American Home Life Insurance Company v. Teodora Barron Zuniga

228 F.2d 403, 1955 U.S. App. LEXIS 3688
CourtCourt of Appeals for the Fifth Circuit
DecidedDecember 30, 1955
Docket15698_1
StatusPublished
Cited by3 cases

This text of 228 F.2d 403 (American Home Life Insurance Company v. Teodora Barron Zuniga) is published on Counsel Stack Legal Research, covering Court of Appeals for the Fifth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
American Home Life Insurance Company v. Teodora Barron Zuniga, 228 F.2d 403, 1955 U.S. App. LEXIS 3688 (5th Cir. 1955).

Opinion

'CAMERON, Circuit Judge. ■

Appellee (plaintiff), Teodora Zuniga, as insured, recovered judgment upon jury verdict for $10,000.00 plus dámagés and attorneys’ fees against appellant Insurance Company (defendant),' upon insurance carried by it on the life of hér husband. The main defense was that the husband bad not been in good health when the policy was, delivered to him; and that the Court below adopted the wrong delivery date. The jury, upon special interrogatories, found the facts in favor of appellee. The. chief question is whether there was .evidence- sufficient to support those findings. ■ .

On February 5, 1953, appellee’s husband ápplied for a fifteen year term policy and was examined by the Company’s doctor February 10th. In 'due course' the Company caused a special undercover investigation ■ to be made about' the applicant, his' state of health, habits,-etc., and a favorable report was made February 13th. The policy was- delivered' to the insured February 23rd, and the full premium of $316.20 was paid, and receipt issued.'

After the delivery of the' $10,000.00 policy had been completed the Company’s agent suggested to1 the insured that it might be wise to split the insurance into two $5,000.00 policies with staggered premium due dates. This suggested arrangement was to the obvious advantage of both parties and. appealed to the insured. By. mutual consent, the $10,000.-00 policy was turned over to the insurance agent solely for effecting those two purposes. The Company issued two $5,-000.00 policies, one effective February 20th and the other March 20th. These new policies were mailed to the insured and were received by him about April 1st.

The $10,000.00 pblicy was retained by the Company, which wrote on its face: “3-24-53 Cancelled & Reissued under Pol. Nos."56538-9 for 5 M ea.-on sdme plan”. Each of. the $5,000.00 policies was inscribed with a typewritten, notation Iliat the $10,000.00 policy had been reissued in the form of two $5,000.00 policies. 1

The application for the $10,000.00 policy contained provisions in fine print above insured’s signature setting forth certain-requirements concerning the good health- of the insured at the time of approval by the. Company’s medical department or at the -time of delivery of the policy. 2 , ,A deposit of $25.00 was made *405 with the application and the entire first premium was paid as above stated at the time the policy was delivered on February 23rd.

Photostatic copies of this application of February 5th were attached by the Insurance Company to the two $5,000.00 policies, this being done upon the election of the Company and without any agreement with the insured. No new application was executed, and the application attached to each of the $5,000.00 policies referred solely to the $10,000.00 policy originally issued and delivered.

The insured died February 12, 1954 of cancer of the esophagus. The first manifestation of this trouble disclosed in the evidence was on April 1, 1953, when insured consulted a physician because of difficulty he was experiencing in swallowing. Appellant introduced medical witnesses in an effort to show that, by reason of the assumed presence of the cancer, insured was not in good health on April 1st, when it claims the two $5,-000.00 policies were delivered, or on February 23rd, when the $10,000.00 policy was delivered. Four doctors were introduced, three of whom had examined insured and the fourth testified as an expert upon hypothetical questions. Appellant further introduced the hospital records and appellee followed by placing on the stand the pathologist who made those records.

The Company’s medical examiner testified that he examined insured at his home on February 10th, confining his examination to heart, lungs, kidneys and other vital organs, and that he did not make any examination by X-ray or any other means which would have disclosed the presence of the tumor beyond palpation of the abdomen. The examiner discovered no sudden loss of weight or other condition which would arouse suspicion that cancer was present.

The second physician, consulted by insured April 1st because of difficulty in swallowing, referred him to a specialist whose examination occurred promptly. X-ray examination disclosed the presence of a mass in the lower three inches of the esophagus which aroused the suspicion of the specialist, and he in turn referred insured to a surgeon. The latter performed a biopsy and excised several “bites” of living tissue from the esophagus. Pathological examination disclosed no cancer cells in those specimens, but this negative evidence was not considered final because the lower portion of the esophagus where the mass was situated could not well be reached because of swelling existing above it.

A resection was performed on insured August 13, 1953 and this mass was removed and submitted to a pathologist who examined the tissues microspically, and found that the mass consisted of an adeno-carcinoma of the lower third of the esophagus and extending into the stomach. The operation prolonged the life of the insured substantially six months.

Each of the four doctors was submitted to extensive direct and cross-examination and they agreed about the fact that the mass was malignant when removed August 13, that it occupied a portion of the esophagus and a portion of the stomach, that part of the tissues were dead when examined and that insured’s death was produced by the cancer, the first evidence of which had been revealed by the April 1st examination. Only one of the four doctors, the one who had not made a physical examination of the insured and had not examined thé X-rays or any of the tissues, testified definitely that, in his opinion, the tumor existed in malignant form on February 23rd. The others were unable to give a definite opinion as to the date of its malignant beginning. Nor did any give satisfactory evidence as to whether the tumor was of a fast or slow growing variety, whether it was benign or malignant on April 1st or theretofore; and they differed as to whether the growth origi *406 nated in the esophagus or in the stomach. It was also shown that' the speed of growth varies with respect to the several types of tumors and that the rapidity of growth varies .in different individuals.

It was developed from a half dozen lay witnesses that the insured was in sound health, working regularly and without complaint, to April 1st, and that he worked several days thereafter. There was no evidence of any loss of weight until after April 6th, at which time there was a rapid loss of weight noted by one of the doctors in his examination of May 18th.

The Court below submitted special interrogatories to the jury in response to which the jury found that the $10,000.-00 policy was delivered to and accepted by the insured and payment of the entire premium made prior to the time the policy was turned over to the Company’s agent to be split into two policies; that the insured was in good health on February 23rd when the $10,000.00 policy was delivered; and that the insured was not in good health on April 1st when the two $5,000.00 policies were delivered. By appropriate procedural moves appellant raised the questions relied on for reversal.

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Related

Texas Prudential Insurance Company v. Dillard
307 S.W.2d 242 (Texas Supreme Court, 1957)

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Bluebook (online)
228 F.2d 403, 1955 U.S. App. LEXIS 3688, Counsel Stack Legal Research, https://law.counselstack.com/opinion/american-home-life-insurance-company-v-teodora-barron-zuniga-ca5-1955.