American Bankers Life Ins. Co. v. Baker

126 S.W.2d 56
CourtCourt of Appeals of Texas
DecidedFebruary 20, 1939
DocketNo. 4992.
StatusPublished
Cited by4 cases

This text of 126 S.W.2d 56 (American Bankers Life Ins. Co. v. Baker) is published on Counsel Stack Legal Research, covering Court of Appeals of Texas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
American Bankers Life Ins. Co. v. Baker, 126 S.W.2d 56 (Tex. Ct. App. 1939).

Opinion

FOLLEY, Justice.

This suit was filed by the appellee, Mrs. Bessie L. Baker, against the appellant, American Bankers Life Insurance Company, to recover upon a certificate of insurance issued by the appellant upon the life of William N. Baker, deceased husband of the appellee. The appellant is a statewide mutual assessment benefit association of Waco, Texas, operating under article 4859f, Vernon’s Ann.Civ.Statutes of Texas. The policy herein involved in the sum of $2500 was issued by the appellant upon the life of the deceased on January 9, 1937. This policy contained a provision to the effect that if a claim arose under the certificate within four months from the effective date of the policy the benefits should be only one-fourth of those otherwise apr plying thereunder, plus a refund of all sums paid as premiums on the policy. The deceased died on April 7, 1937, within such four month period. The cause of his death, as shown from the death certificate filed by Dr. Willis H. Flamm, his physician, was *57 coronary occlusion contributed to by hypertension. The trial court without the intervention of a jury rendered judgment for the appellee for the sum of $657.25, which included one-fourth the face amount of the policy, plus the sum of $32.25 paid by the deceased as the initial payment on the policy. From this judgment the appellant has appealed to this court.

The appellant seeks to avoid liability upon the policy by reason of the alleged false answer of the deceased when asked in the application for the insurance if he had ever had any symptoms of rheumatism. This application was made a part of the contract of insurance. In section 7 of such application a general question was asked the deceased with reference to his having had symptoms of some twenty diseases, among which was rheumatism. This question was answered in the negative. In making proof of death of the deceased, in answer to question No. 6 inquiring if the deceased ever suffered from rheumatism, the appellee answered, “Slightly in ’32”. This ex parte statement of the appellee constitutes the substance of the testimony upon which the appellant relies to show that the answer of the deceased to the above question in the application was false. The only corroboration of such ex parte statement was from Judge W. E. Gee, Judge of the 108th District Court of Potter County, Texas, in whose court the deceased worked as court reporter from 1927 until his death in 1937. Judge Gee testified that some time about 1932 the deceased was in a run down condition from overwork, that he complained of his back, and that the deceased went to New Mexico for about a month for a vacation and rest. Judge Gee did not undertake to testify that the ailment of the deceased at such time was caused by rheumatism. Granting that the deceased had a slight attack of rheumatism in 1932, the testimony of Dr. J. R. Wrather, witness of the appellant, presented a controverted issue of fact as to whether or not such attack contributed to his death in 1937. His testimony was that the materiality of the attack as a contributing cause of his death would depend upon the severity of the attack ; that a slight attack would not amount to anything, and he would not regard it as serious unless it recurred. There was no evidence of any recurrence of the alleged attack. The statute under which the appellant operates as an insurance company provides that no misrepresentations in the application “shall constitute a defense unless same shall be shown to be material to the risk assumed * * Sec. 11, art. 4859f, Vernon’s Ann.Civ.Statutes. The appellant failed to show the alleged misrepresentation was material to the risk assumed, and the judgment of the trial court has foreclosed such controverted issue against the contention of the appellant.

The appellant further asserts that the judgment of the trial court is excessive under the terms of the policy. This contention is based upon two paragraphs of the policy, one of which, as above stated, limited recovery to one-fourth of the benefits otherwise applying if a claim arose within four months from the effective date of the certificate. The other provision is to the effect that if the insured died within one year from the effective date of the certificate from certain diseases, one of which was circulatory or organic trouble, then the benefit should be one-half of the amount otherwise payable, plus the refund of all premiums paid by the insured. The provisions of the policy upon which the appellant relies are as follows:

“In consideration of the small initial payment and the nominal subsequent payments as required hereunder it is provided that in the event of a claim arising under this certificate within four months from the effective date of this certificate or any reinstatement thereof, the benefits to which the beneficiary shall be entitled shall be one-fourth of those otherwise applying hereunder, plus the refund of all amounts paid hereon for such Member while this certificate was continuously in force.
“In further consideration of the nominal payments hereunder it is mutually understood and agreed that should a Member, within one year from the effective date of this certificate or reinstatement, die as a result of or caused or complicated by any form of the following: circulatory or organic trouble (including ‘acute indigestion’), diabetes, tuberculosis, cancer, apoplexy or bacterial infection — then the benefits payable shall be one-half the amount otherwise payable hereunder, plus the refund of all amounts paid hereon for such Member while this certificate was continuously in force.”

Since the testimony shows that the deceased died of coronary occlusion about two months from the effective date of the policy, the appellant contends that instead of $625 being the amount of insurance *58 recoverable, only one-half such amount, $312.50, constitutes the maximum insurance' payable under the policy. In other words, the position of the appellant is that only one-half of one-fourth of the face amount of the policy, plus the premiums paid, may be recovered herein.

From 'a careful analysis of the first paragraph above quoted it will be seen that it may be paraphrased into the following language: “If the insured dies within four months from any cause the benefits shall be one-fourth of the face amount of the policy, or $625.00.” This provision, standing alone, is plain, certain, definite and unambiguous. It would necessarily embrace the disease to which the death of William N. Baker was attributed. It was an unconditional promise on the part of the appellant to pay his beneficiary $625, plus the return of the premium paid, in the event Baker died of coronary occlusion or any other disease within the four month period. Then, there follows the second paragraph which, if construed as appellant contends, would divide the $625 by two if the insured died of circulatory or organic trouble within the first four months, yet such circulatory or organic trouble was necessarily included in the provisions of the first paragraph since such paragraph covered, all diseases.

The construction of the second' paragraph, as contended by the appellant, would be a repudiation of the promise in the first paragraph to pay one-fourth of the amount otherwise payable under the policy upon the death of the insured from any cause. There are no restrictions in the first paragraph as to diseases.

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Bluebook (online)
126 S.W.2d 56, Counsel Stack Legal Research, https://law.counselstack.com/opinion/american-bankers-life-ins-co-v-baker-texapp-1939.