American Franklin Life Insurance v. Galati

776 F. Supp. 1054, 1991 U.S. Dist. LEXIS 15576, 1991 WL 224071
CourtDistrict Court, E.D. Pennsylvania
DecidedOctober 29, 1991
DocketCiv. 91-2786
StatusPublished
Cited by24 cases

This text of 776 F. Supp. 1054 (American Franklin Life Insurance v. Galati) is published on Counsel Stack Legal Research, covering District Court, E.D. Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
American Franklin Life Insurance v. Galati, 776 F. Supp. 1054, 1991 U.S. Dist. LEXIS 15576, 1991 WL 224071 (E.D. Pa. 1991).

Opinion

*1056 MEMORANDUM

LOUIS H. POLLAK, District Judge.

This action arises out of a contract for disability income insurance between plaintiff American Franklin Life Insurance Company (“American Franklin”) and defendant Ronald L. Galati. American Franklin seeks a declaratory judgment declaring that it has the right to rescind the policy for which Galati contracted, a policy that American Franklin claims it entered on the basis of material false statements by Gala-ti. American Franklin also seeks restitution of the approximately $43,000 that it has paid to Galati in the form of benefits under the policy. Galati has filed a counterclaim against American Franklin and a third-party claim against Thomas A. Cetola, an agent affiliated with American Franklin, charging them with bad faith. American Franklin has moved for judgment on the pleadings pursuant to Rule 12(c) of the Federal Rules of Civil Procedure. Galati opposes that motion; in addition, he has filed a counter-motion to dismiss under Rule 12(b)(1) for lack of subject matter jurisdiction. For the reasons given below, I will grant American Franklin’s motion and deny Galati’s counter-motion.

I. Facts

For the purpose of a motion for judgment on the pleadings pursuant to Rule 12(c), the court must interpret the facts alleged in the pleadings and the inferences that can be drawn therefrom in the light most favorable to the non-moving party. The court is thus required to take as true the factual allegations of the non-movant’s pleading, and to treat as false any contradictory allegations in the moving party’s pleading. See Society Hill Civic Ass’n v. Harris, 632 F.2d 1046, 1058-59 (3rd Cir. 1981); 5A Charles A. Wright & Arthur R. Miller, Federal Practice and Procedure 519-20 (2d ed. 1990). The court need not accept the non-movant's conclusions of law, however. 5A Wright & Miller, supra, at 523. In accordance with this standard, the following facts are drawn from the pleadings. 1

Prior to August 1989, defendant Ronald Galati had a policy for disability income insurance with the John Hancock Insurance Company. In August 1989, however, third-party defendant Thomas A. Cetola, Jr., a former agent of the John Hancock Insurance Company who had recently become affiliated with plaintiff American Franklin, persuaded Galati to discontinue his existing policy and to apply for a new policy with American Franklin. On or about August 18, 1989, Galati signed an application for a disability income insurance policy with American Franklin, seeking a policy that would provide a monthly benefit of $4,000 until Galati reached the age of 65. The answers to all questions contained in the application were placed on the form not by Galati himself, but rather by Cetola.

The application averred that Galati was the president and owner of Ron’s Auto Body, a Philadelphia automobile repair business. It stated that his duties were supervisory and managerial, that his annual earned income for 1989 would be $130,-000, and that his annual earned income for 1988 had been $125,000. The application also contained the following questions about Galati’s medical history:

22.
(a) Have you within the past 5 years: consulted a physician or other medical practitioner; been advised to have medical treatment or surgery; been hospitalized; been diagnosed or treated by a physician for any disorder of the blood or immune system including AIDS; requested, received or been refused insurance benefits for any injury or sickness? Are you now pregnant?
♦ % S¡< * * *
(d) Have you ever had any known indication of or been treated for:
***** *
*1057 (2) Diabetes, cancer or tumor, venereal disease; mental or nervous disorders, epilepsy; disease or disorder of the nervous system, skin, glands, or muscles or bones including spine, back or joints?
(e) Do you have any physical impairments or deformities? Have you used illegal drugs? Have you been arrested, been diagnosed or received treatment for drug or alcohol abuse? Have you used prescription drugs in the last five years?

Complaint, Exhibit A. All these questions were answered, “No.”

After receiving Galati’s application, American Franklin issued the policy that Galati sought on November 1,1989. A few months later, an application for benefits bearing Galati’s undated signature was submitted. 2 The application asserted that Galati suffered from a chipped right elbow that left him unable to do his job. Whereas Galati’s initial application had described his duties as supervisory and managerial, the application for benefits stated that Ga-lati’s duties included metal and paint work, tasks that his injury prevented him from performing. Pursuant to the policy, American Franklin began payment of a benefit of $4,000 per month.

In the process of investigating Galati’s claim for benefits, American Franklin requested copies of Galati’s federal income tax returns for 1989 and 1988, which were provided by Galati’s accountant. The return for 1989 reported business income of $51,000, as well as nominal interest income. See Complaint, exhibit H. The total income reported on the 1989 return was nearly $80,000 less than the income amount stated on Galati’s application for insurance. The return for 1988 reported business income of $44,131, and no additional income. See Complaint, Exhibit G. This reported income was nearly $81,000 less than the amount reported on Galati’s application.

By August 1990, American Franklin possessed information, including information provided by Galati during a telephone interview, that supported the conclusion that Galati’s application contained false statements concerning his income and job duties. American Franklin therefore proposed, and Galati accepted, a reduction in the monthly benefit that Galati would receive, from $4,000 to $2,900. This reduction reflected the benefit to which Galati would be entitled given his true annual income and job duties.

Continuing its investigation into Galati’s claim, American Franklin discovered that Galati had an extensive medical history that had not been reported on his application. Specifically, Galati had been involved in traffic accidents in July 1982, August 1983, November 1987, and June 1988. After each accident, Galati filed a civil complaint, seeking to recover damages for physical injuries and medical expenses. The pleadings and medical reports obtained by American Franklin made the following facts clear:

(1) Galati had consulted physicians and received medical treatment on several occasions during the five years prior to August 18, 1989, the date on which he signed the application for insurance. Galati claimed past medical expenses in his verified complaints concerning his November 1987 accident. See Complaint ¶ 61; Answer ¶ 61.

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Bluebook (online)
776 F. Supp. 1054, 1991 U.S. Dist. LEXIS 15576, 1991 WL 224071, Counsel Stack Legal Research, https://law.counselstack.com/opinion/american-franklin-life-insurance-v-galati-paed-1991.