Equitable Life Assurance Society v. Joiner

384 N.W.2d 636, 222 Neb. 504, 1986 Neb. LEXIS 934
CourtNebraska Supreme Court
DecidedApril 11, 1986
Docket84-907
StatusPublished
Cited by3 cases

This text of 384 N.W.2d 636 (Equitable Life Assurance Society v. Joiner) is published on Counsel Stack Legal Research, covering Nebraska Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Equitable Life Assurance Society v. Joiner, 384 N.W.2d 636, 222 Neb. 504, 1986 Neb. LEXIS 934 (Neb. 1986).

Opinion

Garden, D.J.

This appeal arises out of an action filed by Equitable Life Assurance Society of the United States (Equitable), plaintiff-appellee, in the district court for Douglas County, Nebraska, in which Equitable prayed for rescission of a certain lifetime medical insurance policy issued to Harold Joiner, defendant-appellant, which policy also provided coverage for Violet Joiner, wife of the insured. Equitable had rescinded the policy because the Joiners had allegedly failed to disclose certain material medical history of Violet’s on the application. The Joiners’ sole assignment of error is that “[t]he District Court erred in determining Plaintiff-Appellee Equitable met its burden of proving by clear and convincing evidence the Appellant Joiners were guilty of any misrepresentation made knowingly with intent to deceive under the circumstances established at trial.” For the reasons set forth hereinafter we affirm.

Beginning in December 1981, Joiner attempted to contact Jack Webb, an Equitable agent, for the purposes of converting a group medical plan, under which Joiner and his wife, Violet, were covered, to an individual plan. The Joiners’ group plan was issued by Equitable. Joiner testified that under the group plan Equitable provided “blanket coverage.” That is to say, insureds were accepted without any physical examination or disclosure of prior medical history. Because Webb had been unavailable for several months, conversion apparently was not *506 possible and an application for a new policy was required.

On March 23, 1982, Webb traveled to the Joiner home and prepared an application for the Joiners. The application was prepared while the Joiners and Webb sat around the kitchen table, with Webb asking questions from the application, the Joiners responding, and Webb physically filling out the application. The application form itself is six pages in length and contains many questions concerning the applicants’ health and medical history.

The pertinent questions contained in the application, of utmost relevance to the issues in this case, are the following:

B. Has this proposed covered person ever been treated for or had any indications of:
9. Mental or Nervous Disease or Disorder? . . .
C. Has this proposed covered person:
13. Within the last five years, consulted a physician, or been examined or treated at a hospital or other medical facility? ...

In regards to question 9, Webb checked the “No” box on the application. Joiner testified that when Webb approached this question, he (Webb) said to the Joiners, “I think we have all experienced this at one time or another, haven’t we?” Joiner testified his answer was “either a nod or a yes.” Joiner also testified that Webb had spent a great deal of his presentation telling the Joiners about his domestic difficulties. It is for this reason, Joiner argues, that Webb made this comment. Joiner further testified that “I don’t feel that I was given an opportunity [to answer the question].”

Also, the only information written on the application in response to question 13 was a physical exam of Harold Joiner in 1977 and a recent hemoglobin test.

Without going into specific detail the record shows that Violet Joiner had a history of being treated by psychiatrists. She was hospitalized between the years 1961 and 1979 on four separate occasions for various psychiatric problems, for a total period of no less than 43 days. Her latest hospital stay was in *507 April of 1979. Her treatment throughout the years ranged from electric shock and insulin shock treatments to medication. Violet was diagnosed on separate occasions as suffering from an acute psychotic reaction, depression, and schizophrenia. Additionally, beginning in 1968 she consulted, on a regular basis, psychiatrists for the purpose of therapy. Her sessions extended up to and included one in March 1982, the month when the application was completed.

Joiner denies that he intended to defraud Equitable or knowingly give any false information. On cross-examination, in response to opposing counsel’s question as to why Violet’s hospitalization in 1979 had not been disclosed, Joiner testified, “It was an oversight on my part, because it was for a physical examination, and I did not recall it.”

Harold Joiner’s testimony concerning what transpired when the application was taken was uncontroverted. While Webb was listed as a witness in the “Order on Pretrial Conference,” he did not testify at trial. Violet Joiner also did not testify, because she has since died of pancreatic cancer.

Beginning in October of 1982, Violet was hospitalized for treatment of a condition which was eventually diagnosed as pancreatic cancer. She ultimately died of the cancer and related complications in July 1983. Harold forwarded to Equitable all bills submitted by the various health care providers in connection with Violet’s treatment. These bills amounted to over $38,000. Under the policy’s terms, Harold argues, all but $2,000 would be covered and payable by Equitable.

Equitable sent a “Notice of Rescission” dated March 3, 1983, to Harold, stating: “Since the application failed to disclose material facts . . . the Equitable declares the above-numbered policy rescinded and null and void, and denies any liability thereunder.” Specifically, Equitable denied the claims because of Violet’s “Undisclosed Medical History.” A check representing a return of the premiums with interest was also enclosed with the rescission notice, but acceptance of the check was refused.

In its petition filed March 24, 1983, Equitable sought rescission of the policy and alleged misrepresentation on the part of the Joiners in failing to disclose in their application *508 mental and nervous disorders suffered by Violet prior to the application date; that the false answers were known to be false and that the information concealed lay peculiarly within their knowledge and was offered as an inducement for Equitable to issue the policy; and that the answers were material to the risk, were relied upon by Equitable, and deceived it, to its injury. Equitable later filed an amended petition expanding its allegations of misrepresentation, setting forth in factual detail concealed hospitalizations of Violet.

In their answer to Equitable’s petition, the Joiners denied allegations of misrepresentation and intent to defraud and asserted good faith in answering all questions put to them to the best of their knowledge. In their counterclaim and amended counterclaim the Joiners sought enforcement of the policy and reimbursement for medical and hospital expenses incurred by Violet.

Trial was had without a jury in the district court for Douglas County, Nebraska, on October 30,1984, and on November 1 an order was entered, supported by separate findings, finding generally for Equitable. The Joiners’ motion for a new trial was overruled.

This is an action in equity for the rescission of an insurance contract. Actions in equity are reviewed by this court de novo on the record. See Neb. Rev. Stat. § 25-1925 (Reissue 1979).

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Cite This Page — Counsel Stack

Bluebook (online)
384 N.W.2d 636, 222 Neb. 504, 1986 Neb. LEXIS 934, Counsel Stack Legal Research, https://law.counselstack.com/opinion/equitable-life-assurance-society-v-joiner-neb-1986.