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Goot v. Metropolitan Government of Nashville and Davidson County11/9/2005
erstanding of how the waiver of premium provision worked; (2) that her spouse either did not receive timely information regarding the waiver of premium benefit or received erroneous information regarding their eligibility for the benefit; (3) that her spouse would have applied for the waiver of premium benefit in a timely manner had he known about it; (4) that her spouse met all the requirements for the benefit; and (5) that as a result of her spouse's failure to submit a timely application for the waiver of premium benefit, she received a death benefit of $7,500 rather than the $50,000 benefit she would have otherwise received. On cross-examination, each of the surviving spouses testified that they had not read the group life insurance contract and that they had gained their understanding of the operation of the waiver of premium provision from employees of the Metropolitan Benefit Board.
The surviving spouses also presented the testimony of two former employees of the Metropolitan Benefit Board who described the Metropolitan Government's haphazard approach to informing disabled employees of the waiver of premium provision or how to qualify for it. During its cross-examination of these employees, the Metropolitan Government introduced into evidence one page of the thirteen-page letter purportedly given to all employees who qualified for a disability retirement. This letter contained the following statements regarding the waiver of premium provision:
With the effective date of your disability pension, your life insurance, under coverage provided by The Metropolitan Government, will be reduced to $7,500 unless you are totally disabled. If you are totally disabled and are less than sixty (60) years of age, then you may apply for a waiver of premium and the amount of insurance that you had in effect as an employee will continue in effect. You are considered to be totally disabled if you are completely prevented by injury or sickness from doing, for pay or profit, any work for which you are fitted by education, training, and experience. The amount of your insurance coverage will be $7,500 at age 65.
Should you die within the first (1st) year of being on a disability pension, the amount of insurance that was available to you as an employee is still in effect if it can be shown that you were totally disabled. If you are totally disabled, you may continue to be covered for the amount that you received as an employee if you file proof of your disability within one (1) year of going on disability. If you wish to file such a claim, you should contact the Benefit Board Office and we will assist you in processing that application.
Thus, when the surviving spouses closed their case-in-chief, the following proof was before the jury: (1) that the Metropolitan Government offered group life insurance containing a waiver of premium provision to its employees; (2) that all city employees received life insurance coverage equal to twice their annual salary up to $50,000; (3) that the life insurance benefit for employees on disability retirement was $7,500; (4) that employees who became totally disabled before their sixtieth birthday were eligible for the waiver of premium benefit and that if they qualified for the benefit, their life insurance coverage would continue at the level it was when they were active employees; (5) that the spouses of each of the plaintiffs became disabled before their sixtieth birthday and that they were totally disabled; (6) that the Metropolitan Government was required to provide all its employees with "full information" of their rights and status regarding their benefits; and (7) that neither the employee spouses nor the plaintiffs were provided "full information"
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