Edna L. Evans v. United Life & Accident Insurance Company, a New Hampshire Corporation, Edna L. Evans v. United Life & Accident Insurance Company, a New Hampshire Corporation

871 F.2d 466, 14 Fed. R. Serv. 3d 307, 1989 U.S. App. LEXIS 3532
CourtCourt of Appeals for the Fourth Circuit
DecidedMarch 23, 1989
Docket88-3910
StatusPublished
Cited by30 cases

This text of 871 F.2d 466 (Edna L. Evans v. United Life & Accident Insurance Company, a New Hampshire Corporation, Edna L. Evans v. United Life & Accident Insurance Company, a New Hampshire Corporation) is published on Counsel Stack Legal Research, covering Court of Appeals for the Fourth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Edna L. Evans v. United Life & Accident Insurance Company, a New Hampshire Corporation, Edna L. Evans v. United Life & Accident Insurance Company, a New Hampshire Corporation, 871 F.2d 466, 14 Fed. R. Serv. 3d 307, 1989 U.S. App. LEXIS 3532 (4th Cir. 1989).

Opinion

871 F.2d 466

14 Fed.R.Serv.3d 307

Edna L. EVANS, Plaintiff-Appellee,
v.
UNITED LIFE & ACCIDENT INSURANCE COMPANY, a New Hampshire
Corporation, Defendant-Appellant.
Edna L. EVANS, Plaintiff-Appellant,
v.
UNITED LIFE & ACCIDENT INSURANCE COMPANY, a New Hampshire
Corporation, Defendant-Appellee.

Nos. 88-3910, 88-3936.

United States Court of Appeals,
Fourth Circuit.

Argued Nov. 1, 1988.
Decided March 23, 1989.

John Y. Pearson, Jr. (Bruce T. Bishop, James C. Howell, Jill M. Mayo, Willcox & Savage, P.C., Norfolk, Va., on brief), for defendant-appellant.

Philip Browder Morris, Ann Adams Webster (William J.G. Barnes, Browder, Russell, Morris and Butcher, P.C., Richmond, Va., on brief), for plaintiff-appellee.

Before ERVIN, Chief Judge, HALL, Circuit Judge, and KNAPP, Senior Judge for the Southern District of West Virginia, sitting by designation.

ERVIN, Circuit Judge:

The United States Life & Accident Insurance Company ("United") appeals from the denial of its motions to alter judgment, for a judgment n.o.v., or for a new trial. United submitted its motions after a jury returned a special verdict in favor of Edna L. Evans ("Mrs. Evans"), the beneficiary under a life insurance policy United issued to her husband. United argues, in effect, that there was insufficient evidence to sustain the verdict. Mrs. Evans, in her cross appeal, challenges the district court's admission of an insurance application containing information damaging to Mrs. Evans's claim for benefits. Mrs. Evans also appeals the district court's refusal to amend judgment to increase her interest award. We reverse and remand for entry of a $500,000.00 judgment in favor of Mrs. Evans, based on our conclusion that the district court erred in admitting the insurance application.

I.

Volunteer State Life Insurance Company ("Volunteer") and United are wholly-owned subsidiaries of Chubb LifeAmerica ("Chubb"). James Brisco is an agent for both Volunteer and United. The practices Volunteer and United followed in marketing and issuing life insurance policies, and the statements Brisco made to sell the policy under which Mrs. Evans claims, are the essential background to our decision.

In the summer of 1985, Brisco visited Dr. William N. Evans, a 54-year old radiologist, and Mrs. Evans at the couple's Tazewell, Virginia home. Dr. Evans then held a $500,000.00 life insurance policy issued by Phoenix Mutual Life Insurance Company through another agent. Brisco told Dr. Evans that Volunteer or United could provide the same coverage at a lower, more stable premium. Dr. Evans accordingly completed and signed a Volunteer life insurance application.

The Volunteer application stated that misrepresentations about one's age or sex would prompt Volunteer to prorate death benefits to what the insurer would have approved had it known the truth. The application did not specifically address the consequences of other sorts of misrepresentations, but declared that "any false statements or misrepresentations may result in the loss of coverage under the policy."

Apparently responding to a question from the Evans', Brisco expanded on Volunteer's policy concerning misrepresentations by insurance applicants. Brisco said that Volunteer treated misrepresentations that an applicant was a nonsmoker (smokers' misrepresentations) as it did misrepresentations about age or sex, that is, by prorating death benefits. Dr. Evans then proceeded falsely to state that he had not used tobacco in any form in the past twelve months.1 Dr. Evans died on March 19, 1986, from complications after a fall down a flight of stairs. Neither of the parties appeared to have learned of Dr. Evans' misrepresentation prior to his death.

Mrs. Evans timely filed a claim for death benefits. United, the company that had issued the policy then in effect, denied liability, stating that Dr. Evans' statements that he was a nonsmoker was a material misrepresentation that voided the policy ab initio.2 Mrs. Evans then commenced this action, during the course of which much information emerged about how United had come to be Dr. Evans' insurer and about United's policy on smokers' misrepresentations.

Volunteer underwriters had approved Dr. Evans' application for a $500,000.00 policy, with Mrs. Evans as the beneficiary, on October 1, 1985. Brisco then asked United to review Dr. Evans' application. Brisco had apparently not consulted the Evans before bringing in United; certainly Dr. Evans never completed or signed a United application until he received a copy of his United policy.

On October 21, 1985, United approved Dr. Evans for a $500,000.00 whole life policy naming Mrs. Evans as beneficiary. United based its decision on the information in Dr. Evans' Volunteer application. After approving the policy, United created a United application for Dr. Evans by transcribing information from the Volunteer application onto a United form.3 Neither application was ever attached to either the United or the Volunteer policy.

Chubb sent both the Volunteer and the United policies to Brisco on December 9, 1985. Chubb regarded the United policy as an "alternate" policy that would take effect only if Dr. Evans surrendered the primary Volunteer policy.

On January 3, 1986, Brisco delivered to Dr. Evans two copies of the transcribed United application, but not the Volunteer application, with the policies. Dr. Evans opted to hold the United policy and to surrender the Volunteer policy, and handed Brisco a $10,140.00 premium check.

The United policy states that its "issue date" is November 10, 1985 ("policy date"). The policy does not define "issue date". An affidavit from Jon D. Schneider, a vice-president of Chubb and of United, states that "issue date" as used in the United policy is synonymous with the phrase "policy date" used in the Volunteer policy, and that "[t]he terms are used in both policies to indicate a definite starting date ... the date used to determine, for example, when the incontestability [sic] and the suicide clauses begin to run ... [and from which] the cash value of the policy begins to build...."4

A wealth of evidence establishes that Dr. Evans' misrepresentations should have come as no particular surprise to United. United was well aware that smokers commonly misrepresented themselves as nonsmokers on life insurance applications.5 United nonetheless decided, and repeatedly affirmed, that it would not amend its applications to warn that misrepresentations about smoking would result in proration, and much less in denial, of death benefits.6 Apparently, none of United's competitors had declared that misrepresentations about smoking could prejudice an insurer, and United feared that to do so would leave it at a disadvantage in the marketplace.

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Bluebook (online)
871 F.2d 466, 14 Fed. R. Serv. 3d 307, 1989 U.S. App. LEXIS 3532, Counsel Stack Legal Research, https://law.counselstack.com/opinion/edna-l-evans-v-united-life-accident-insurance-company-a-new-hampshire-ca4-1989.