Craver v. Union Fidelity Life Ins.

307 N.E.2d 265, 37 Ohio App. 2d 100, 66 Ohio Op. 2d 170, 1973 Ohio App. LEXIS 807
CourtOhio Court of Appeals
DecidedOctober 29, 1973
DocketC-73204
StatusPublished
Cited by10 cases

This text of 307 N.E.2d 265 (Craver v. Union Fidelity Life Ins.) is published on Counsel Stack Legal Research, covering Ohio Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Craver v. Union Fidelity Life Ins., 307 N.E.2d 265, 37 Ohio App. 2d 100, 66 Ohio Op. 2d 170, 1973 Ohio App. LEXIS 807 (Ohio Ct. App. 1973).

Opinion

Palmer, J.

This appeal arises from an action filed by plaintiff-appellee against the defendant-appellant insurance company, for a declaratory judgment pursuant to R. C. 2721.03, praying for a declaration that the policy of insurance and rider issued by defendant to plaintiff required defendant to pay hospital benefits of $100 per week to plaintiff beginning with the first day of hospital confinement of plaintiff’s wife after the effective date of the policy, and for damages to which he was entitled upon defendant’s refusal to pay such benefits. Following the completion of discovery procedures and the overruling of plaintiff’s motion for summary judgment, the matter proceeded to trial to the court, without a jury, pursuant to certain stipulations of fact involving, inter alia, the admission into evidence of a certain advertising brochure published by defendant in local newspapers by means of which defendant solicited plaintiff’s application for insurance which, upon acceptance, ripened into a contract of insurance between the two parties, and of the contract of insurance and surgical rider thereto issued to plaintiff subsequent to his application, one clause of which, under the heading “Definitions,” provided the following:

“ ‘Sickness’ means sickness or disease resulting in hospital confinement where such sickness or disease is first *102 manifested after the Effective Date of the Policy and while the Policy is in force.”

It was further stipulated that plaintiff’s wife was confined in a hospital for a period of 28.14 weeks after the effective date of the policy and that the defendant paid plaintiff $500 for five weeks of such confinement but refused to pay for the balance of 23.14 weeks which, it was stipulated, was occasioned by sickness or disease antedating the effective date of the policy.

Following a brief trial consisting solely of the above and other stipulations not relevant herein, and of the testimony of the plaintiff, the court submitted the matter and in due course announced its opinion (see 35 Ohio Misc. 15)' setting forth in detail its findings and conclusions, and directing the presentation of a judgment entry, subsequently journalized, granting judgment for plaintiff in the sum of $2,314. Prom this judgment defendant appeals, asserting a single assignment of error that the judgment of the trial court was contrary to law and was against the manifest weight of the evidence.

Defendant directs its principal arguments in opposition to the two reasons announced by the trial court in its opinion in support of its judgment. These reasons were summarized by the court as follows:

“For the two reasons set out: (1) that the contract is ambiguous and the ambiguity must be interpreted against the company, and (2) even if the contract be interpreted to exclude the illness of plaintiff’s wife due to pre-existing conditions, plaintiff was induced to enter into the contract by false representations * #

Defendant argues that, contrary to the trial court’s finding, the contract provision in question (defining a “sickness” covered by the policy as one which “is first manifested after the Effective Date of the Policy,” a provision admittedly read by the plaintiff after a receipt by him of the policy) is clear and unambiguous, and may be relied upon by defendant to exclude plaintiff’s right to recover for those expenses of his wife’s confinement resulting from her sickness or disease antedating the effective date of the policy. ..... ......

*103 While it may be said that we have experienced difficulty in following the somewhat exiguous basis advanced for a finding of ambiguity in the above definition, yet we find it unnecessary to decide this issue, since it is clear to us that there is substantial and credible evidence of probative value in the record to sustain the finding of the trial court that plaintiff was induced by defendant to enter into the contract by means of false representations contained in the advertising brochure. The trial court set forth at some length, in its learned opinion, those aspects of the eight page, illustrated, and colored brochure which were obviously designed to attract the naive and unskilled, and the small-print caveats therein by which the defendant proposed to escape the consequences of its deceptive and misleading advertising. Thus, on the first page of the brochure, in varying styles and oversized type, appeared, in part, the following:

“Now * * * for people of all ages, learn how YOU CAN LEAVE THE HOSPITAL WITH EXTRA CASH IN YOUR POCKET! YOU GET $100.00 A WEEK whenever you go to the hospital!
At last, here is a plan that actually pays you: EXTRA CASH up to $10,000.00. EXTRA CASH from the first day in the hospital. EXTRA CASH to use as you see fit. EXTRA CASH in addition to hospitalization, Medicare, or any other insurance!”

Also on the first page appeared the following:

“Now * * * and only until the date shown above * * * You can have CASH protection regardless of your age or ihe size of your family.”
On the second page, under the headline “YOU GET $100.00 A WEEK TAX-FREE,” appears a photograph of of a handsome young couple enjoying, with their two children, a picnic on the shores of a lake, and under this idyllic pastoral scene, the legend in large type:
“NOW * * * you and your family can join this Extra Cash Income Plan with * * * no red tape * * * no questions to answer * * * no age limit * * * without having to see a salesman * * * without any qualification whatsoever.”

Under this, in smaller type, appears a paragraph call *104 ing attention to the catastrophic nature of many hospital expenses, which concludes:

“Wouldn’t it be comforting to know 'these financial problems could be solved by your Extra Cash Plan? This Plan gives you tax-free EXTRA CASH from the first day in the hospital for up to 100 full weeks.”
On the third page of the brochure, in large type and in columnar style, appears the following:
“You can be secure, knowing that when hospitalization is necessary, you will receive: $100.00-a-week TAX FREE when you go to the hospital; $10Q.00-a-week from the first day in the hospital; $100.00-a-week sent directly to you * * * not doctor or hospital.”

Not until the fifth page of the brochure, and in the smallest type yet used, does the following appear:

“THESE ARE THE ONLY EXCLUSIONS! The neto Union Fidelity ‘Extra Income Hospital Plan’ has NO WAITING PERIODS. It covers you immediately for every kind of sickness and accident except, of course, hospitalization caused by mental disorders; act of war; pregnancy, childbirth or miscarriage; or care provided in a government hospital. What’s more, if you’ve been sick before, or if you are sick now, you’ll be covered even for this condition after your policy has been in effect for only 2 years. EVERYTHING ELSE IS COVERED.”

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Bluebook (online)
307 N.E.2d 265, 37 Ohio App. 2d 100, 66 Ohio Op. 2d 170, 1973 Ohio App. LEXIS 807, Counsel Stack Legal Research, https://law.counselstack.com/opinion/craver-v-union-fidelity-life-ins-ohioctapp-1973.