Bertrand v. Protective Life Ins. Co.

419 So. 2d 1254, 1982 La. App. LEXIS 7483
CourtLouisiana Court of Appeal
DecidedMay 26, 1982
Docket8846
StatusPublished
Cited by8 cases

This text of 419 So. 2d 1254 (Bertrand v. Protective Life Ins. Co.) is published on Counsel Stack Legal Research, covering Louisiana Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Bertrand v. Protective Life Ins. Co., 419 So. 2d 1254, 1982 La. App. LEXIS 7483 (La. Ct. App. 1982).

Opinion

419 So.2d 1254 (1982)

Dorothy Young BERTRAND, et al., Plaintiff-Appellee,
v.
PROTECTIVE LIFE INSURANCE CO., et al., Defendant-Appellant.

No. 8846.

Court of Appeal of Louisiana, Third Circuit.

May 26, 1982.

*1255 Dubuisson & Dubuisson Edward B. Dubuisson, Opelousas, for defendant-appellant.

Kermit A. Doucet, Lafayette, for plaintiff-appellee.

Sandoz, Sandoz & Schiff Lawrence B. Sandoz, Jr., Opelousas, for defendant-appellee.

Before GUIDRY, STOKER and LABORDE, JJ.

STOKER, Judge.

Plaintiff-appellee, Dorothy Young Bertrand, seeks recovery under a policy of insurance issued by defendant-appellant, Protective Life Insurance Company (Protective Life) to plaintiff's husband, Theogene Peter Bertrand, Jr. (Bertrand). The trial court rendered judgment in favor of plaintiff against Protective Life in the sum of $12,075.00 as well as for penalties of six percent per annum from the date Protective Life received proof of Bertrand's death until the judgment was paid. Protective Life appeals this ruling.

FACTS

On July 10, 1974, Bertrand applied for $12,500.00 of credit life insurance with Protective Life through Lawrence Larcade, Jr. (Larcade) of the St. Landry Homestead Association in connection with a loan from the homestead of $13,000.00. Larcade filled out the application form according to the responses elicited from Bertrand. The policy was issued by Protective Life in the amount of $12,500.00. Bertrand died on June 12, 1975, of cancer. At the time of his death, the benefits due under the policy amounted to $12,075.00. Plaintiff made a claim on Protective Life for this amount, and the insurance company denied the claim on the basis that Bertrand made material misrepresentations on his application for the insurance.

WAS BERTRAND GUILTY OF MATERIAL MISREPRESENTATION?

LSA-R.S. 22:619(B) states:

"B. In any application for life or health and accident insurance made in writing by the insured, all statements therein made by the insured shall, in the absence of fraud, be deemed representations and not warranties. The falsity of any such statement shall not bar the right to recovery under the contract unless such false statement was made with actual intent to deceive or unless it materially affected either the acceptance of the risk or the hazard assumed by the insurer."

*1256 This court in Ryan v. Security Industrial Insurance Company, 386 So.2d 939 (La.App. 3rd Cir. 1980) construed § 619(B) as follows:

"In order for an insurer to avoid liability on the basis of material misrepresentations the insurer must meet a three-tiered burden. It must be shown that the statements were false. Second, the insurer must establish that the representations were made with an actual intent to deceive. Third, the insurance company must establish that these misstatements materially affected the risk assumed by the insurer. Martin v. Security Industrial Insurance Company, 367 So.2d 420 (La. App. 2nd Cir. 1979), writ refused 369 So.2d 1364 (La.1979)."

Questions nine and ten on the application for insurance in the instant case appear as follows:

"Yes No "9. X Do you have any physical or mental impairment? If YES, explain: ___________ "10. X Have you consulted or been treated by a physician or other practitioner for any illness, or been confined in a hospital during the last seven years? If answer is yes, give particulars below."

An "X" appears in the box under the column designated "No" next to both questions. In the space provided under question ten, the notation "Good health" appears.

Protective Life claims that these responses were false representations concerning Bertrand's health. Specifically, Protective Life contends that Bertrand knowingly concealed with the intent to deceive the insurer the fact that he suffered from obesity, diabetes, high blood pressure, and alcoholism and that the misstatement of these facts on the application for insurance materially affected the risk which it assumed. Protective Life also contends that Bertrand intended to deceive the insurer by concealing the fact that he had seen and been treated by doctors and had been hospitalized numerous times in the seven years prior to the date he applied for insurance.

The trial court's reasons for judgment in favor of plaintiff can be summarized in three grounds:

1) Any misrepresentations on the application for insurance are attributable to officials of Protective Life;

2) Bertrand had no intent to deceive Protective Life; and

3) No misstatements on the application for insurance "materially affected the risk assumed by the insurer". We will address the arguments raised by Protective Life against each of these reasons for judgment. Are the misstatements attributable to Protective Life?

Larcade, who handled Bertrand's application for the credit life insurance, and Merrick Cormier, the loan officer who handled Bertrand's loan, were both licensed agents of Protective Life. Both men knew Bertrand before this time through his dealings with the homestead association. The amount of the loan was $13,000.00, yet the credit life insurance only covered $12,500.00 of that loan. Larcade filled out the application form for Bertrand. The trial court found that Larcade filled in the figure of $12,500.00 in the blank on the application labeled "Amount of Loan". The trial court noted that a photocopy of the homestead ledger sheet contained this handwritten note: "Loan was $13,000.00. Took out $12,500.00 because this was non-medical limit at age 49." In other words, $12,500.00 was the maximum amount of insurance which Protective Life would issue to a 49 year old applicant without requiring him to undergo a medical examination. Bertrand was 49 years old at the time he applied for the insurance. Finally, the trial court expressed doubts as to Larcade's testimony that he accurately recorded Bertrand's responses on the application form and found further that the notation "Good health" on the form was Larcade's opinion and was not based on an answer by Bertrand.

Based on these findings, the trial court concluded that the misstatements on the application form were a result of Protective Life's agent having falsely filled out *1257 the application. It is well settled that the acts of an insurance agent in filling out an application form falsely are the acts of his principal, the insurer, and they do not bind the innocent insured nor bar recovery by him or his beneficiaries. See Ryan v. Security Industrial Insurance Company, supra, and the cases cited therein at page 941. The trial court relied on the following quotation from the case of Frugé v. Woodmen of the World Life Insurance Society, 170 So.2d 539 (La.App. 3rd Cir. 1965), as excerpted in Ryan:

"... if the agent by mistake, fraud or negligence inserts erroneous or untrue answers to the questions contained in the application, these representations bind the insurer but are not binding upon the insured."

However, we do not believe that the rationale of the Frugé and Ryan cases and the other cases cited for this proposition is applicable to the present case. In the Frugé case, the insurance agent was informed of the insured's medical condition ("leaking heart") before he filled out the application form for the insured. In Ryan,

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Bluebook (online)
419 So. 2d 1254, 1982 La. App. LEXIS 7483, Counsel Stack Legal Research, https://law.counselstack.com/opinion/bertrand-v-protective-life-ins-co-lactapp-1982.