Duke v. Valley Forge Life Ins. Co.

341 So. 2d 1366, 1 A.L.R. 4th 1193, 1977 La. App. LEXIS 3564
CourtLouisiana Court of Appeal
DecidedJanuary 12, 1977
Docket7715
StatusPublished
Cited by5 cases

This text of 341 So. 2d 1366 (Duke v. Valley Forge Life Ins. Co.) is published on Counsel Stack Legal Research, covering Louisiana Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Duke v. Valley Forge Life Ins. Co., 341 So. 2d 1366, 1 A.L.R. 4th 1193, 1977 La. App. LEXIS 3564 (La. Ct. App. 1977).

Opinion

341 So.2d 1366 (1977)

Mrs. Harry G. DUKE
v.
VALLEY FORGE LIFE INSURANCE COMPANY et al.

No. 7715.

Court of Appeal of Louisiana, Fourth Circuit.

January 12, 1977.
Rehearing Denied February 15, 1977.

*1367 Deutsch, Kerrigan & Stiles, Francis G. Weller, New Orleans, for defendants-appellants.

Louis C. Philips, New Orleans, for plaintiff-appellee.

Before GULOTTA, STOULIG and BEER, JJ.

BEER, Judge.

Plaintiff-appellee, the widow of decedent, Harry Duke, filed this suit against Valley Forge Life Insurance Company, The Planning Corporation and The International Association of Electrical Inspectors for recovery of $10,000 (plus legal interest and costs) allegedly due her as sole beneficiary under a group life insurance policy.

In all matters pertinent to this litigation, The Planning Corporation was the local agent for Valley Forge Life Insurance Company (hereafter "Valley Forge") and The International Association of Electrical Inspectors (hereafter "IAEI") was an account holder of the insurance company in behalf of those of its members who chose to participate in the group life insurance program of Valley Forge.

Defendants contend that the alleged insurance coverage which Mrs. Duke seeks to enforce on a theory sounding in tort never, in fact, came into existence. They further contend that even if it had, material misrepresentations vitiated coverage. They contend such tort recovery requires proof of the insurer's unreasonable delay in providing coverage and that similar coverage could, otherwise, have been obtained elsewhere. They argue that Mrs. Duke failed to produce any evidence to support the second part of this burden and that the time factor involved does not support a fair definition of "unreasonable delay."

Trial on September 2, 1975, was followed by judgment in favor of plaintiff Mrs. Duke and against defendant Valley Forge for $10,000 (the coverage amount of the policy), together with legal interest thereon from date of judicial demand until paid, and for all costs. On December 19, 1975, Valley Forge's motion for a new trial was denied. Suspensive appeal by Valley Forge was answered by Mrs. Duke seeking legal interest "from the date of receipt of due proof of death" until paid and reasonable attorneys' fees.

It is helpful to consider certain relevant facts in chronological order:

Early in 1972, a brochure circulated among the members of IAEI had solicited them to purchase life insurance provided by a group policy underwritten by Valley Forge (with The Planning Corporation acting as its agent). The program, sponsored by IAEI, was made available to all of its members under 65 years of age. If the member applied during the charter period ending May 1, 1972, no medical examination was initially required.

Harry Duke, a member of IAEI, 61 years of age, filled out an application and forwarded it (accompanied by a premium check in the amount of $157.60) on February 23, 1972. He sought to obtain life insurance coverage in the amount of $10,000. However, the payee of the check was incorrectly shown as "Mrs. Harry Duke" and so it was returned by the company's agent. A new check in the same amount with the payee properly shown was sent forward by *1368 Duke on or about March 10 and, thereafter, negotiated by Valley Forge on or about March 21.

The application, signed by Duke, contained the following representation:

"I represent that the statements and answers shown above are complete and true to the best of my knowledge and belief and understand that the Insurance applied for will not become effective unless and until the first premium has been paid during the lifetime of the insured and the Valley Forge Life Insurance Company unconditionally approves and accepts this application." (Emphasis ours.)

Thereafter, on April 14, 1972, the underwriting department of Valley Forge requested its agent, The Planning Corporation, to secure, from Duke, an authorization for them to obtain a statement from Duke's physician detailing a high blood sugar situation that had been reported by Duke on the application form[1] which had been sent to the company with his original check. This was handled by letter dated April 26, 1972, to Mr. Duke, enclosing, for his signature, an authorization permitting Valley Forge to obtain additional information from his physician. A signed authorization bearing Duke's signature then permitted Valley Forge (through The Planning Corporation) to contact Dr. J. D. Landry, which they did on May 3, 1972, asking that he complete a "Diabetes Questionnaire" concerning Mr. Duke and return same to Valley Forge. Dr. Landry responded to this on May 8[2] in a manner that made it clear that any problem that Mr. Duke had with diabetes was totally overshadowed by the fact that, on May 6, it was discovered that he was suffering from terminal stage cancer.

At this point in describing the existent circumstances, we must go back in time to May 1. On that day, Mr. Duke had been hospitalized as a result of "intestinal obstruction" which, on May 6, required surgical intervention and that surgical intervention resulted in a diagnosis of metastatic adenocarcinoma. Thus, Dr. Landry's report of May 8 was essentially unconcerned with Duke's diabetic condition since he was clearly dying of cancer. Though he returned home for a short period of time, Mr. Duke was again hospitalized on May 26 and died on June 1 of Metastatic Carcinoma of Colon.

On May 24, 1972, The Planning Corporation received and transmitted the May 8 memorandum of Dr. Landry to Valley Forge, resulting, on June 21, in Valley Forge notifying The Planning Corporation that Duke's application was declined because of adenocarcinoma. Based on this notification, The Planning Corporation, on July 5, issued a premium refund check for $157.60.

At the trial, Dr. J. Durel Landry testified (via deposition) regarding all aspects of Duke's medical history: In August, 1971, he had made arrangements for Mr. Duke's hospitalization for a "checkup." Duke was admitted on September 13, 1971, and was, at that time, diagnosed as suffering from "Diabetes Mellitus." He was discharged on September 16, 1971. Dr. Landry classified Duke as a "mild diabetic" but went on to observe that by April, 1972, his blood sugar was "under control as far as diabetes was concerned."

Notwithstanding these observations, able counsel for all parties have stipulated that the underwriting department of Valley *1369 Forge had not been informed that Mr. Duke had been hospitalized in September, 1971, and thus were unaware that a diagnosis had been made—at that time—indicating that Duke was suffering from diabetes mellitus. It was further stipulated by counsel for all parties that if such information had been disclosed to said department at the time Duke submitted his application, or at any time between the submission of the application and Duke's death, the application would have been unequivocably rejected in accordance with the company's standard underwriting practices and guidelines.

The only other testimony adduced was that of Mrs. Harry Duke. She testified that Mr. Duke had "other insurance" besides the insurance which concerns us here and also testified that her husband had never been refused insurance to her knowledge. Finally, Mrs. Duke testified that Mr. Duke had no way of knowing that he had cancer prior to the surgery performed in May, 1972.

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Bluebook (online)
341 So. 2d 1366, 1 A.L.R. 4th 1193, 1977 La. App. LEXIS 3564, Counsel Stack Legal Research, https://law.counselstack.com/opinion/duke-v-valley-forge-life-ins-co-lactapp-1977.