Cartusciello v. Allied Life Insurance Co. of Texas

661 S.W.2d 285, 1983 Tex. App. LEXIS 5263
CourtCourt of Appeals of Texas
DecidedNovember 3, 1983
Docket01-83-0206-CV
StatusPublished
Cited by12 cases

This text of 661 S.W.2d 285 (Cartusciello v. Allied Life Insurance Co. of Texas) 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
Cartusciello v. Allied Life Insurance Co. of Texas, 661 S.W.2d 285, 1983 Tex. App. LEXIS 5263 (Tex. Ct. App. 1983).

Opinion

OPINION

DOYLE, Justice.

This is an appeal from a summary judgment in favor of the appellee, denying the *286 appellant the proceeds of a credit life insurance policy.

The facts are simple and virtually undisputed. Michael Cartusciello obtained a credit life insurance policy from the appel-lee after executing an application on March 7, 1978, which stated in pertinent part as follows:

I hereby certify that I am in good health and gainfully employed and that my age is as stated above, ... I certify that I have read and that the information provided hereinbefore to the best of my knowledge is true and I understand that any false statement, inaccuracy, or misrepresentation material to the risk, may be used by Allied Life Insurance Company of Texas to contest a claim. I have not been attended by a physician or been a patient in a hospital within the last 12 months preceding the date of this Application for any of the following impairments: Diseases of the (1) heart, (2) lungs or respiratory system, (3) stomach or digestive system, (4) brain or nervous system, or (5) cancer to any part of the body, except as follows: (Emphasis ours)

The policy was issued on March 7 and the insured died on March 8 from coronary thrombosis. Lymphatic leukemia was listed as the secondary cause of death. The ap-pellee refused to pay the $53,078.28 which the appellant, executrix of the estate of Michael Cartusciello, claimed to be due under the policy. The appellant sued for the proceeds and the appellee filed an answer and cross-action denying liability under the policy for three reasons: First, a valid contract never issued because the insured breached the warranties contained in the insurance policy; second, there could be no recovery by the appellant because the conditions precedent to the issuance of a valid policy were never met by the decedent; and third, there was a misrepresentation by the decedent as to his state of health. The appellee then filed a motion for summary judgment urging the above three grounds as its basis for a take nothing judgment. The trial court granted the motion. The appellant urges two points of error.

The appellant’s points of error jointly complain that the trial court erred in entering the take-nothing judgment against her and that the grounds set forth in the appel-lee’s motion for summary judgment were not sufficient to support the granting of such motion.

In order to resolve the issues raised by appellant’s contention, it is necessary to first resolve a pivotal issue, i.e., whether the life insurance policy herein involved contained a “good health warranty” or a mere “representation” of good health. Perhaps no ease cited by the parties gives a more detailed discussion of the issues here presented than Allied Bankers Life Ins. Co. v. De La Cerda, 584 S.W.2d 529 (Tex.Civ. App.—Amarillo 1979, no writ). In De La Cerda, as in our case, the insurance company relied on breach of warranty and misrepresentation defenses. The pertinent policy provisions contained the phraseology, “I hereby certify that I am not being treated ...,” for high blood pressure, cancer and other named diseases and conditions. While we do not deem it necessary to set out the entire certificates of insurance in De La Cerda or in our case, suffice it to say that they are almost identical. The De La Cerda court, 584 S.W.2d at 532 stated:

The Texas Supreme Court has recognized that a warranty in an insurance contract is “ ‘a statement made therein by the insured, which is susceptible to no construction other than that the parties mutually intended that the policy should not be binding unless such statement be literally true.’ ” Lane v. Travelers Indemnity Company, 391 S.W.2d 399, 402 (Tex.1965), quoting Phoenix Assur. Co. v. Munger Imp. Cotton-Mach. Mfg. Co., 92 Tex. 297, 49 S.W. 222, 225 (1898). In other words, the parties must have intended that the policy stand or fall on the literal truth or falsity of the statement in question. Such warranties which cause forfeiture are disfavored in the law. Lane v. Travelers Indemnity Company, supra. See also 12 J.A. Appleman, Insurance Law & Practice § 7342 (1943).

*287 In affirming the judgment of the trial court which held that the insured’s estate was entitled to proceeds of the credit life insurance policy, the De La Cerda, court concluded, “... as a matter of law, that the statement of good health is a representation rather than a warranty.”

We recognize the authorities which hold that certificates of insurance may be so worded that valid warranties of good health are provided.

In those cases where the courts have recognized a valid good health provision, the parties specifically agreed to condition the effectiveness of the policy upon the validity of the insured’s warranty of good health. For example, in Lincoln Income Life Ins. v. Mayberry, 162 Tex. 492, 347 S.W.2d 598 (1961), the policy read as follows:

When Policy is Voidable — This policy shall be voidable by the Company if on its date of issue the insured is not in sound health, ... Id. at 599.

Similar language is found in Great American Reserve Ins. Co. v. Britton, 406 S.W.2d 901 (Tex.1966): “the policy shall not take effect until it has been delivered to its owner during the lifetime and good health of the insured...” Id. at 903. The court has also found that a good health clause existed when the policy expressly stated that its effectiveness was conditioned upon the continued insurability of the proposed insured under acceptable company rules and practices. United Savings Life Ins. v. Coulson, 560 S.W.2d 211 (Tex.Civ.App.—Amarillo 1977, writ ref’d n.r.e.).

In recent cases involving “good health provisions” the courts have required that the policy clearly state that the certificate of insurance is not binding unless the good health statement is true. The Texas Supreme Court addressed this issue in Mayes v. Massachusetts, Mutual Life Ins. Co., 608 S.W.2d 612 (Tex.1980), and found that the insurance policy did not contain a good health provision because the effectiveness of the policy was under its terms, not dependent on the actual health of the insured, but rather on the truthfulness of the representations in the application at the time of delivery. Id. at 616.

In essence, since the law disfavors warranties which cause forfeiture, the Texas courts follow the modern trend of construing policies to prevent forfeitures.

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Bluebook (online)
661 S.W.2d 285, 1983 Tex. App. LEXIS 5263, Counsel Stack Legal Research, https://law.counselstack.com/opinion/cartusciello-v-allied-life-insurance-co-of-texas-texapp-1983.