Diaz Lamoutte v. Lincoln Nat. Life Ins. Co

188 F.2d 526, 1951 U.S. App. LEXIS 3065
CourtCourt of Appeals for the First Circuit
DecidedApril 26, 1951
Docket4483
StatusPublished

This text of 188 F.2d 526 (Diaz Lamoutte v. Lincoln Nat. Life Ins. Co) is published on Counsel Stack Legal Research, covering Court of Appeals for the First Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Diaz Lamoutte v. Lincoln Nat. Life Ins. Co, 188 F.2d 526, 1951 U.S. App. LEXIS 3065 (1st Cir. 1951).

Opinion

HARTIGAN, Circuit Judge.

Plaintiffs-appellants filed suit as beneficiaries of a life insurance policy issued by the defendant-appellee to their father, Ignacio Diaz Luzunaris, who died January 1, 1946.

*527 The appellee filed its answer and counterclaim alleging in substance that: (1) Insured, in his application for the policy, had made false and untrue statements, answers and representations, which were material to the risk and to the subject matter of the insurance for which reason the insurance contract has always been void and of no effect 'and (2) it was a condition of the contract that a policy should have been issued and received by the applicant and the first premium paid by him while in good health and that when Ignacio Diaz Luzunaris received the policy and paid the first premium he Was not in good health in that he was suffering from latent lues, for which reason the contract was never in force.

The district court entered judgment dismissing the complaint and granting defendant’s counter-claim from which judgment plaintiffs appealed.

The appellants list 17 points in their statement of points filed January 5, 1950, but in their brief rely upon the following 5 points:

“1. The evidence does not support the finding, nor that part of the judgment, which adjudges insured made untrue statements in application for the insurance policy upon answering Questions Nos. 10, 11, 14 and 15, thereof, propounded to him by the company’s medical examiner. 1
“2. There is no evidence to support the necessary finding that the statements in question influenced insurer’s estimation of the risk.
“3. The trial court overlooked the application had been previously prepared by insurer and erroneously failed to rule that in the construction of its contents insured should be protected against obligations arising in the nature of a ‘warranty’, specially in view of the law and of the condition agreed upon in the insurance contract to the effect that any statement made by insured, or on his behalf in the application shall, in the absence of fraud, be deemed a representation and not a warranty.
“4. The evidence does not support the conclusion that at the time the insurance policy was received and accepted, and first premium paid, by Ignacio Diaz Luzunaris, the latter was not in ‘good health’ and suffering from ‘neuro-lues’, or ‘latentlues’.
“5. The lower court committed fundamental error when denying the admission of letters dated October 16, 1943 and October 28, 1943.”

It appears from the record that the insured from 1932 until his death was a member of a medical institution known as “Auxilio Mutuo” and that he visited the clinic of said institution many times for medical consultation and treatment.

On the occasions when insured went to the institution for consultation he complained of gastric disturbances, pains in different regions of the body, difficulty in *528 walking, etc. In 1943 the director of the institution, Dr. Roldan, in view of the symptoms he saw in the insured, referred him to Dr. Homedes, a specialist of the nervous system. Dr. Homedes after various tests treated the insured for neurolues. He also treated him for malaria as did Dr. Bonelli.

The insured made application for the policy of insurance April 10, 1945. In September, 1945 insured had a coronary thrombosis and he died on January 1, 1946.

There is ample testimony in the record to support the finding of the court below “That at the time that insurance policy No. 803646 was received and accepted by Ignacio Diaz Luzun'aris and the first premium paid by him, the insured Ignacio Diaz Luzunaris was not in good health in that he was suffering from ‘latent lues’.”

The insured consulted Dr. Homedes at least 25 times from November, 1943 to May, 1945. Although insured may not have been told by Dr. Homedes that he had latent lues, he was aware that he had a nervous disease. Dr. Homedes gave him over 30 injections of tri-parysomide, a drug which is used for the treatment of nervous syphilis.

The application of the insured completely failed to disclose that he had consulted Dr. Homedes at all. (See Footnote above, questions 10 and 15). He stated in his application that the last time he consulted a physician was in October, 1943 when he consulted Dr. Bonelli for malaria when in fact he was under treatment with Dr. Homedes as late as May, 1945. Thus, while he was still consulting Dr. Homedes, the insured made application for the policy in issue here.

Dr. Ferrer, a syphilologist and urologist testified as follows:

“ * * * Everything is confusing, until Doctor Homedes took hold of the case and from the history that he had of a primary lesion, of a chancre in 1928, which might be latent for lack' of treatment or from incomplete treatment or no treatment at all, because I don’t know from what you have told me if he had any treatment at all, the only positive diagnosis that can be made is that this is so typical it is a primary lesion of Lues. * * *
******
“ * * * as far as I myself am concerned I would never dare use Tri-Parysomide to try to help a patient’s physical condition because it is a dangerous drug, such a dangerous drug that it might produce permanent blindness, and that is no poppycock.”

The record further discloses: “Q. In your opinion, Doctor, as a syphilologist, would any competent syphilologist recommend Parysomide, except in a case of Neuro-Lues? A. It is recommended, it is the drug per se, to use for Neuro-Lues; T ri-Parysomide.”

Two other experts also corroborated Dr. Homedes in his diagnosis. Dr. Marina said there was enough “to make a diagnosis of Neuro-Syphilis,” and that the insured’s disease was “almost a text-book picture” of syphilis.

Dr. Cabrera’s opinion was that if he were making a diagnosis he did not believe he could make any other than that of neuro-lues.

The ambiguity suggested by the appellants in questions 10 and 15 is fictitious. Dr. Homedes as indicated, although attached to the “Auxilio Mutuo”, was a physician and one who was treating insured for over a year and was still seeing him at the time insured applied for insurance. That Dr. Homedes was attached to the “Auxilio Mutuo” did not excuse the insured from answering questions 10 and 15 unequivocally in accordance with the true facts.

The case of Ettelson v. Metropolitan Life Ins. Co., 3 Cir., 1947, 164 F.2d 660, upon which the appellants place weight is clearly distinguishable from the instant case. In the Ettelson case the insured’s physician, Dr. Levy, sent insured to two other physicians for X-ray and for blood count examinations. These doctors made their reports to Dr. Levy. The court held that the insured’s failure to mention these *529

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Related

Ettelson v. Metropolitan Life Ins. Co.
164 F.2d 660 (Third Circuit, 1947)
Rigby v. Metropolitan Life Insurance
87 A. 428 (Supreme Court of Pennsylvania, 1913)

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Bluebook (online)
188 F.2d 526, 1951 U.S. App. LEXIS 3065, Counsel Stack Legal Research, https://law.counselstack.com/opinion/diaz-lamoutte-v-lincoln-nat-life-ins-co-ca1-1951.