Clemens v. Metropolitan Life Insurance

20 Pa. Super. 567, 1902 Pa. Super. LEXIS 278
Superior Court of Pennsylvania·Decided July 10, 1902·No. Appeal, No. 75·Published·Cited by 8 cases

Opinion

Opinion by

Orlady, J.,

The plaintiff brought suit to recover on an insurance policy issued by the defendant July 28, 1897, on the life of Andrew Clemens, her husband; in which policy it is provided: “ Third. After two years this policy shall be noncontestable, except for the nonpayment of premiums as stipulated or for fraud.” Andrew Clemens died March 25,1900, and it was admitted in the affidavit of defense offered in evidence on the trial that the plaintiff had “ from time to time paid or caused to be paid eacli and every of the premiums which fell due upon the said policy, and in all other respects complied with the terms thereof.” The defense suggested in the affidavit was limited to two statements : 1. “ In answer to statement two, I have never liad any of the following complaints or diseases,” among which is disease of the heart, and it was averred that at the date of the application and prior thereto the decedent had valvular insufficiency of the heart. 2. That the applicant had averred, “3d. I am now in sound health,” whereas the applicant was not in sound health, but in fact had been drawing sick benefits from the St. Aloysius society of St. Michael’s Church for several months prior to the date of said application and of said policy.

On the trial it was contended that there was not sufficient proof of the identity of Andrew Clemens to entitle the plaintiff to recover, which argument is fully met by the proof of the agent’s certificate that Andrew Clemens was examined by him and was the person to be insured at the time the application was written which was signed in his (the agent’s) presence, and that he recommended the policy to be issued and was convinced of the identity of the person examined with the life proposed, [570] and the further affirmative proof by the widow, this plaintiff. The principal contention was that the policy had been procured by fraud, and that the fraud consisted in false statements and misrepresentations, which, under the terms of the policy, were warranties, as follows: First, that there was a misstatement in regard to the occupation of the insured; second, that the applicant concealed the fact that he was then receiving sick benefits from a society. In the application it is stated: “ 1. My occupation is laborer in rolling mill and I have no other occupation, except . . .” The testimony on this phase of the case was that Andrew Clemens had been a laborer in Byer’s rolling mill, and that his name did not appear on their pay rolls after December 3,1896; it was not contended that he had any other employment or engaged in any other kind of labor after that date. It was shown that he did not quit work because he was not able to work, but that he was a delicate man and had caught cold, and under the advice of a doctor did not go back to his work. The widow, this plaintiff, when called as if on cross-examination testified with reference to his condition at that time: “Q. Was there anything the matter with him? A. No, sir.” Our attention has not been called to any case which holds that in answering truthfully in regard to his occupation the applicant must be continuously engaged therein up to the date of application. 'Under the evidence Andrew Clemens had a right to call himself a laborer in á rolling mill. There is no evidence that he had another occupation, nor that he had been engaged in any other or different work. The mere fact that he had not been at work for six months did not necessarily mean that he had abandoned his occupation. He had been a mill worker or laborer and his self designation as such was natural and reasonable, particularly so as he had not engaged in other work. The plaintiff’s second point, as follows : “ The insured having stated in his application that his occupation was laborer in rolling mill, and he had no other occupation, if the jury believe from the evidence that he had not been able on account of ill health to follow his occupation for a considerable time before the date of his application and concealed the fact, that constituted a fraud upon the company and the policy thereupon became void and the verdict should be for the defendant,” was. rightly answered by the court as follows: “Affirmed if the jury believe [571] that the deceased was in ill health at the time of his application.” The principal thought suggested in the point was whether or not Andrew Clemens “ had not been able on account of ill health to follow his occupation ” and concealed that fact and not whether he was truthfully holding himself out as a laborer in a rolling mill.

Under the second defense it was shown that Andrew Clemens had been receiving sick benefits from the St. Aloysius Benevolent Society of the South Side, from February 9, 1897, to a time after the date of the application. The character of this society is not shown in the evidence. Its objects, rules, bylaws or conditions entitling a member to benefits therein do not appear anywhere in the proof, and in the light of the testimony that the society pays benefits for minor and trifling ailments or injuries, and that he was “ well all the time,” taken in connection with the testimony and report of the medical examiner of the defendant company, that he had made a physical examination of the lungs and heart, which were found to be normal, and, at the date of the application was “ of the opinion that said life is in good health; that said life’s constitution is sound, and I, therefore, recommend said life to be accepted at first-class rates,” which report was declared to be true and correct by the same physician, when examined at the trial.

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Clemens v. Metropolitan Life Insurance, 20 Pa. Super. 567, 1902 Pa. Super. LEXIS 278 (Pa. Ct. App. 1902).

20 Pa. Super. 567 (Clemens v. Metropolitan Life Insurance) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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