59 Ga. App. 104 | Ga. Ct. App. | 1938
Mrs. Edith L. Gilbert sued the North American Accident Insurance Company in the municipal court of Atlanta on a policy of accident and health insurance, and alleged that the defendant, on or about December 1, 1933, issued to her a policy of accident and health insurance, by the terms of "which the insurance company obligated itself to pay her $100 per month for a period of three months in the event she should be totally and continuously disabled by tuberculosis, during the period thus specified, and $50 per month hospital charges for a period of two months, in case she should be confined to a hospital during such disability; that in November, 193-1, she became ill with tuberculosis and, on account of said illness, was confined in Wesley Memorial Hospital from November 18, 1934, to April 8, 1935, when she was removed to her home, and that she was still confined to her bed when her suit was filed on August 8, 1935; that the disability was total and continuous during said period, and that she spent considerably more than $50 per month for hospital bills while she was confined in the hospital; that she had complied with the terms of the insurance policy, but that the insurance company had failed and refused to pay her the benefits due thereunder, and that said refusal was in bad faith and without justification in law or fact. She sued for $300 disability benefits for three months, $100 hospital charges for two months, and for an additional $100 (25% of the amount of the liability) and $200 attorney’s fees, on account of the alleged bad faith in the failure and refusal to pay as provided by the policy sued on.
The defendant in its answer admitted that the policy was issued, that the premiums were paid, that Mrs. Gilbert became ill with tuberculosis about a year after the policy was issued and was confined in the hospital and disabled as alleged in her petition, and
Code, § 56-820, provides: “Every application for insurance shall be made in the utmost good faith, and the representations contained in such application shall be considered as covenanted to be true by the applicant. Any variation by which the nature, extent, or character of the risk is changed shall void the policy.” .Code, § 56-821, provides: “Any verbal or written representations of facts by the insured to induce the acceptance of the risk, if material, must be true, or the policy shall be void. If, however, the party shall have no knowledge, but shall state on the representation of others, bona fide, and shall so inform the insurer, the falsity of the information shall not void the policy.” It is contended by the insurance company that the plaintiff answered “no” to- the following question in her application for the insurance policy: “Have you received medical or surgical attention within the past two years, except as herein stated?” that said answer was untrue and voided the policy of insurance. This is denied by the plaintiff, who contends that her answer to the aforesaid question was neither false nor material, so as to void the policy here involved.
The evidence shows that the plaintiff, in November, 1933, when the application for the insurance policy was made, and for several years prior thereto, was employed in a responsible position as a clerk in the office of the Southern Traffic Association in Atlanta, Georgia; that, on the night of August 18, 1933, she had returned from a trip to North Georgia, and, after taking a bath, spat up a
In Federal Life Ins. Co. v. Summergill, 45 Ga. App. 829 (166 S. E. 54), it was held: “The term ‘medical or surgical attention’ in questions propounded to the applicant for a sick-benefit insurance policy, as to whether he had received ‘medical or surgical attention within the past five years,’ means medical or surgical attention for some illness or disease of substantial importance or of a serious
Affirmed on condition.