Clohesy v. United States

199 F.2d 475, 1952 U.S. App. LEXIS 3377
CourtCourt of Appeals for the Seventh Circuit
DecidedNovember 5, 1952
Docket10589_1
StatusPublished
Cited by7 cases

This text of 199 F.2d 475 (Clohesy v. United States) is published on Counsel Stack Legal Research, covering Court of Appeals for the Seventh Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Clohesy v. United States, 199 F.2d 475, 1952 U.S. App. LEXIS 3377 (7th Cir. 1952).

Opinion

*476 SWAIM, Circuit Judge.

This is an appeal from a judgment rendered in favor of the defendant, the United States Government, in an action brought by Evelyn A. Clohesy as the principal beneficiary under a National Service Life Insurance policy on the life of her deceased husband, John C. Clohesy.

The case was submitted to the District Court on an agreed statement of facts which, in its essential particulars, is as follows:

John C. Clohesy, the insured, while in the military service of the United States during World War II, was issued a National Service Life Insurance policy in the amount of $10,000. Evelyn A. Clohesy, the plaintiff in this action, was designated the principal beneficiary. The insured was discharged from the military service in 1945, and the insurance thereafter lapsed for non-payment of premiums. In July of 1947 the policy was reinstated but it again lapsed for non-payment of the premium due the following month. On December 20, 1947, the insured again applied for reinstatement of the policy. In this application in response to the question, “Are you now in as good health as you were on the due date of the premium in default,” he answered, “Yes.” He answered, “No,” to the question as to whether, since the lapse of the insurance, he had been ill or suffered or contracted any disease or infirmity or been prevented from attending his usual occupation or consulted a physician. Relying upon the truth of these statements, the Veterans Administration, on January 27, 1948, approved the request for reinstatement. The fact was, however, that on December 19, 1947, the day before the insured last applied for reinstatement of his policy he had suffered an acute heart attack and had consulted a physician.

On March 11, 1948, the insured filed in the Chicago Regional Office of the Veterans Administration an application for compensation in which he stated his disability to be “Acute coronary occlusion began December 19, 1947.” He further stated that he had been treated by Robert L. Ladd, M. D., from- December 19, 1947. A statement by Dr. Ladd was submitted, which read: “This is to certify that Mr. John Clohesy * * * has been under my care since December 19, 1947, for treatment of an acute coronary occlusion. It is my opinion that he will be disabled for an indefinite period of time.” This application was disapproved for the reason that the disability alleged was not shpwn to have been incurred in or aggravated by service.

On May 22, 1948, by letter addressed to the Insurance Service, District Office No. 7, Chicago, Illinois, the insured inquired of the Veterans Administration concerning the possibility of his obtaining any total disability benefits under his National Service Life Insurance. In this letter he stated that, “On December 19, 1947, I had a Heart Attack was totally disabled for ten weeks. Then on April 27-48 had another attack, and have been disabled ever since.” He further indicated that he had applied for compensation, and gave the claim number. In reply to this letter he was advised that total disability income under. National Service Life Insurance might be secured in proper cases upon application therefor and payment of an extra premium for such protection.

The insured died of coronary occlusion on January 13, 1949. Premiums on the policy had been paid regularly from the date of the last application for reinstatement. Plaintiff thereupon filed a claim for National Service Life Insurance as the principal beneficiary under the policy. With the claim she enclosed this statement by Dr. Ladd: “I have been acquainted with John Clohesy for the past twenty years * * * December 19, 1947, he suffered an acute coronary occlusion for which he was hospitalized for several weeks. He was under strict medical management until his death, January 13, 1949.”' The Medical Certificate of Death was signed by Robert L. Ladd, M. D.

In February 1949, the month following-the death of the insured, his compensation folder, which had been maintained in the-Regional Office of the Veterans Administration, was transferred to Branch Office No. 7 of the Veterans Administration for consolidation with his insurance file. The *477 Veterans Administration then decided, in considering plaintiff’s claim, that on the basis of the veteran’s statement of comparative health in his request for reinstatement, the subsequent statements of his physician and his own later statements, the insurance was reinstated in reliance upon the insured’s fraudulent representations; and that had his true physical condition been disclosed at the time, the request for reinstatement would not have been approved. The reinstatement of the policy was therefore cancelled, and the plaintiff’s claim for the insurance was disallowed.

Plaintiff thereupon filed an action in the District Court to recover on the policy. The United States denied liability, alleging that the insured had procured the approval of his last application for reinstatement by fraudulent representations in his application for reinstatement. Upon submission to the court the facts were stipulated and judgment was rendered for the defendant.

Congress has provided, 38 U.S.C.A. § 802(w), that National Service Life Insurance policies may be contested on the ground of fraud. Plaintiff does not, as she obviously cannot, deny that the insured committed fraud in this application for reinstatement. However, it is here contended that the fraud was vitiated by a subsequent full disclosure of his physical condition, made when the insured filed a claim with the Veterans Administration for disability compensation; that with notice of the material facts relating to the insured’s physical condition, the Government elected to continue the policy and cannot now cancel the reinstatement.

As appears from the agreed statement of facts, prior to the insured’s death his compensation folder and his insurance file were maintained in separate offices or divisions of the Veterans Administration. It is thus plaintiff’s contention that although employees of the Veterans Administration - in charge of the compensation folder were in no way concerned with and had no knowledge of the insured’s application for reinstatement, nevertheless their knowledge of his true physical condition constituted notice to the Veterans Administration of false representations in that application.

In urging this proposition, the plaintiff relies heavily on United States v. Kelley, 9 Cir., 136 F.2d 823, 825. In that case the Compensation Section of the Veterans Administration had received and acted upon an application from the insured for “compensation of veteran disabled in the World War.” When the insured subsequently applied to the Insurance Section for Government life insurance, he answered, “No,” to the question of whether he had ever applied for “Government compensation.” The jury did not find that this answer was made with knowledge of its falsity or with intent to deceive, and the Court of Appeals held that the evidence did not require a finding that it was so made. Continuing, however, the court there said that the Insurance Section of the Veterans Administration was not a “se'parate entity” but was “merely a function or activity of the Administration”, and that an application for compensation “was a part of the Administration’s own records.

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Bluebook (online)
199 F.2d 475, 1952 U.S. App. LEXIS 3377, Counsel Stack Legal Research, https://law.counselstack.com/opinion/clohesy-v-united-states-ca7-1952.