25 Ind. App. 608 | Ind. Ct. App. | 1900
—Appellee sued appellant upon a policy of insurance upon the life of her husband, deceased. The complaint was in two paragraphs. The first alleged full compliance with all the conditions of the policy, and the second alleged compliance with the conditions except as'to furnishing proofs of death, which, it was averred, were waived. A copy of the policy is made a part of each paragraph. To this complaint appellant filed 'an answer in three paragraphs: (1) General denial; (2) breach of warranty contained in the so-called certificate of health and revival contract, in this, that in said certificate of health and revival contract, the insured stated that he had not consulted or been prescribed for by any physician, or received any medical treatment since the date of the original application, when, in fact, the insured had consulted, been prescribed for, and received medical treatment for inflammatory rheumatism in 1894; (3) breach of warranty contained in the
The first paragraph of reply was a general denial. The second was addressed to the third paragraph of answer, and sets forth facts showing that the answer as to diseases, etc., which appellant alleges to be false, was not false in any material respect, and alleges facts showing good faith of insured in making the statement within the statute of Pennsylvania relating to representations in applications for life insurance, which statute is set out in the reply, and is as follows: “That hereafter, whenever the application for a policy of life insurance contains a clause of warranty, of the truth of the answers therein contained, no misrepresentation or untrue statement in such application made in good faith by the applicant, shall effect a forfeiture or be a ground of defense in any suit brought upon any policy of insurance issued upon the faith of such application, unless such misrepresentation or untrue statement relate to some matter material to the risk.” The fifth is also addressed to the third paragraph of answer, and is, in effect, the same as the second. The sixth is addressed to the second paragraph of answer. It takes up each separate allegation of the second paragraph of answer and denies the same, pleads the 'statute of Pennsylvania set forth in the second paragraph of reply, and alleges facts showing the good faith of insured in making the statements in the health certificate and revival contract.
A demurrer was filed to the second, fifth, and sixth paragraphs of reply, and same was overruled as to each. Trial was had and verdict and judgment rendered in favor of appellee for $2,175. The jury also answered interrogatories propounded by the court.
The demurrer to the second paragraph of reply to the third paragraph of the answer was overruled. The third paragraph of answer bases the defense upon the policy and written application of the insured. Counsel for appellee make the point that inasmuch as neither the policy nor the application is made a part of this paragraph, it is bad; citing Supreme Lodge, etc., v. Edwards, 15 Ind. App. 524, and Landon v. White, 101 Ind. 249, arguing therefrom without conceding that the third paragraph of reply is bad, that if the second paragraph of reply, which is addressed to the third paragraph of answer is bad, it is good enough for a bad answer. The policy, which is made a part of the complaint, and is the foundation of the action, reads: “In consideration of the application for this policy, which is made a part hereof, a copy of which is hereto attached.” The application is indorsed upon the policy. The policy in suit is referred to in the answer, and statements in the application alleged to have been false are set out in the answer. There is much force in the claim of appellant’s counsel that the application is a part of the policy. The reference to the policy in the answer obviates the necessity of making it an exhibit to the answer. But conceding, without deciding,
The third paragraph of answer avers that the insured was sick of la grippe for two weeks; that he was prescribed for and attended by a physician. The second paragraph of reply, after denying that he had la grippe, alleges that if he did have the same, the medical examiner of appellant knew the fact; that such examiner, upon examining the insured, stated to him that he was a first class risk, physically sound and a fit subject for life insurance; that the insured believed this. It then alleges the Pennsylvania statute set out at page two of this opinion regarding the effect of misstatements in the application, and avers that the alleged attack of la grippe was not la grippe but a severe cold, which yielded readily to treatment; that it did not affect the physical condition of the insured; that no bad effect of a permanent nature resulted therefrom to the insured, and that his death was not in any manner hastened nor caused thereby. From the averments of this part of the reply, it, appears that the knowledge of the illness of the insured, which it is alleged appellant had at the time it accepted the application and issued the policy, was acquired by reason of the fact that the medical examiner of the company was intimately acquainted with the insured and was the partner of his family physician who had treated him for the diseases, the knowledge of-which, he concealed from the com
In Fidelity, etc., Assn. v. Ficklin, 74 Md. 172, 21 Atl. 680, 23 Atl. 197, the Maryland court of appeals held that the 'policy of appellant was a Pennsylvania contract and controlled by its laws, using the following language: “Everywhere, within and without the state which created it, its contracts are limited, construed, and sustained according to its charter, and the laws which affect its operation. In McKim v. Glenn, 66 Md. 484, 8 Atl. 130, this court said: ‘It is á familiar principle, that a corporation, and all who deal with it, are bound by the law of its creation, and all
In Penn Mutual Life Ins. Co. v. Mechanics, etc., Co., 19 C. C. A. 286, 72 Fed. 413, 38 L. R. A. 33, 56, it is said: “This is one of a class of statutes passed in many states to relieve against the hardships arising from the strict enforcement at common law of warranties in insurance policies concerning matters having no real or proximate relation to the risk assumed by the insurer. By the aid of such warranties, and the innocent mistakes of the insured, it often happened that the insurer was able to escape liability on a ground having no real merit, and of the purest technicality; that such statutes are remedial in their nature, and are quite within the police power of the legislature, is no longer a debatable question * * *. The statute has been construed by the supreme court of Pennsylvania, and our conclusions above stated are in accordance with the views of that court. * * * The construction of a state statute by the highest court of the state is usually authoritative in courts 'of the United States. * * * And, even if it were otherwise, we should reach the same conclusion in this case.”
Ooupsel for appellant question the application of the Pennsylvania statute only upon the ground that it does not contain the word “warranty” which word is used in the statute. The use .of the word “warranty” is not necessary to make a warranty. Jones v. Quick, 28 Ind. 125; Long v. Anderson, 62 Ind. 537. It is agreed in the application that the statements contained therein are material; they have the effect of express warranties. The failure of the insured to state in his application that he had had a severe cold and
In Billings v. Metropolitan Life Ins. Co., 70 Vt. 477, 41 Atl. 516, the insured was required in the application to give full particulars of any illness had since childhood and name the medical attendant or attendants. In construing this question, the court said: “A mere temporary indisposition, not serious in its nature, such as indicated by the evidence on the part of the defendant, other than measles can not be considered an illness, and the mere calling into a doctor’s office for some medicine to relieve such temporary indisposition, or the calling at the home of the insured by the doctor for the same purpose, can not be considered an attendance by a physician,.nor a consultation with a physician, within the meaning of the question. ‘Illness,’ as used, means ‘a disease or ailment of such a character as to affect the general soundness and healthfulness of the system seriously, and not a mere temporary indisposition which does not tend to undermine and weaken the constitution of the insured.’ ” See, also, Northwestern, etc., Co. v. Heimann, 93 Ind. 24; Continental Ins. Co. v. Yung, 113 Ind. 162; Connecticut, etc., Co. v. Union Trust Co., 112 U. S. 258, 5 Sup. Ct. 119, 28 L. ed. 708; Bacon on Ben. Soc., etc., (2nd ed.) §234, and authorities there cited; Germania Ins. Co. v. Rudwig, 80 Ky. 223.
Counsel for appellant cite many cases in support of its claim, among them the five cases following, from the supreme court of Pennsylvania. In Mutual Aid Soc. v. White, 100 Pa. St. 12, the insured in his application misstated his occupation. The court held that the insured’s occupation was material to the risk. In Mutual Aid Soc. v. O’Hara, 120 Pa. St. 256, 13 Atl. 932, it was pleaded that the insured had consulted physicians generally, and, not as in the case before us, that he had consulted a physician for a specified disease.
Counsel for appellant argue that the deceased having agreed that the answers were material, and the answer to the eomplaint averring the misrepresentations thereof, that the deceased had been treated by a physician, it was not competent to evade such by the averment that although it was true that he had misrepresented the facts, yet because the disease and the treatment by the physician left no vice in his constitution that the company was not therefore relieved from its liability. We think it may be conceded that the concealment of the fact that the insured had had a cold which yielded readily to treatment was not a misrepresentation of a material fact; but under the decisions, we are of the opinion that a statement of the insured in his application that he had not been attended or treated by a physician, was a misrepresentation of a matter material to the risk. An untrue answer to the question as to whether the insured had been accepted or rejected by another company is a material misrepresentation or concealment which will avoid whether the answer is made a part of the contract or no'Biddle on Ins., §783. A statement by an applicant in answer to a question that he had been accepted at the ordinary rate, when in point of fact he had been declined at one office and accepted at another but nothing further done, was thought by the court to be a suppressio veri. Fowkes v. Manchester, etc., Ins. Co., 3 F. & F. 440. Where in answer to a question as to whether he had been rejected the applicant stated that he was in process of negotiation with another office, and in fact, though he was negotiating, his
Whether a misrepresentation by an applicant for insurance is material is a question of law when the facts are ascertained. American, etc., Soc. v. Bronger, 11 Ky. Law Rep. 902, 15 S. W. 1118. A false answer in a written application for life insurance to a question as to whether any other company had declined to carry a policy on the applicant’s life was a material misrepresentation and avoided the policy. In Mutual Aid Soc. v. While, 100 Pa. St. 12, 16, the applicant stated in his application that he was a, laborer and a widower. His answers in this respect were false. The court held that the questions are material not only in this, but by the terms of the agreement.
A false statement that the insured had not applied to any other company and been rejected voids a policy of life insurance, although the insured in making it believed it to be true, and the agent of the company knew it to be false when it was made. Clemans v. Supreme Assembly, 131 N. Y. 485, 30 N. E. 96, 16 L. R. A. 33. A policy of insurance is voided by a false statement in an application that no foreign insurance company has declined to grant a policy on the life of the insured. Kemp v. Good Templars, etc., Assn., 64 Hun 637, 19 N. Y. Supp. 435.
It is for the court to rule whether or not a matter is material, and for the jury to determine whether the statements concerning such matters material are substantially true. Bacon on Benefit Societies and Life Ins., §212; Campbell v. New England, etc., Ins. Co., 98 Mass. 381; Davenport v. New England, etc., Ins. Co., 6 Cush. (Mass.) 340; Phoenix Life Ins. Co. v. Raddin, 120 U. S. 183, 7 Sup. Ct. 500, 30 L. ed. 644; Day v. Mutual, etc., Ins. Co., 1 McArthur (D. C.) 41, 29 Am. Rep. 565.
In Carson v. Metropolitan Life Ins. Co., 1 Pa. St. 1, it was held that parties to a contract by the very written stipulations settle for themselves all question as to its materiality. The test of materiality of a misrepresentation or concealment in a contract of insurance is that it influences the insurer in determining whether to accept the risk or not. If the insured conceals from the insurer the fact that prior to the date of the policy he had been attended for a serious disease, there can be no recovery, and the fact that he did not die from the disease for which he was attended has no proper place in the consideration of the question. In this
In Joyce on Insurance, par. 2070, the authority cites and summarizes numerous cases. Some of them we give. “If specific inquiries are made whether the assured has medical attendance within a stated period of1 time, the fact is thereby made material, and must be disclosed.” Mutual Aid Soc. v. O’Hara, 120 Pa. St. 256, 13 Atl. 932, where the inquiry was made, “How often has medical attention been required ?” and the answer was “Two years ago,” and the name of the medical attendant being asked, assured gave the name of Doctor E-, who had in fact attended him about a year before, but the assured did not disclose the fact that he had a relapse shortly thereafter when he was attended- by Dr. 0. and that three physicians in attendance had despaired of his life; such information was found immaterial by the jury, and no intended fraud existed; nevertheless, the policy was declared void. Cazenove v. British, etc., Co., 29 L. J. C. P. 160.
In Metropolitan Ins. Co. v. McTague, 49 N. J. L. 587, 9 Atl. 766, it is -held that the statement by the assured that he has not been prescribed for by a physician is falsified by the fact that a physician has prescribed for a cold. This decision is cited with approval in Cobb v. Covenant, etc., Assn., 153 Mass. 176.
In White v. Providence, etc., Soc., 163 Mass. 108, 39 N.
In Brown v. Metropolitan Ins. Co., 65 Mich. 306, 32 N. W. 610, it is held that where the name of the physician who had last attended was asked, that this must be construed to mean an attendance for some disease of .importance and not a mere temporary indisposition.
In World, etc., Ins. Co. v. Schultz, 73 Ill. 586, it is held that if the inquiry is as to the last medical attendant the fact is so far rendered material that it must be disclosed or truly stated. The insurer may desire to consult with the medical man who was last in attendance, since the information possessed by him may have an important bearing upon the risk and influence largely the judgment of the insurer. If the name of the last medical attendant is asked, it must be given whether he be a quack or regular physician. Everett v. Desborough, 5 Bing. 503. Concluding section, 2070, supra, Joyce says: “In all cases, however, where questions are asked as to assured’s medical attendant, consultation of physician, medical treatment, and the like, the assured should answer in good faith; having in view that the obvious purpose of the inquiry, manifest’ from the words used, should be considered. If in the light of the evidence presented it is apparent that the assured’s answer can be viewed otherwise than-as evasive and incomplete, and as intended to prevent a disclosure as to past health from the physician who could best give information as to the same, or to t prevent further inquiry by the assurer, then such evasive or incomplete answer ought to avoid the contract. But courts should not by construction in any ease force words out of their ordinary and accepted meaning, and if
The latest case to which our attention has been called is March v. Metropolitan, etc., Ins. Co., 8 Ins. L. J. (N. S.) 30, 40 Atl. 1100. The case was decided by the supreme court of Pennsylvania in January, 1899. It was one involving the statute in question. After quoting the section of the statute upon which appellee in this case relies, the court say:' “The meaning of this language is perfectly plain. A misrepresentation or untrue statement in an application, if made in good faith, shall not avoid the policy unless it relate to some matter material to the risk. If it does relate to such matter, the act is inapplicable. If the matter is not material to the risk, and the statement is made in good faith, although it is untrue, it shall not avoid the policy. As we said in Hermany v. Association, 151 Pa. St. 17, 24 Atl. 1064, this act has effected a change in life insurance policies, and a very wise and wholesome change it is. It provides against the effect which formerly attached to warranties as to many frivolous and unimportant matters contained in the questions and answers set forth in the applications, which often were of no consequence as to the risk involved, but which the courts were obliged to uphold simply because they were warranties. This class of merely technical objections to recovery is now swept away. Ordinarily questions of good faith and materiality are for the jury, and, where the materiality of.a statement to the risk involved iá itself of a doubtful character, its determination should be submitted to the jury. But it was never intended by the act of 1885, nor did that act assume, to change the law in cases where the matter stated was palpably and manifestly material to the risk, or where it was absolutely and visibly false in fact. * * * * A strong case
The averment in the answer that the insured was attended by and prescribed for by a physician was of a material fact. The reply does not meet this averment. It follows that it was only a partial reply to the paragraph in question.
The fifth paragraph of reply is subject to the same objections made to the second. The authorities heretofore cited apply. The sixth paragraph seeks to avoid the materiality of the agreement made between the defendant and the insured by a statement of facts. It is bad under the authorities cited.
The tenth specification of error is based upon the action of the court in refusing leave to the defendant to amend the interrogatories propounded to the jury after it had returned the general verdict, and before it had returned answers to interrogatories, and to require the jury to return to the jury box and return answers to the interrogatories as amended, and in directing the jury to sign answers to interrogatories as they stood. This action is assigned as a reason for a new trial. The facts, as shown by the bill of exceptions, are as follows: Interrogatories were prepared by both appellant and appellee and were submitted by the court to the jury. In interrogatories three, five, ten, eleven, twelve, thirteen, fourteen, fifteen, sixteen, seventeen, eighteen, nineteen, counsel for appellant, after the jury had returned into the court room with their general verdict, and after the general verdict had been signed, and the interrogatories to the jury read with the answers of the jury to each interrogatory, claimed to have discovered a mistake in the interrogatories, in this, to wit, that in each of said interrogatories the year “1895” had been written when it was intended to write therein the year “1894,” and counsel for appellant there
Judgment reversed, with instructions to sustain the demurrers to the third, fifth and sixth paragraphs of reply.