Dixon v. Business Men's Assurance Co. of America

285 S.W.2d 619, 365 Mo. 580, 1955 Mo. LEXIS 606
CourtSupreme Court of Missouri
DecidedOctober 10, 1955
Docket43873
StatusPublished
Cited by32 cases

This text of 285 S.W.2d 619 (Dixon v. Business Men's Assurance Co. of America) is published on Counsel Stack Legal Research, covering Supreme Court of Missouri primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Dixon v. Business Men's Assurance Co. of America, 285 S.W.2d 619, 365 Mo. 580, 1955 Mo. LEXIS 606 (Mo. 1955).

Opinions

[584]*584COIL, C.

[622] This case came to the writer on reassignment.

John P. Dixon, respondent (herein called plaintiff), was the insured in an accident and health policy (containing also a provision for a death indemnity) issued by appellant, Business Men’s Assurance Company of America (herein sometimes called defendant or BMA). Plaintiff had verdict and judgment for $8,187-50, including indemnities allegedly due under the policy, “vexatious penalties,” and attorneys ’ fees. BMA here contends that the trial court erred: in failing to direct a defendant’s verdict; in giving an instruction; in submitting the -question of damages and attorneys’ fees for vexatious refusal to pay; and in failing to discharge the jury because of alleged misconduct on the part of plaintiff’s counsel.

Plaintiff, 59. at trial time, was a machinist for the Missouri Pacific Railroad Company. He had obtained an accident and health policy from BMA in March 1946. He was in the Missouri Pacific Hospital in St. Louis from September 16 to September 24, 1947. (According to plaintiff, the .only purpose of the hospitalization was for an operation on his jawbone in order that dentures would fit properly.) On September 25,1947, he notified BMA of his confinement “for an operation on Lower Mandible performed by Dr. W. A. Shinneman”. When BMA’s agent delivered a check for $40 as indemnity for the hospital confinement, conversations occurred which resulted in the execution by. plaintiff, on October 22, 1947, of an application for a new policy like and in addition to the one then in force. As a result, the policy giving rise to the present controversy was issued, dated October 22,. 1947. .

Of the 35 questions in the application, only five (or portions of. them) and the answers thereto are material to the issues:

“1. Are you in good health and free from any bodily impairment ? (If not,,explain). [A] Yes.

[585]*585“2. Have you consulted or been treated by any physician, surgeon or practitioner within five years? (Give full particulars, including date, name and address of physician). [A] Oct. 1, 1947. Oper. on jaw bone. Alveolectomy. Dr. Shinnmann. Mo. Pac. Hosp. St. Louis, Mo.

“4. Has any physician ever given an unfavorable opinion of yoilr physical condition after either formal or informal examination, or have you ever changed your residence on account of your health? (If so, give particulars). [A] No.

“7. Do you now or have you had any of the following? - (a) * * * Arthritis, # * *;? Dates-Duration-Results-Doetors. [A] No.

“35. * * * Do you represent each and all of the foregoing answers to be true and complete ? [A] Yes. ’ ’

[623] Plaintiff had worked regularly without incident from September 25 until November 18,1947, when he sustained an injury to his lower back which totally disabled him continuously to trial time, May 25, 1953. He was hospitalized in the Missouri Pacific Hospital as a result of this injury from April 10 to April 20, 1948. Plaintiff was paid monthly indemnities for total disability under both policies through June 1948.

In May 1948, Ralph E. Weaverling, then Director of Field Service for BMA, reviewed plaintiff’s policies and file pursuant to company routine requiring a review of cases in which indemnities had been paid for six months. As a result, he obtained from plaintiff a written authorization to Missouri Pacific Hospital to furnish BMA information concerning plaintiff, including hospital and medical records, in the hospital’s possession. Pursuant to the authorization and a request by BMA, the hospital sent a letter dated July 12, 1948, and received by Weaverling of BMA on July 16, 1948. (That letter will sometimes be called the hospital letter.)

Weaverling took a portion of the hospital letter to BMA’s chief underwriter and inquired “if a history of that kind would have permitted the company to have issued the policy that was issued to Mr. Dixon on October 22, 1947 ’ ’. Upon being informed that the company would not have issued the policy “under these conditions had they known of it”, Weaverling shortly thereafter stated the'company’s position to plaintiff as follows: “ * # * that the policy was improperly issued and we did not know until we had received the hospital report from St. Louis with regard to the impairment that was recited in the hospital record and I told him at that time that the-company would discontinue payments that had already been paid for seven months on this policy and that we would ask for a refund of $700 that had been made as an overpayment. ” ■

After other meetings and negotiations between Weaverling and Dixon, during some of which plaintiff was represented by an attorney, a settlement was effected and a release executed by plaintiff. (The [586]*586number, details, and effect of the meetings and negotiations which culminated in the settlement and release are described and argued extensively by counsel for both parties. In oúr view, these matters are not material on the narrow issue which determines submissibility and therefore we do not include those details in this statement.) Suffice to say, it is admitted that on September 16, 1948, plaintiff, with the approval of his attorney, executed a release (and at the same time surrendered the policy), by the terms of which the stated consideration was a payment by BMA to plaintiff of $275 and the waiver by the company of its claim for a refund of the $700 theretofore paid plaintiff. Plaintiff released and discharged BMA from all claims, present or future, that he had or might have arising on account of the policy issued on October 22, 1947.

Plaintiff alleged and sought to prove that the release was invalid on the sole ground that there was no consideration for it; it being plaintiff’s position below and here that no bona fide dispute existed between the company and plaintiff at the time of the release, and that therefore the amounts paid plaintiff (including the $700 and the $275) were indemnity payments for which the company was legally liable.

Generally, it is defendant’s theory that a bona fide dispute existed based on defendant’s reasonable belief in good faith at the time of the release that plaintiff misrepresented material facts when he stated in the application that he did not have arthritis, and when he failed to state that, at times during a period of about two months immediately prior to the date of the application, his fingers had cramped while he was doing critical work as a machinist; and that both the “no” answer as to arthritis and the failure to disclose prior cramping of his fingers were material misrepresentations in that they actually contributed to plaintiff’s disability resulting from the November 1947 accident. This latter, because, defendant says, the low back injury was superimposed on a pre-existing arthritic [624] condition in plaintiff’s spine, and-that the answer “yes” to the arthritis question would have disclosed the arthritic spine, and that a disclosure of the fact of the prior cramping of his fingers would have caused defendant to make further investigations which would have led to defendant’s discovery of the arthritic condition in plaintiff’s spine.

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Bluebook (online)
285 S.W.2d 619, 365 Mo. 580, 1955 Mo. LEXIS 606, Counsel Stack Legal Research, https://law.counselstack.com/opinion/dixon-v-business-mens-assurance-co-of-america-mo-1955.