Coscarella v. Metropolitan Life Insurance

157 S.W. 873, 175 Mo. App. 130, 1913 Mo. App. LEXIS 197
CourtMissouri Court of Appeals
DecidedJune 3, 1913
StatusPublished
Cited by16 cases

This text of 157 S.W. 873 (Coscarella v. Metropolitan Life Insurance) is published on Counsel Stack Legal Research, covering Missouri Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Coscarella v. Metropolitan Life Insurance, 157 S.W. 873, 175 Mo. App. 130, 1913 Mo. App. LEXIS 197 (Mo. Ct. App. 1913).

Opinion

NORTONI, J.

This is a suit on a policy of life insurance. Plaintiff recovered and defendant prosecutes the appeal.

[135]*135The policy is in the amount of $220. It appears that it was issued on April 11, 1910, on a written application executed by the insured a few days theretofore, to which was attached a detailed examination of the insured’s physical condition and concerning her health, by defendant’s physician. By its terms the policy is payable to plaintiff, husband of the insured, in event of the prior death of his wife, and it appears she died May 10, 1910.

The principal matter relied upon in defense is a condition contained in the policy to the effect that no obligation is assumed by the insurance company unless, on the date of the issue of the policy, the insured is in sound health. The policy contains such a provision and the evidence tends to prove that the insured was not in sound health at the time the policy was issued and delivered.

It is urged that the court should therefore have directed a verdict for defendant and thus declared the force of the condition in the policy above mentioned without submitting the matter'to the jury. It is said' that such conditions in the policy are universally sustained as proper and enforcible in law, and the case of Bell v. Missouri State Life Ins. Co., 166 Mo. App. 390, 149 S. W. 33, is relied upon as so declaring the rule.

The question involved here is to be determined by reference to our statute concerning life insurance, declaring that misrepresentations made in obtaining a policy of life insurance are to be deemed immaterial except in those cases where it shall appear the fact misrepresented actually contributed to the cause of death. It is true that we declared the rule with respect to a condition in the policy postponing the taking effect of the insurance contract in event the insured was not in good health at the time, as argued by defendant, in Bell v. Ins. Co., supra. But be that as it may, no such question as that presented here was made in that case. Indeed, there the contract under review [136]*136was not within onr statutes on the subject at all but, instead, the policy invoked was an Arizona contract. The insured applied for the policy in the State of Arizona. It was issued in Missouri but delivered to the insured in Arizona where the premiums were paid, and it became effective there as an insurance contract. For the facts, see Bell v. Ins. Co., above cited. Therefore, the policy in judgment in that case was not within the influence of our statutes for the very good reason that it was an Arizona contract. [See Cravens v. New York Life Ins. Co., 148 Mo. 583, 50 S. W. 519.] Here it appears the insured resided in St. Louis, where the insurance was negotiated, the premiums paid and the policy delivered. Such a contract is to be determined in accordance with our law on the subject.

By section 6937, R. S. 1909, it is providéd, in substance, that no representations made in connection with obtaining a life insurance policy shall be regarded as warranties. On the contrary all such representations are to be regarded and treated as immaterial, unless it shall appear that a misrepresentation was made with respect to a fact concerning the health of the insured, which condition of health so represented actually .contributed to the death of the insured. The statute further provides that the question as to whether it so contributed in every case is one for the jury. Under this statute, we have heretofore declared the rule is established that conditions in the policy such as that under review are to be considered and determined on the ba-. sis of representations. In other words such conditions are not available to defeat the insurance vouchsafed in the policy, unless it appears the condition of health of the insured was such that it contributed to the death, and the question of fact concerning this matter is one for the jury. [See Lynch v. Prudential Ins. Co. of America, 150 Mo. App. 461, 131 S. W. 145 ; Salts v. Prudential Ins. Co., 140 Mo. App. 142, 120 S. W. 714 ; [137]*137see, also, Burns v. Metropolitan Life Ins. Co., 141 Mo. App. 212, 124 S. W. 539.]

Here the question was submitted to the jury and the finding concerning it was for plaintiff, but it is said there is no evidence to support the verdict. The only evidence introduced by defendant concerning the condition of the health of the insured at the time the policy was issued is a recital in the physician’s certificate accompanying the proof of death furnished by plaintiff to defendant. As before said, the policy was issued and delivered on April 11th and the insured died on May 10th. Afterwards, within due time, a proof of death was furnished, in accordance with the provisions of the policy, and in connection with this the attending physician stated the cause of the insured’s death to be phthisis pulmonalis. A further statement by the attending physician in the same certificate reveals that the insured had been ill two months. It is insisted that these statements revealed beyond question that plaintiff’s wife was not in good health within the terms of the condition of the policy above referred to, even when considered under our statute. Therefore, it is said the question is concluded by the recitals contained in the proof of death and accompanying physician’s certificate, which the policy required to be furnished as a prerequisite to the payment.

There can be no doubt of the general rule that proofs of death furnished by a beneficiary to the insurer, in accordance with the requirements of the policy, are admissible in evidence against such beneficiary as admissions by him of the truth of the statements therein contained. 'There is strong reason for the rule where the statement invoked is made directly by the beneficiary, but it is qualified even then so that such statements will not operate an estoppel if they appear to have been erroneously made. When made by the beneficiary, the statements are prima facie evidence [138]*138only, and may be explained or overthrown in proper cases. This being true, it is certain they may be explained away or overthrown, though appearing in the proof of death, when made by another than the beneficiary, as here. [See Queatham v. Modern Woodman of America, 148 Mo. App. 33, 127 S. W. 651 ; Almond v. Modern Woodman of America, 133 Mo. App. 382, 113 S. W. 695.]

To the end of explaining and repelling the force of the statements so made in the proof of death by the attending physician, plaintiff introduced the original application executed by the insured, and utilized that portion of it revealing a medical examination made of the insured by the defendant’s examining physician shortly before the policy was issued. From this examination and report so made by defendant’s examining physician, it appeared the insured .was in good health at the time and was not afflicted with any kind of pulmonary trouble. But it is.argued this evidence was incompetent, for the policy provides on its face that it constituted the entire contract between the parties. Obviously such a provision in the policy will not suffice to render the application on which it was issued as incompetent evidence in the case, when considered under our statute. It is true, as asserted by defendant, that the application is only a proposition for insurance which carries with it a statement made by the medical examiner of the company, but when the application is accepted and acted upon and the policy issued thereon, no one can doubt that such a proposition becomes a part of the contract between the parties. Moreover our statute (Sec.

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Bluebook (online)
157 S.W. 873, 175 Mo. App. 130, 1913 Mo. App. LEXIS 197, Counsel Stack Legal Research, https://law.counselstack.com/opinion/coscarella-v-metropolitan-life-insurance-moctapp-1913.