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Fox v. Catholic Knights Insurance Society
649 N.W.2d 307
Wis. Ct. App.
2002
Check Treatment

*1 J. minor, Austin T. Fox, Fricker, Matthew guardian Plaintiff-Appellant, litem, ad

v. Knights Society, Wisconsin Catholic Insurance corporation, Defendant-Respondent. †

Court of Appeals No. 01-1469. Submitted on February 2002. Decided briefs April App 2002 WI (Also 307.) reported 649 N.W.2d granted † Petition to review 7-29-02. *3 plaintiff-appellant, of the cause was On behalf the T. of the briefs Matthew Fricker Kersten submitted on McKinnon, S.C., of Milwaukee. & defendant-respondent, the cause of the

On behalf of Michelle M. Stoeck was submitted the brief Legal Group, Ltd., of Hills Waukesha. Wedemeyer, Schudson, RJ., Fine and JJ.

Before by guard- J. his SCHUDSON, Fox, i. J. Austin (Fox) appeals T. from the litem, Fricker, ad Matthew ian summary granting judg- order court's amended circuit (CKIS), Society Knights Insurance ment to Catholic summary judgment, denying and dis- motion for his prejudice. missing complaint and on merits with his concluding argues that circuit court erred Fox policy father, for his life CKIS had taken effect the time Patrick Fox, Patrick not therefore, contends, Fox in a car accident. died summary judgment upholding granting court erred policy $150,000 his under denial of claim CKIS's applied. Patrick had for which circum- that under unusual conclude We by operation of Wis. case, this

stances of 631.11(3) (1999-2000),1 in effect Patrick's *4 if a a his even blood test was the time of death at policy, precedent even to the activatiоn condition having though test, and even Patrick died before performed only though on been test could have blood are to the Wisconsin Statutes All references indicated. unless otherwise 1999-2000 version the blood that had been drawn from Patrick following his fatal accident.2 Accordingly, we reverse.

I. BACKGROUND 3. The facts relevant resolution of this appeal are According to undisputed. and sum- complaint mary judgment submissions, May 21, 1997, Patrick Fox completed CKIS For "Application Membership And Life $150,000 Insurance" for a term life insurance policy, Austin, years old, then naming two as the primary beneficiary for benefits payable upon Patrick's May 21, 1997, death. Also on Patrick CKIS paid $31.94 for the first premium. 4. The included application titled, a section "Re- For

ceipt Payment Conditional Insurance Agree- which ment," provided, relevant part: Coverage A. Amount.

The amount of insurance that is effect Agreement Proposed this each In- sured is the applica- amount shown in the tion .... Coverage

B. Limitations. coverage

2. No shall be in per- force if the 2Resolving the appeal on this basis obviates the need to the interesting arguments address parties present on sev eral of Fox's theories challenging the circuit court's conclusion. (1938) Hoffman, See Gross v. 227 Wis. 277 N.W. addressed). (only dispositive issue need be acknowledge, We do however, argued, things, that Fox has among other policy regardless Patrick's in was effect whether blood testing opinion, done. In this we will assume that the required testing coverage blood before could commence.

son(s) is not a proposed to be insured risk in accordance with CKIS insurable rules .... Coverage (subject to the Limitations in Begins

C. When above) section B

Coverage Agreement begins of on latest under ‍​​‌​​​​‌​‌​​​​‌‌‌​‌‌‌‌​‌‌​‌​​‌​‌‌‌‌​‌​​​​​‌‌‌‌‌​‍this the following dates: the application of

—The date this Agreement —The date of this ' requested effective specifically —The date application completion of of all examina-

—The date required by medical tions and studies practices rules and of CKIS. original.) (Underlining added; and italics in bold application titled, ¶ a The also included section 5. containing questions "Agent's Report," insur- for the applicant, completing agent with ance concluding the form stating: medical "Check with subsection options, requirements four There followed ordered." agent allowing "Blood," "Exam," to indicate whether Specimen" required. On was "EKG," "Urine and/or only agent application, an "x" in entered Patrick's for "Blood." the ’Yes"box his blood Patrick scheduled have 6. appointment, May cancelled that 30,1997.

drawn He of June for the afternoon however, and rescheduled morning early Tragically, of June hours and face trauma of massive head Patrick died as result Shortly death, after his in a car accident. suffered sample County Karen Baker drew a Coroner Washburn blood, his which was to the forwarded Wisconsin State Laboratory Hygiene.3 7. CKIS refused to any death benefit. Fred pay *6 Muenkel, Services, W. CKIS Vice President for Member father, Fox, wrote Patrick's Bernard in exрlaining, part: Although [Patrick] did blood have a draw scheduled death, to he prior his canceled the blood draw and did prior one application not have done to his death. The process and the need for a fully [sic] blood draw was at the time of explained application application and the signed acknowledgement includes of procedures such requirements. and Because of the failure obtain to necessary draw, blood the life policy never took effect. result,

As a CKIS refunded the initial premium pay- estate, ment to Patrick's but denied insurance coverage. 19, 1997, 8. On at August Patrick's father's request, Thomas Attorney Graham wrote Vice Presi- Muenkel, dent enclosing 29,1997 a July letter from the Washburn District County Attorney to Patrick's par- ents regarding the of sample Patrick's blood drawn following fatal accident and retained the Labo- ratory Hygiene.4 Attorney Graham's letter con- cluded, in relevant part: judgment In a number of the summary submissions to refer, Laboratory

which will Hygiene we the Wisconsin State referred as "the State Crime Lab" or variations of those terms. July letter, The County from Washburn District Attorney Bitney J. Fox, stated, Michael to Donna and Bernard in part: inquired rеgarding Our office has from the coroner's office any sample your son, blood taken from Pat. Ms. Baker advises that sample taken, a blood was that it sent to the Crime State Madison,

Lab in WI. the Estate of Patrick of Bernard Fox and On behalf sample blood you use that Fox, I ask that would May Fox on insurability of Patrick determine arrangements make with you I would ask 1997. of that shipment Lab for State Crime the Wisconsin testing facility or medical sample to whatever blood Mr. Fox's insur- you to use to determine facility wish so, doing I would be you If need assistance ability. you. to assist happy Muenkel President 26,1997, Vice August On Graham's Attorney declining a letter with

responded to obtain the laboratory the state to contact request Mr. Muenkel letter, provided In his sample. blood "no CKIS's conclusion for lengthy explanation Fox he before [Patrick] place was ever In he wrote: part, died." *7 gave Mr. that he agent] states [the importantly,

[M]ost Insurance Payment and Conditional for Receipt Fox a coverage [not] will clearly states that which Agreement of all examinations completion begin until "the date practices and by the rules required and medical studies ofCKIS." a Knights specifies Rate Book...

The Catholic applica- for all requirement a routine profile blood is $99,999. applied Fox Mr. coverage in excess tions for informed that Lab and were the Crime then contacted We sample may normally kept The samples for six months. are blood testing crime facilities. The only or to medical facilities he released facility. sample package to the and forward lab will sample you like the blood would let me know where Please then contact directed. I will it should be and to whom sent Court a they release the same without [sic] if will lab and see crime If, however, Pat's behalf. claim on an insurance Order to further private you suggest that contact they I [sic] refuse would cooperate with that you. officewill attorney for This to handle this attorney. $150,00[0] coverage, and, therefore, a blood profile was a condition of our Conditional Insurance Agreement form, without which a final decision for coverage insurance could not be made. The rate [b]ook explains that the profile blood is to be done one of paramedical our providers, with a analysis according done to our prescribed protocol by Osborne Laboratories. agent...

The attests fully explained that he of the Agreement terms Conditional Fox, to Mr. includ- ing the requirement that a blood draw would be needed from Mr. Fox before coverage could become effec- tive ....

... The purpose of the profile blood is to determine insurability of an applicant. Clearly, a person deceased Therefore, not insurable. a blood draw from a de- person ceased cannot be used to determine insurability. 10. Fox brought an action alleging breach of contract under the application the conditional and/or agreement. Resolving cаse on cross- motions for summary judgment, the circuit court stated it had "struggled with it back and forth" but ultimately concluded that C, section "When Coverage Begins," established that coverage had not begun that Patrick "died before the policy began."

II. DISCUSSION 11. Summary judgment methodology is used to ‍​​‌​​​​‌​‌​​​​‌‌‌​‌‌‌‌​‌‌​‌​​‌​‌‌‌‌​‌​​​​​‌‌‌‌‌​‍determine whether a legal dispute trial. U.S. requires *8 Oil Co. v. Servs., Midwest Auto Care Inc., 150 Wis. 2d (Ct. 80, 86, 1989). 440 N.W.2d 825 App. A circuit court must enter summary judgment when "the pleadings, depositions, answers to interrogatories, and admissions file, together with the affidavits, if any, show that

640 no issue as to fact and genuine any there is material is entitled to a as a moving party judgment 802.08(2). mattеr of law." Wis. Stat. § Reviewing granting summary judg ¶ 12. an order apply methodology employed by ment, we the same Milwaukee, Doe 211 circuit court. v.Archdiocese Wis. of (1997). Accordingly, 312, 332, 2d 565 94 we will N.W.2d only summary judgment "the reverse decision when genuine record that one or more issues of reveals dispute moving party fact are in or the material not judgment entitled to as a matter of law." Strasser v. Serv., ¶87, 30, Inc., Transtech Mobile Fleet 2000 WI 435, 2d 142. 236 Wis. 613 N.W.2d interpretation ¶ 13. The of an insurance contract question presents a of law we review de novo. Tower Chang, 667, 672, v. 230 2d 601 N.W.2d848 Ins. Co. Wis. (Ct. 1999), App. denied, 36, 2000 234 2d review WI Wis. Statutory pre 177, also 612 N.W.2d 733. construction subjеct question review. sents a of law to our de novo City Francis, v. St. 2d Gloudeman Wis. of (Ct. 1988). examining App. Here, N.W.2d applying and conditional insurance contract Wis. Stat. 631.11(3), § we conclude that CKIS was not entitled judgment and, indeed, that Fox was. as matter of law blush, C of the Conditional At first section coverage Agreement, specifying when be- Insurance gins, coverage preclude Patrick, because would seem "completion by death, not reached the time of his had required all examinations and medical studies practices however, case, In this Wis. rules CKIS." 631.11(3) might trumps be the what otherwise Stat. preclusive provision. effect of that §-631.11(3) provides:

¶ 15. Wisconsin *9 promis- of failure of condition or breach of Effect sory warranty. prior a condition to a No loss failure of promissory warranty and no breach of a constitutes grounds of, obliga- rescission or an insurer's affects under, tions an insurance unless it exists at the time the loss and either increases the risk at the time of the loss or contributes to the loss. This subsection of does not apply payment pre- to failure to tender mium. added.) To avoid the

(Emphasis statute's an impact, insurer has the to prove burden the "failure of a condition to а prior obligations loss" affects its under (1994) See Comment policy. to Wis JI — Civil (On § issues relating 631.11(3), Wis. Stat. "[t]he burden of is proof upon as to all company burden."). and it questions Here, is middle while the of a "failure of the completion blood test condition" — and required medical studies —existed at the time of the loss, it did not loss," and CKIS did "contributed not prove that it "increase at [d] risk the time of the loss."5 631.11(3) argues CKIS that Wis. "does not explic

itly state whether or not apply it was intended to to conditions precedent" and capable being ways "is construed different respect with to whether the term 'condition' includes сonditions precedent" ambiguous. and is therefore beyond CKIS then looks the statutory terms and contends that the statute simply is inapplicable to disagree. this case. We It is undisputed that CKIS and Patrick entered into a conditional insurance contract. It is undisputed completion of a blood test and related medical studies was a potentially affecting condition the date of coverage. statutory terms, The failure of a prior "[n]o condition loss," to a unambiguous clearly are applicable. See Peterson Co., 213, 8, v. Midwest Sec. Ins. 2000 App WI 238 Wis. 2d ("If clear, 617 N.W.2d language statutе's we look no Obviously, complete ¶ 16. the failure to the blood test and related medical studies did not contribute to in a accident, the loss. Patrick was killed car unrelated to his failure to the test. prove Further, CKIS did not that the failure *10 complete the blood and test related medical studies

increased the risk at the time of Patrick's death. Had accident, Patrick's blood been drawn before the CKIS arranged analysis could have of his blood to deter- was, mine he in whether the words of the conditional agreement, "a risk insurable accordance with CKIS Only study rules." the medical of Patrick's blood if something rightfully revealed his insur- reduced ability would "the risk at the timе of the loss" have been 631.11(3); § increased. See Wis. Stat. see also Wis JI— (1994) (providing, part, Civil that under Wis. 631.11(3), § "[r]isk is increased whenever the Stat. condition"). by chance of loss is increased a failure of the summary judgment ¶ Indeed, 18. CKIS's submis- very point. According sions clarified this to the affidavit Santiago, of Emma a senior underwriter for CKIS: The blood and urine test results are used to deter- mine a number of impact factors which the underwrit- ing policy including, decision on a life insurance but not to, disease, usage, limited tobacco indications of liver diabetes, kidney drug usage. function and finding sample

An in the blood or urine can adverse materially underwriting by affect the either decision increasing premium rating or declination to coverage. extend sample

Without a reliable blood and urine from the to the and circum simply apply further and statute facts us."), aff'd, stances before 2001 WI 248 Wis. 2d N.W.2d 727.

applicant, complete [CKIS] is unable the underwrit- ing guidelines. in accord its process with standards analyzing following Thus, 19. the blood drawn Patrick's fatal accident could have enabled CKIS to insurability determine whether his would have been by any through condition, affected detected blood test- ing, [d] "increase risk at the time" of his death. 631.11(3). § pеrforming See Wis. But not Stat. analysis precluded determining CKIS from whether a failure to "all examinations and medical stud- required by practices CKIS," ies the rules and under pre- contract, of the section C conditional would have the detection of a condition vented that would have [d] at "increase the risk the time" of Patrick's death. See 631.11(3). Wis. presents intriguing Nevertheless, CKIS two that, if correct,

fact-based theories analysis. could counter our theory, substantially misrepre- however, One *11 supportable, record; other, the the sents while more still fails. ‍​​‌​​​​‌​‌​​​​‌‌‌​‌‌‌‌​‌‌​‌​​‌​‌‌‌‌​‌​​​​​‌‌‌‌‌​‍in First, court, 21. its brief to this CKIS writes "required sample

that it а both blood and urine as a coverage subject condition to commencement of the ato insurability," determination of sample and that "no urine required as for this level of insurance was ever documentary record, however, submitted." The refutes CKIS's contention that Patrick's conditional contract required sample. Santiago a urine the While affidavit "[w]ithout sample states that a reliable and urine blood applicant, [CKIS] from the is unable to underwriting process in accord with its standards and guidelines," agent's and while affidavit stated that he told Patrick "the that terms of the Conditional Agreement required Insurance that a blood and urine specimen analyzed coverage be collected and before required only effective," could become Patrick's contract added.) (Emphases noted, a blood test. As on Patrick's agent application, indicating an "x" did not enter Specimen" among require- that "Urine was the "medical ments ordered."6 argues post- Second, CKIS that Patrick's sample satisfy require-

mortem blood not would its Lee, ments. CKIS relies the affidavit of Dr. Charlotte Senior Vice-President and Medical Director of Osborne independent testing labоratory Laboratories, an "performed analysis [CKIS] blood and urine tests for applications," post- life insurance stated that "the who sample mortem blood collected from Patrick ... would sample rendering not have in been useful reliable test required by underwriting [CKIS] require- results for its explained, sample ments." She "Since the blood uncentrifuged, the chemical constituents would have period become altered over the of death time between specimen and the date the was made available for re-testing." laboratory Thus, concluded, the she results

6 CKIS, court, writes, "[CKIS] its brief to this also undergo requires applicants paramedical life insurance providing samples." exam which includes blood and urine added.) assertion, (Emphasis support In of that it cites the containing Payment "Receipt document and Conditional Agreement" of Insurance "Notice Insurance Informa document, however, referring tion This while Practices." "completion required all examinations and medical studies CKIS," does practices specifically rules and not refer to testing blood or urine and does not substantiate CKIS's claim *12 809.19(l)(e) (3)(a) any way. (appel other See Wis. Stat. Rule & authority arguments supported by late must be and record references). testing sample "would not be accurate for

from testing purposes." persuaded. not We are opined, if, Dr. Lee Patrick's blood 23. Even as "uncentrifuged" sample not accurate and "would be was testing purposes," nothing in Patrick's for insurance insurability any specific on contract conditioned his timing methodology or for the "medical studies." Nota- summary judgment sug- bly, submissions while the gested analysis "according done that blood was to be [CKIS] prescribed protocol Laboratories," Osborne Agree- concedеs that "the Conditional Insurance CKIS require medical be ment does not that studies living." applicant conducted significantly, any possible inaccuracy And most while study

in the uncentrifuged testing purposes" blood "for insurance punctuates point: post-mortem with or without testing, simply prove blood CKIS could not sample provide a his Patrick's failure to blood before "increase[d] loss," the time of the death the risk at 631.11(3). under Wis. by insisting sample Thus, CKIS, a that urine required, by claiming only needed and

"centrifuged" sample pur- blood would have served its poses, appellate quick- theories in factual anchors its may by adding not assist conditions to sand. We CKIS Equitable contract. Brown v. Co. its See Ins. Life (1973) Iowa, 620, 630, 2d 60 Wis. N.W.2d 431 involving "insurability" (considering case as "condition coverage, precedent" appellate to insurance court does power not have "the to create a new contract for the may deny coverage parties"). And CKIS not based ultimately, emerges what, as failure to even its own attempt perform the medical studies its conditional required. Variance, Losinske, Inc. v. contract See *13 (1976) ("[A]party may 31, 40, 2d Wis. 237 N.W.2d not advantage take of a failure of a condition when it has unjustifiably рrevented taking that condition from (life place."); Brown, see also 2dWis. at 627 insur applicant's ance death does not eliminate insurer's obligation complete good investigation to faith to ascer applicant tain whether was "insurable as a standard liability risk" so as to determine insurer's under condi receipt); tional Smith v. N. Am. Co. & Health for Life (7th 1985) (where Ins., 775 F.2d Cir. life applicant during application died time of processing, duty-bound insurer "was its investigation, investigation and if the had shown that (if survived) [the applicant] he had would have been contractually entitled to the issuance of the insuranсe paid premium," on which he the first insurer applicant's would have owed beneficiaries face value of policy).

¶ 25. Therefore, under the unusual circum- completion" language case, stances of this the "date of triggered postpone section C was not and did not coverage. coverage began, commencement Patrick's express "[t]he C, under the terms of section date of application" "[t]he Agreement": this May date of this days

21, 1997—sixteen before his death. Accord- ingly, grant- we conclude that the circuit court erred in ing summary judgment; CKIS's motion for we reversе entry granting and remand for the of an order Fox's summary judgment.7 motion 7 Fox also asks this court to conclude that CKIS owes 628.46(1). prejudgment § under interest Wis. Stat. Fox ac knowledges, however, granted that because the circuit court summary judgment CKIS, it did not reach the interest issue. remand, On request. the circuit court can consider Fox's

By and cause remanded the Court.—Order reversed with instructions. ‍​​‌​​​​‌​‌​​​​‌‌‌​‌‌‌‌​‌‌​‌​​‌​‌‌‌‌​‌​​​​​‌‌‌‌‌​‍(dissenting). WEDEMEYER, I EJ. write majority

separately from I believe the trial because 631.11(3) correctly ruled that Wis. does court apply case, not to this and that because blood *14 the died, not drawn from Patrick until after he life go poliсy did not into effect. insurance significant development ¶ a in the 27. This is case of insurance law as it is the first Wisconsin case 631.11(3). § interpret I conclude that the Wis. Stat. majority incorrectly interpreted Al- has the statute. though the unusual and unfortunate circumstances presented generate sympathy in this case for Patrick by family, and his our decision cannot be influenced by lan- circumstances, those but must be decided the guage language of the statute and the of the insurance provisions saying "tough involved. There is an old happen I law," cases make bad and fear that is what will published. here if this case is summary judg- ¶ noted, 28. As our review on interpretation decision, statute, ment of a and the interpretation present of an insurance contract issues independently. law, which this court reviews agree I 29. with the trial court that Wis. Stat. §631.11(3) trump provisions does not the contractual apply involved it does not under the circum- because presented by statutory this case. section stances This policy applies after the to conditions comes policy into effect. Because the insurance here never 631.11(3) § apply. effect, went into does not My supported seрarate ¶ 30. conclusion is four statutory language suggests First, sources. itself requirements apply, that for the under the statute to policy in effect. See Wis. must be an insurance there 631.11(3) ("No of a condition ... affects failure {an insurance] obligations under insurer's added). jury (emphasis policy....") Second, in- clearly imply on this statute and comment structions policy only applies is in effect. after that the statute examples of the "condition" The instructions use two the insured's in the statute. The first was referred to night premises" on the "failure to have a watchman inflammables the insured stored the second was where premises. The comment on the Wis JI — Civil 3105. one the statute refers to is states that the "condition" something [s] require or shall not be shall "that added). (Emphasis policy takes effect."Id. done after suggest that "condition" The instructions/comment 631.11(3) precedent, §in is not a condition referred to Rather, takes effect. which must occur before the an that takes the statute is event the "condition" under place being. into after the contract has come history legislative My third source is the *15 legislative com- The committee behind the statute.1 631.11(3) § explain: ments to Wis. Stat. balance, the protecting

This draft seeks a better of conditions that against fraud and violations insurer risk, giving [the acceptance of the preclude would to under- information it needs access to the insurer] 1 that the statute is not majority summarily concludes The court in split the of this ambiguous. disagree. I As evidenced meaning, statute, minds differ as to its analyzing reasonable Sweat, 2d v. 208 Wis. ambiguous. State and it is therefore (1997). I conclude that 416-17, Because 561 N.W.2d history legislative of the ambiguous, an examination statute is UVE, 274, 281-82, LIRC, 2d v. 201 Wis. Inc. appropriate. (1996). N.W.2d 57

write, giving arbitrary without power it over the in- through sured application of the harsh common law doctrines.

¶ 32. Fourth, a Wisconsin federal court faced with apply this issue concluded that statute this does not to policy yet the situation where a is not in effect due to precedent. failure of a condition LaBonte v. Connecticut (E.D. 1989) Supp. Co., Ins. Gen. 723 F. Wis. Life (the applies "condition" referred to in the statute to conditions that occur after effect, takes not before). my is, 33. This view, the more reasonable interpretation only interpreta- of the statute and the comports tion that with common sense. It would lead to applies absurd results to conclude that the statute to required policy goes conditions Taking before a into effect. premise logical such to its conclusion, an applicant indefinitely postpone required could medical examinations and secure life insurance without afford- ing any opportunity the insurer to evaluate the risk or insurability applicant. majority of the In fact, the points company out that the insurance did not set forth any "specifictiming" Majority for the studies. at medical entirely potential ¶ 23. This was within the insured's majority's control. The conclusion will eliminate an company's ability insurance to underwrite the risk that applicant it is to assume in all cases where an postpones repeatedly delays submitting required or medical studies. There is no reason to infer that Wis. 631.11(3) was intended to remove an insurer's ability perform underwriting. effective Having language

¶ concluded that the of the apply, analysis statute does not turns to lan- guage at Here, issue the contract. the conditional *16 agreement provided coverage begin that would not

650 completion "[t]he of all examinations and until date practices required the rules and medical studies Thus, the life insurance contract did not come CKIS." completed required being Patriсk the medical into until the "If a condition is attached to contract's studies. being, yet coming there as no contract." Kocinski into is 738, Co., Ins. 147 2d 433 N.W.2d654 v. Home Wis. (Ct. 1988) (citation omitted), App. 154 Wis. 2d aff'd, (1990). N.W.2d Although dispute

¶ there 35. is some whether required were or both a urine test and a blood test only required, dispute a blood test was whether Patrick immaterial because neither test occurred before important The trial court made an distinction died. ruling required on this matter. It stated that when completed until exam—a blood draw—was not medical If blood had been drawn after Patrick died. Patrick's language policy, аccording of the died, before he to coverage gone case Thus, have into effect. this would distinguishable Equitable In from Brown v. was Life (1973) Co., 620, 211 surance 60 Wis. 2d N.W.2d completed all the medical examina Mr. Brown because required he died. Id. at 625. tions that were before company in Brown had the neces Thus, the insurance sary information to underwrite the risk. undisputed That was not the case here. It is obligation he had an to submit

that Patrick understood coverage not be draw and that the would the blood time. Patrick did not effective until that coverage and, therefore, death blood draw beforе his majority suggests into The never went effect. company attempted perform should have using required tests drawn from Patrick's

the body post-mortem. blood

Majority disagree. It at 19.1 responsibility to a blood test Patrick's to submit *17 prescribed company. manner the insurance More- company expert over, the insurance submitted an affi- attesting perform davit that it would not be able to the necessary post-mortem tests the blood because the components changed chemical of the blood would have underwriting requirements. and become insufficient for majority ¶ 37. The also states that the insurance comрany prove "could not that Patrick's failure to provide sample ’increase[d] a blood before his death required by risk at the time loss,'" of the as Wis. 631.11(3). § Majority ¶at 23. This statement reveals 631.11(3) §why apply another reason cannot to medical required precedent studies as conditions before an appli- If becomes effective. the insured completing required cant dies before medical stud- company ies, an insurance will never be able to show purpose that such failure "increased the risk." The insuring the medical studies is to determine the risk applicant. compаny The insurance does not have ability timing required to control the of the medical rely applicant studies, but must on the to submit to testing timely in a fashion. The incentive for the applicant timely the medical studies is that coverage until he or so, she does no in effect. The majority's opinion changes applicant all Now, that. an postpones does not have that incentive if because he/she submitting the medical tests and dies before to the company way prove studies, the insurance no has applicant that the would have been denied for medical company pay reasons. The insurance will have to though opportunity benefits even it had no to under- legislature write the risks. The could not have intended 631.11(3). such a result when it enacted I dissent.2 respectfully Accordingly, "Coverage Limita agreement also listed The conditional coverage "No shall be second limitation stated: tions." The not a risk to be insured is person(s) proposed force if the rules, with CKIS limits standards insurable accordance to determine whether ...." CKIS was never able plans for the *18 because he did not Patrick was a "risk insurable" Thus, he the limitation required before died. medical studies coverage ‍​​‌​​​​‌​‌​​​​‌‌‌​‌‌‌‌​‌‌​‌​​‌​‌‌‌‌​‌​​​​​‌‌‌‌‌​‍conclusion that no support for the provides additional or the insurance agreement the conditional effect under policy.

Case Details

Case Name: Fox v. Catholic Knights Insurance Society
Court Name: Court of Appeals of Wisconsin
Date Published: Apr 9, 2002
Citation: 649 N.W.2d 307
Docket Number: 01-1469
Court Abbreviation: Wis. Ct. App.
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