has been alleged in these cases under this
statute. I would therefore affirm the Appellate Division orders
outright.
I.
In the Gaidon action, defendant's motion to dismiss pursuant
to CPLR 3211 was granted, dismissing plaintiffs' complaint
containing their causes of action for violations of General Business Law § 349. The standard applied in this case is whether
a pleading and its factual allegations manifest any cause ofaction "cognizable at law" ( Guggenheimer v Ginzburg, 43 NY2d 268,
275). Dismissal is appropriate when evidentiary material is
considered where an alleged material fact "is not a fact at all
and * * * no significant dispute exists regarding it" ( id.).
Here, the complaint must sufficiently set forth a "forbidden
type of deception" ( id.). While the failure to disclose
information may be found "less than candid, it cannot, as a
matter of law, be found deceitful" when there is no evidence in
the record to refute defendant's assertions ( see, St. Patrick's
Home for the Aged and Infirm v Laticrete Intl., Inc., __AD2d__,
696 NYS2d 117, 122). The failure of a pleading to present a
deceptive act or practice, under the sweep and provenance of
General Business Law § 349, should render the asserted claims
deficient on the face of, and at the outset of, the dispute
brought to a court ( see, id.).
Defendants moved in the Goshen action for summary judgment.
Thus, reviewing the pleadings as well as the evidentiary
materials, plaintiffs must present a triable issue of fact to
defeat the motion. I conclude, as did the courts below, that no
genuine triable issue of fact is presented on this record, and
summary judgment was appropriately granted to defendants.
In the instant cases, plaintiffs essentially charge that the
use of illustrations by defendants' sales agents, depicting time
lines at which premium payments might "vanish," misled the
consumers within the meaning of the statute. Additionally, in
Goshen, plaintiffs claim that defendant MONY knew the use of the
"vanishing premium" sales promotion was not viable and that the
company attempted to conceal this awareness from the plaintiff
class. The Goshen plaintiffs submitted affidavits purporting
that the dividends illustrated by MONY were not sustainable. In
my view, on these records, the allegations do not measure up to
cognizable causes of action necessitating a trial on the General Business Law § 349 claims.
II.
In 1970, the Legislature enacted section 349 of the General
Business Law to "strengthen the consumer protection powers of the
Attorney General by enabling him to obtain injunctions against
all deceptive and fraudulent practices affecting consumers and by
clarifying his powers to obtain restitution for defrauded
consumers in such proceedings" (Governor's Mem approving L 1970,
of chs 43 & 44, 1970 NY Legis Ann, at 472). Consumers were given
a protection for an "honest market place" enforceable by the
Attorney General ( id.). Section 349 tracked the actions of the
FTC with respect to interpretation and enforcement of the Federal
Trade Commission Act (15 USC 45), in that agency's effort to
eradicate or penalize deceptive acts and practices ( see
generally, Lefkowitz v Colorado State Christian Coll. of theChurch of Inner Power, Inc., 76 Misc 2d 50, 54).
In 1980, the New York Legislature enhanced this State's
protective mechanism. It gave a private right of action to
allegedly wronged consumers to pursue consumer fraud claims
personally (General Business Law § 349[h]). This powerful tool
was to "supplement the activities of the Attorney General in the
prosecution of consumer fraud complaints" (Governor's Mem
approving L 1980, ch 346, 1980 NY Legis Ann, at 147). Moreover,
the enactment of this statutory remedy was not to deprive
plaintiffs of any common law remedies ( see generally, Schuster v
City of NY, 5 NY2d 75, 85 [statutory remedy is "merely
cumulative"]).
I am not persuaded that support exists to justify a further
enhancement of General Business Law § 349 to make it a "catchall" remedy. It should not be construed as providing allencompassing redress. To interpose such a procedural and
remedial disincentive against aggrieved persons pursuing
longstanding traditional remedies at common law, as well as other
statutory and regulatory measures affecting a gigantic industry
like insurance and precedentially all others is a
remarkable step and development that I do not believe is
warranted or intended.
III.
Section 349, unlike other states' deceptive practicestatutes, does not supply a definition of "deceptive acts or
practices." Noting the undeniable remedial nature of section
349, this Court proportionately recognized the potential for
overbreadth inherent in the interpretation and application of the
statute. Oswego Laborers' Local 214 Pension Fund v Marine
Midland Bank (85 NY2d 20) announced the test which should
determine whether defendants here violated section 349. The
standard is whether "defendant is engaging in an act or practice
that is deceptive or misleading in a material way" and whether
"plaintiff has been injured by reason thereof" ( id., at 25).
While I agree with the Majority's acknowledgment of the
appropriate test, my application of it results in an affirmance
and resolution against the groundbreaking availability of New
York's General Business Law § 349. Based on the Majority's
holding, a wide expansion of the theory underlying this statutory
remedy will henceforth be operative.
Yet, to avoid the possibility of "excessive litigation"
(class or individual) under General Business Law § 349, this
Court evoked "'an objective definition of deceptive acts and
practices, whether representations or omissions, limited to those
likely to mislead a reasonable consumer acting reasonably under
the circumstances'" ( Karlin v IVF America, Inc., 93 NY2d 282,
294, quoting Oswego, supra, 85 NY2d, at 26; contrast, Note, New
York Creates a Private Right of Action to Combat Consumer Fraud:Caveat Venditor, 48 Brooklyn L Rev 509, 548).
The judicial framework and resolution can be determined as a
matter of law or fact ( Oswego, supra, 85 NY2d, at 26).
Particularly in omissions cases, the statute does not require
businesses to "guarantee that each consumer has all relevant
information specific to its situation. The scenario is quite
different, however, where the business alone possesses material
information that is relevant to the consumer and fails to provide
this information" ( id.).
The capacity and potential of the material to qualify as a
misleading act that deceives must be assessed in individual cases
and circumstances. The determination of the deceptiveness of the
conduct that bears on the reasonableness of the consumer should
not be bifurcated between the sales materials and the contract
policies themselves, as the Majority's analysis does. That is a
commercially unrealistic segmentation that artificially skews the
statutory reach.
Deception requires a misrepresentation of fact under the
whole set of dealings of the parties ( see generally, State of New
York v Unique Ideas, 85 Misc 2d 258, affd & modified as to
damages 56 AD2d 295, affd & modified as to damages 44 NY2d 345).
The language of the policies, which included statements that
premiums are regularly due, cannot be so facilely cast aside in
determining whether a misrepresentation of fact was alleged whichwould mislead a reasonable consumer, acting reasonably, into
buying that policy. The reasonableness of the consumer viewpoint
in my judgment of the statute, ought to be evaluated in light of
all the facts before the consumers the sales promotion, the
written illustrations expressing no guarantees, and the policies
excluding extraneous facets from the sales transaction and
agreement. In other words, the integrated transaction determines
the availability of the statute, not just the initial contact,
sales pitch or some predicate facet.
IV.
Thus, application of Oswego's standards to plaintiffs'
General Business Law § 349 claims demonstrates, as a matter of
cogent, even compelling, record dealings, that plaintiffs fail to
propound cognizable claims or a triable issue of fact under the
statute. The complaints, and the accompanying submissions in
Goshen, simply do not allege a sustainable basis or theory that
plaintiffs were materially deceived and harmed by defendants'
actions that is, by the entire array of interrelated steps
leading to the purchase of the policies.
In Gaidon, the asserted deceptive act is that defendant
Guardian, through its sales presentations and policy
illustrations, misrepresented that payment of premiums only
during the first several years of the policy would suffice to
carry out the cost of the policy for the life of the insured. Plaintiffs allege that this illustrative sales promotion induced
purchase of the policies and falls within the limitless statute.
Yet, the express terms of the policy plainly indicate the
duration of the required premium payments; and the written policy
illustrations used by defendant Guardian specifically stated they
were neither part of the actual insurance policy, nor that the
dividends were guaranteed.
Moreover, to the extent that plaintiffs in Gaidon argue that
they pled a cognizable section 349 claim based on defendant
Guardian's use of misleading dividend scales in its
illustrations, plaintiffs' argument is baseless. The
illustrations accord with applicable official regulations which
require that "[i]f dividends are illustrated, they must be based
on the insurer's current dividend scale and the illustration must
contain a statement to the effect that they are not to be
construed as guarantees or estimates of dividends to be paid in
the future" (11 NYCRR 219.4[n]). The Majority's conclusion
that the use of standard, officially approved and authorized
illustrations amounts to a deceptive practice under General Business Law § 349 is a breakaway proposition with troubling
precedential implications and a fundamental unfairness by
changing the rules of trade after the fact.
Similarly, in Goshen, the certified class members sought to
recover under General Business Law § 349 based on theirunderstanding of written policy illustrations that premium
payments would only have to be paid for a limited number of
years. Defendant MONY utilized different versions of the written
illustrations. All illustrations, however, included statements
that they were not valid without a "Limitations and Definitions"
form, which, at minimum, cautioned any potential purchaser that
only the policy itself with the application is the entire
contract. The policies then repeated the same admonition that
they alone constituted the entire agreement of the parties. To
wholly sideline these pervasively employed integration clauses in
these circumstances is a discretely portentous precedential
development. That alone justifies my dissenting expression as
fair notice to the Bench and Bar, and as an incentive for
legislative consideration of some reasonable limitations on the
sweep of the law.
As an additional argument, the plaintiff class in Goshen
urges that MONY executives knew that the "vanishing premium"
concept was not viable, given inevitably uncertain predictions
about future economic conditions. But that unpredictability is a
known constant to the world at large, not just to insurance
executives.
Oswego Laborers' Local 214 Pension Fund further teaches
another axiom: MONY was not required to "guarantee that each
consumer has all relevant information specific to its situation." The sales nomenclature of "vanishing premium" does not even
denote a type of life insurance policy ( see, Fischel & Stillman,
The Law and Economics of Vanishing Premium Life Insurance, 22 Del
J Corp L, 1, 7). Rather, the "vanishing premium" notion is a
marketing technique and advertising device based on a proposed
financing spread sheet which provides "a vanishingpremium option
or rider to the basic life insurance policy" (Fischel & Stillman,
supra, at 7). The illustrations "are based on projections of
certain economic factors which may or may not come true" (Fischel
& Stillman, supra, at 7 [emphasis added]). Consumers know as a
matter of common sense and knowledge, or ought to be reasonably
charged with knowing that truism. Besides, they were informed of
this very point in writing twice at least. The illustration
materials themselves and the actual policies so declare. They
are unassailable documentary proofs, not wispy disappointment
claims that the deals did not turn out as hoped for or expected.
The point at which the premium payment obligation
"vanishes," as advertised through the illustrations, does not
imply, moreover, that the policyholder will never again have an
obligation to pay premiums. Rather, the illustrations project
that the policy may be "selfperpetuating," at a point when
future premium payments should be paid up using the generated
policy dividends (Fischel & Stillman, supra, at 7). Reasonable
consumers should not be allowed to infer by operation of lawthrough interpretive judicial rulings, statutes and regulations that external economic factors would remain static and that the
cessation of cash premium payments would be a certainty, for lack
of which statutory liability is primed. That consequence defies
history and fair dealing on a common sense landscape.
Plaintiffs' allegations that they were deceived into
believing that the premium payments would inevitably cease at a
fixed point in time is, moreover, contradicted by all the
available documentation. Courts should not ignore the explicit
language of the insurance contracts and the reasonable
understanding and expectation concerning the ineffability of
extrinsic economic and market forces. Everyone should be charged
with the plain fact that only the unknowable future could
ultimately shape and control these matters.
Next, the use of interest rate assumptions in the policy
illustrations should not be deemed realistically to have the
capacity to mislead prospective policyholders. That is a too
farout legal fiction. The probable level of future interest
rates is, again, most certainly and most commonly known and
appreciated as something not solely within an insurance company's
or anyone else's ability to forecast ( see, Fischel & Stillman,
supra, at 14). Even Allan Greenspan and the Federal Reserve
Board hedge their "bets" and just do their best. Furthermore,
any general information defendants had involving marketprojections was the type of information plaintiffs, indeed
anyone, "could reasonably have obtained" ( Oswego, supra, 85 NY2d,
at 27), on their own, through financial advisors or via the
"Internet".
Plaintiffs argue and the Majority adopts the
proposition that defendants created a misleading impression of
these policies by not revealing their potential downsides. This
aspect, as that syllogism sets the stage for the future, helps to
drive the General Business Law § 349 claims in these cases. My
simple answer is that the entire insurance industry, by its
nature, insures many things. But to derive an insurance
obligation out of this new "pros and cons" balancing technique is
a farreaching concept and legal responsibility, bound to
confound any rate or risk underwriter. Risk projections and reallocation on this basis constitute a major shift for any type of
salesoriented business. By court decree instead of market
forces they must, when emphasizing the positive aspects of their
policies or products, also provide minimizing features and
negatives ( contrast, Fischel & Stillman, supra, at 15).
To hold, even in part, that giving a product its best sales
"face," even with some "puffery" and artfully spun advertising,
is actionable under General Business Law § 349 pushes this
consumer protection statute into uncharted and unintended
territories. "Puffing" defenses a seller's claim that noreasonable person would believe some sales promotion to be
literally true should have some reasonable place in the
General Business Law § 349 universe as to who bears the risk of
the bargain ( see generally, Pitofsky, Beyond Nader: Consumer
Protection and the Regulation of Advertising, 90 Harv L Rev 661,
677). If not, this statute launches limitless liability.
Reasonable consumers acting reasonably recognize sales
pitches and ordinarily discount them accordingly. In addition,
to acknowledge that consumers understand that future interest
rates will affect their future premium rates is reasonable and
even respectful of individual intelligence, personal
accountability and good common sense ( see, Fischel & Stillman,
supra, at 16).
Based on the records of these cases, I agree with the lower
courts that plaintiffs failed to show that defendants engaged in
materially misleading or deceptive acts or practices. The
alleged representations made by defendants were not "likely to
mislead a reasonable consumer acting reasonably" ( Oswego, supra,
at 26). Prospective market forces predominantly control here,
and a remedial rescue by statute or judicial gloss on a statute after the economic facts inexorably unfold under their own
power ought not become the benevolent standard for shifting
fault, reallocating risk and relieving individuals of some
measure of reasonable responsibility and private accountability.
In sum, I would wholly affirm the orders of the Appellate
Division in the actions entitled under Gaidon and Goshen. While
I agree with the Majority rationale and result on plaintiffs'
common law fraud claims, I respectfully dissent for the reasons
given and conclude that plaintiffs have not propounded cognizable
or triable General Business Law § 349 claims.
Case No. 173: Order modified, without costs, by reinstating the
General Business Law § 349 cause of action and remitting to
the Appellate Division, First Department, for consideration of
issues raised but not determined on the appeal to that court
and, as so modified, affirmed. Opinion by Judge Rosenblatt.
Chief Judge Kaye and Judges Levine, Ciparick and Wesley concur.
Judge Bellacosa dissents in part and votes to affirm in an
opinion. Judge Smith took no part.
Case No. 174: Order modified, without costs, by reinstating the
General Business Law § 349 cause of action and remitting to
Supreme Court, New York County, for further proceedings in
accordance with the opinion herein and, as so modified, affirmed.
Opinion by Judge Rosenblatt. Chief Judge Kaye and Judges Levine,
Ciparick and Wesley concur. Judge Bellacosa dissents in part and
votes to affirm in an opinion. Judge Smith took no part.
Decided
Guardian moved to dismiss in a preanswer motion, made
before plaintiffs sought class certification.
2
These clauses typically stated that "[t]he actual
provisions set forth the full details and conditions of this
policy; only the actual provisions will control."
3
Guardian allegedly informed Frank Gaidon that he would be
required to pay premiums for the rest of his life.
4
The complaint included causes of action for fraud,
fraudulent inducement, breach of fiduciary duty, breach of
contract, negligence, negligent misrepresentation, unjust
enrichment and imposition of a constructive trust, declaratory
and injunctive relief, reformation, violation of General Business Law § 349 and violation of Insurance Law §§ 2123 and 4226.
5
Supreme Court held that, with the exception of the Gaidon
trustees, all plaintiffs lacked standing to assert any claims
against Guardian.
Specifically, the court determined Frank
Gaidon lacked standing because his policy was owned by trusts and
not Gaidon himself. The court further ruled that Frank and
Nicholas DeHamer and Kathleen Warner lacked standing because they
signed releases as part of forms Guardian required them to sign
to cancel their policies. Supreme Court then dismissed the Gaidon
trustees' fraudulent inducement claims and General Business Law § 349 claims, holding that Guardian did not make the alleged
misleading or fraudulent representations directly to the
trustees; rather, that its sales agents interacted only with and
made representations to Frank Gaidon himself.
6
MONY policies provide that "[t]he policy and the
application is the entire contract."
7
Plaintiffs asserted causes of action for fraudulent
concealment and deceit, negligent misrepresentation, reckless,
wanton and/or negligent supervision, breach of contract, breach
of fiduciary duty, fraudulent inducement, violations of Insurance Law §§ 4226 and 2123 and violations of General Business Law § 349.
8
The propriety of the class certification is not before us
on this appeal.
9
We are not persuaded by the assertion in the dissent that
defendants are, as a matter of law, relieved of General Business Law § 349 liability for having based their illustrations on the
then "current dividend scale" ( see, Dissent, at 8 [discussing 11
NYCRR 219.4(n)]). Rule 219.4(n) was promulgated to preclude
insurance companies from depicting speculative interest rates
above those currently paid by the carrier. It certainly does not
mandate that a carrier project a premium payment plan that it
allegedly knows to be unsustainable, while revealing nothing as
to the improbability of the projection.
10
We note also that 25 states have adopted measures similar
to these regulations expressly aimed at combating alleged
deception caused by "vanishing premium" illustrations ( see, e.g.,
Cal Ins Code § 10509.955; 40 Penn Stat § 6258; RI Gen Laws § 27625; Ala Ins Reg 114, § 6; 3 Alaska Admin Code 28.815; Colo Ins
Reg 418, § VI; Conn State Agencies Regs § 38a81961; Code of
Del Regs 50000062; 50 Ill Admin Code 1406.70; 191 Iowa Admin
Code 14.6, 15.3[507B]; Maine Bureau of Ins Rule Ch 910, § 6; Miss
Dep't of Ins Regs 982; 210 Neb Admin Code § 72006; Nev Admin
Code 686A.4785; NJ Admin Code § 11:441.24; 11 NC Admin Code
4.0504; ND Admin Code § 450401.104; Ohio Admin Code Ann 3901604; Okla Admin Code 365:10354; Oregon Admin Rules § 8360510540; SC Code Regs 6940; Ann Rules of South Dakota §
20:06:38:05; Texas Admin Code § 21.2206; Utah Admin Code R5901776; Code of Vermont Rules 21020042, § 6; Wisc Admin Code Ins
2.17).
11
We further note that courts in other jurisdictions have
sustained deceptive trade practice causes of action under
statutes similar to New York's ( see, e.g., Nepomoceno v Knights
of Columbus, No Civ A 96 C 4789, 1999 US Dist LEXIS 1366 [ND Ill
Feb 8, 1999]; Force v ITT Hartford Life & Annuity Ins. Co., 4 F
Supp2d 843 [D Minn 1998]; Parkhill v Minnesota Mutual Life Ins.
Co., 995 F Supp 983 [D Minn 1998]) .
12
See generally, 2 Harper & James, Law of Torts, § 7.14 (2d
ed 1986); Prosser & Keeton, Law of Torts, § 106 (5th ed 1984).
"When using an illustration in the
sale of a life insurance policy, an
insurer * * * shall not * * * use
the term 'vanish' or 'vanishing
premium' or a similar term that
implies the policy becomes paid up,
to describe a plan for using nonguaranteed elements to pay aportion of future premiums." ( see,
11 NYCRR 533.2[b][8]).
"the illustration must clearly
disclose that a charge continues to
be required and that, depending on
actual results, the premium payer
may need to continue or resume
premium outlays. Similar
disclosure shall be made for
premium outlay of lesser amounts or
shorter durations than the contract
premium. If a contract premium is
due, the premium outlay display
shall not be left blank or show
zero unless accompanied by an
asterisk or similar mark to draw
attention to the fact that the
policy is not paid up (11 NYCRR 533.3[13] [emphasis added]).
"This illustration assumes that the
currently illustrated nonguaranteed elements will continue
unchanged for all years shown. This is not likely to occur, and
actual results may be more or less
favorable than those shown" (11
NYCRR 533.3[b][5][emphasis
added]).
[n.10]
Notes
1
Named plaintiffs are Frank Gaidon, Frank DeHamer, Nicholas
DeHamer and Kathleen Warner, along with Allen Glass and Barbara
Gaidon, as trustees of two different trust funds that at
different times owned the life insurance policy on Frank Gaidon's
life. Frank Gaidon, himself, never owned the policy.