Clark v. John Hancock Mutual Life Insurance

447 N.W.2d 783, 180 Mich. App. 695
CourtMichigan Court of Appeals
DecidedJuly 7, 1989
DocketDocket 106424
StatusPublished
Cited by10 cases

This text of 447 N.W.2d 783 (Clark v. John Hancock Mutual Life Insurance) is published on Counsel Stack Legal Research, covering Michigan Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Clark v. John Hancock Mutual Life Insurance, 447 N.W.2d 783, 180 Mich. App. 695 (Mich. Ct. App. 1989).

Opinion

Per Curiam.

Plaintiff, Daniel Clark, a self-employed carpenter and president of his own construction company, purchased from defendant, John Hancock Mutual Life Insurance Company, a total disability insurance policy. A few months after issuance of the policy, plaintiff suffered severe injuries when his right hand became entangled in an operating table saw. Defendant denied benefits on the ground that plaintiff had misrepresented his medical history in applying for the policy. Plaintiff sued, but the trial court granted summary disposition in favor of defendant under *697 MCR 2.116(C)(10). Plaintiff appeals as of right, raising three issues, none of which merits reversal.

First, was a factual issue raised as to whether plaintiff had made any false representation on the insurance application? Plaintiff’s completed application did not inform defendant that plaintiff had experienced epilepsy during his childhood. 1 The pertinent part of the application was completed during plaintiff’s visit with a registered nurse working for defendant. Following a brief physical examination, the nurse verbally asked plaintiff the questions on the application questionnaire and recorded his answers. Specifically, per plaintiff’s deposition testimony, the nurse read through the entire questionnaire aloud and, then, went through it again and asked the questions individually. The relevant questions dealing with plaintiff’s medical history were as follows:

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Plaintiff claims that, when he answered, he was under the impression that all of the questions *698 covered only the preceding five years. However, as previously indicated, the entire questionnaire was read aloud to him and, in particular, the prefatory language of question 2. Plaintiff claims that he, himself, never actually read the questionnaire before signing it.

However, had plaintiff read the questionnaire, he would have understood the true scope of the questions posed. While the questions must be liberally construed in favor of plaintiff, 2 the language of the form is clear in its inquiry as to whether the proposed insured had "ever” been treated for convulsions, etc. Plaintiff’s negative response to this question (viewed in its proper context) was untrue. Plaintiff, nevertheless, signed the questionnaire attesting to the truth and completeness of his responses. As stated by the Supreme Court in Komraus Plumbing & Heating, Inc v Cadillac Sands Motel, Inc, 3 "[i]t was his duty to examine the contract, to know what he signed, and [the other contracting party] cannot be made to suffer for this neglect on his part.” 4 Viewed in this light, it cannot be said that a genuine factual issue existed as to whether plaintiff made a false representation on the application.

Second, was there a genuine issue of fact as to whether plaintiff made a material misrepresentation? MCL 500.2218(1); MSA 24.12218(1) provides:

No misrepresentation shall avoid any contract of insurance or defeat recovery thereunder unless the *699 misrepresentation was material. No misrepresentation shall be deemed material unless knowledge by the insurer of the facts misrepresented would have led to a refusal by the insurer to make the contract.

Defendant attached to its motion the affidavit of one of its underwriting consultants, which stated in pertinent part as follows:

10. In evaluating disability insurance risks, underwriters at John Hancock rely upon the Personal Health Medical Manual (the "Manual”). This Manual describes several classifications of illnesses and provides guidelines for underwriters responding to applications from persons suffering from medical problems. ... In this Manual, descriptions and definitions are given for medical problems.
12. The rating schedule for persons suffering from ailments such as epilepsy is set forth on page 60 of the Manual. That chart indicates for for [sic] persons who have suffered seizures, no policy of this type would have been issued. Because Daniel B. Clark had been under treatment, he would have been treated as those who had suffered from epilepsy, and his application would have been denied.

Plaintiff countered with the affidavit of an independent underwriter stating that, under insurance industry standards, plaintiff’s history of epilepsy would not render him an uninsurable risk. However, while suggesting that insurance companies, generally, might have insured plaintiff, plaintiff’s affiant notably did not suggest that this defendant would have or might have insured plaintiff had it known of his history of epilepsy.

The appropriate focus of our materiality analysis is the reliance or nonreliance of the particular *700 insurance company involved. MCL 500.2218(1); MSA 24.12218(1) refers to misrepresentation of facts which, if known by "the” insurer, would have led to refusal by "the” insurer. In Mannino v Dominion Life Assurance Co, 5 the federal district court for the eastern district of Michigan stated:

It is not relevant to this inquiry that other insurance companies might have, or would have, issued a policy of insurance to [the plaintiff]. Evidence that other insurance companies may have applied [defendant insurance company’s] underwriting manual in a different manner, or that certain physicians, in making marks on medical records, did not mean to suggest that certain severe conditions were present, is irrelevant at this point. This Court must ask whether this insurance company would have issued the policy that has been sued upon in the absence of certain misrepresentations by [plaintiff].

The court went on to grant the defendant insurance company’s motion for summary disposition, stating:

[I]nasmuch as Michigan has made the meaning of "materiality” turn on subjective considerations, a Plaintiff must produce evidence, in the form of affidavits or otherwise, which suggests that the insurance company would have issued the policy had the correct information been provided. In the present case, Plaintiff might have elected to determine whether [the defendant] had ever issued a policy, which was similar to the subject contract, under similar factual circumstances. But having elected not to seek that discovery, and, instead, having insisted on proceeding as though an objective standard governed the meaning of "materiality” (i.e., whether any insurance company would have issued any coverage to [the plaintiff]), Plain *701 tiff cannot survive [the defendant’s] Motion for Summary Judgment.[ 6 ]

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Cite This Page — Counsel Stack

Bluebook (online)
447 N.W.2d 783, 180 Mich. App. 695, Counsel Stack Legal Research, https://law.counselstack.com/opinion/clark-v-john-hancock-mutual-life-insurance-michctapp-1989.