Cummings v. Federal Kemper Life Assurance Co.

908 F. Supp. 512, 1995 WL 746939
CourtDistrict Court, E.D. Tennessee
DecidedOctober 18, 1995
DocketCIV 3-91-0718
StatusPublished

This text of 908 F. Supp. 512 (Cummings v. Federal Kemper Life Assurance Co.) is published on Counsel Stack Legal Research, covering District Court, E.D. Tennessee primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Cummings v. Federal Kemper Life Assurance Co., 908 F. Supp. 512, 1995 WL 746939 (E.D. Tenn. 1995).

Opinion

FINDINGS OF FACT AND CONCLUSIONS OF LAW

JORDAN, District Judge.

This civil action came on for trial without a jury on July 2, 1993. After the trial, the court considered evidence which the parties offered in the form of deposition testimony and exhibits to the depositions. The court is now prepared to rule on the case. The following are the court’s findings of fact and conclusions of law under Federal Rule of Civil Procedure 52(a).

I

Many of the relevant facts are stated in the pretrial order entered in this civil action [doc. 10]. The late Ernest W. Cummings, together with other shareholders of Drain-All, Inc., a closely held corporation, decided to enter into a shareholders’ agreement under which the corporation would purchase a deceased shareholder’s shares, and, for the purpose of funding its obligations arising out of this agreement, would hold a policy of life insurance covering the life of each shareholder. Mr. Cummings applied for the policy to cover his life, in the amount of $1,000,000.00, on December 22, 1989. 1

*513 In his application, Mr. Cummings stated his medical history as he knew it. He underwent a physical examination, which the insurer, the defendant Federal Kemper Life Assurance Company (Kemper), required. This examination revealed no health problems.

Between the time when he first applied for this policy and underwent a physical examination, and when he signed an amendment to his application, on the basis of which Kemper issued the policy in issue, Mr. Cummings experienced pain in his left ear. He visited a physician, who diagnosed Mr. Cummings’ condition as an ear infection with localized swelling of the lymph node near his left ear. This physician prescribed treatment with an antibiotic. A few days after Mr. Cummings visited his physician, the pain and swelling subsided.

On April 10,1990, Mr. Cummings met with an agent of Kemper to sign the amendment to his application. In this amendment, Mr. Cummings stated that the representations in his original application were true, that he had not suffered any illness or injury since the date of his original application, and that he had not consulted a physician since that date. Mr. Cummings did not disclose his visit to his physician for treatment of what he believed was an ear infection combined with swelling of one lymph node.

The unfortunate truth is that, unknown to anyone on April 10, 1990, Mr. Cummings’ condition was much more serious. After the issuance of the life insurance policy in issue, Mr. Cummings suffered a recurrence of the symptoms of pain and swelling, and his physician recommended a biopsy. Study of the tissue taken from him on May 17, 1990 showed the presence of melanoma. On May 30, 1990, Mr. Cummings underwent surgery, which was followed by radiation therapy. Mr. Cummings died on December 22, 1990.

The court will state additional findings of fact below, in the context of its discussion of the issues and evidence presented.

II

Kemper defended against liability on the life insurance policy in issue on the ground of Mr. Cummings’ misrepresentation in the amendment to his application. The applicable statute, Tennessee Code Annotated § 56-7-103, 2 states,

No written or oral misrepresentation or warranty therein made in the negotiations of a contract or policy of insurance, or in the application therefor, by the assured or in his behalf, shall be deemed material or defeat or void the policy or prevent its attaching, unless such misrepresentation or warranty is made with actual intent to deceive, or unless the matter represented increases the risk of loss.

The parties stipulated that in omitting to note in the amendment to his application his recent visit to and treatment by his physician, Mr. Cummings did not disclose the truth. Kemper disavowed any intention to prove at trial that Mr. Cummings had the intent to deceive when he neglected to note that he had visited his physician for treatment of the pain and swelling in and around his left ear. There certainly was no evidence of any such intent on Mr. Cummings’ part. The whole case therefore depends on whether this unintentional omission was “material,” that is, whether it increased Kemper’s risk of loss. In an agreed order drawn by the parties’ attorneys, 3 they framed the issues for trial as:

a. What precise matter or matters did Ernest Cummings misrepresent to Kemper?
b. Did the matter or matters misrepresented by Ernest Cummings increase Kemper’s risk of loss under Tenn.Code Ann. § 56-7-103? 4

The parties did not dispute the defendant Kemper’s burden with respect to these is *514 sues. “The burden of establishing a ‘misrepresentation’ defense is clearly placed on the insurance company.” McDaniel v. Physicians Mutual Insurance Company, 621 S.W.2d 391, 393 (Tenn.1981).

III

There was no dispute concerning the court’s jurisdiction of the subject matter of this civil action. The plaintiff is a citizen of the State of Tennessee, as was her husband before his death. Kemper is a corporation organized under the laws of the State of Illinois, and has its principal place of business there. The amount in controversy, the face amount of the life insurance policy, is well in excess of $50,000.00. The court concludes that it has jurisdiction of the subject matter of this civil action under 28 U.S.C. § 1332.

IV

The court can summarize the evidence presented at trial as follows. Kemper, having the burden of proof, presented its evidence first. Steven MacDonald, its chief underwriter, testified first. Mr. MacDonald has a bachelor’s degree in biology from Boston College; he is not a physician. He has knowledge concerning what to look for in medical records and how what is found in such records should affect the underwriting of life insurance, gained through experience in the insurance industry. As chief underwriter, Mr. MacDonald reviews medical records and histories to determine whether Kemper should issue life insurance policies on the applications under review, and he supervises others’ reviews of similar records for this purpose. Mr. MacDonald was consulted twice concerning Mr. Cummings’ application for life insurance.

In Mr. Cummings’ initial application for this insurance, it is noted that he had a condition of high blood pressure, but that it was under control. Mr. MacDonald testified that an underwriter looks to see whether an applicant’s hypertension is under control. The only other items concerning Mr. Cummings’ medical history disclosed in this application were a double hernia, for which Mr.

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Related

Womack v. Blue Cross & Blue Shield of Tennessee
593 S.W.2d 294 (Tennessee Supreme Court, 1980)
McDaniel v. Physicians Mutual Insurance Co.
621 S.W.2d 391 (Tennessee Supreme Court, 1981)
Independent Life Ins. Co. v. Russell
80 S.W.2d 846 (Court of Appeals of Tennessee, 1934)

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Bluebook (online)
908 F. Supp. 512, 1995 WL 746939, Counsel Stack Legal Research, https://law.counselstack.com/opinion/cummings-v-federal-kemper-life-assurance-co-tned-1995.