Evans v. Penn Mutual Life Insurance

186 A. 133, 322 Pa. 547, 1936 Pa. LEXIS 847
CourtSupreme Court of Pennsylvania
DecidedJanuary 30, 1936
DocketAppeal, 48
StatusPublished
Cited by154 cases

This text of 186 A. 133 (Evans v. Penn Mutual Life Insurance) is published on Counsel Stack Legal Research, covering Supreme Court of Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Evans v. Penn Mutual Life Insurance, 186 A. 133, 322 Pa. 547, 1936 Pa. LEXIS 847 (Pa. 1936).

Opinion

Opinion by

Mr. Justice Drew,

Plaintiff is the beneficiary of a policy of insurance issued by the defendant company on the life of her son, Edward W. Evans. The policy was issued, without a medical examination, on April 29, 1932, at which time Evans was 21 years old and was employed as right of way agent for the Bell Telephone Company. He died on the following August 9th. The certificate of the attending physician stated that the immediate cause of death was cerebral hemorrhage and the duration of the last illness was one day. Upon due notice and filing of proofs of death, defendant offered to return the amount of premium paid, $17.46, but denied further liability on the ground of false representation in the application. In plaintiff’s suit for the face amount of the policy two trials were had, each of which resulted in a verdict in plaintiff’s favor. The present appeal followed the entry of judgment upon the second verdict.

The statements upon which defendant relies are contained in the following questions and answers appearing in the application, which was executed on April 19, 1932: “17. D. Have you had any other illness or injury? No. E. Have you, or have you ever had, vertigo, appendicitis, rheumatism, heart disease, Bright’s disease, lung disease, or any other disease or infirmity? No. 18. Have you ever been disabled or had any medical or surgical treatment, or X-rayed for treatment, disease or diagnosis, other than as stated by you above? If so, full details. No. 19. Are you aware of any circumstances *550 connected with your own health or that of your family which might affect the risk of insurance on your life? No.” 1 Defendant averred that these answers were false and were known by Evans to be false when he made them and that in fact he had, five or six years prior to the date of the application, suffered dislocation of a vertebra near the base of the brain, that he had thereafter had several similar dislocations, and that one of these dislocations ultimately led to his death. It was further averred by defendant that during the five years preceding his death Evans had received medical treatment from three doctors, all of whom had treated him for the various dislocations. Plaintiff in reply denied that insured had suffered dislocation of a vertebra or any other injury, or that insured had at any time been paralyzed, as defendant had averred, or otherwise disabled or had any medical or surgical treatment. Plaintiff’s reply likewise stated that “one of the vertebrae would sometime get out of its rigid position in the spinal column which was promptly restored by osteopathic treatment and massage.” The pleadings thus presented issues of fact for determination by the proper tribunal.

In view of the frequency with which cases of this sort have been arising, we consider it advisable to restate here the chief principles applicable to this type of case, in the hope of making our position in the matter clearer and thereby affording additional guidance to lower courts and to litigants in the disposition of this kind of litigation.

The policy in suit contained the usual provision that all statements made by insured or on his behalf should be deemed representations and not warranties. The contention has been made that false statements material to the risk avoid the policy in a case of this sort, as well as *551 where the statements are warranted to he true. 2 It is true that in some of the older cases 3 that rule has been applied apparently without a consideration of whether the statements were in fact representations or warranties, although those cases may well be explained by the fact that at that time most if not all policies did expressly provide for a warranty of the truth of the statements in the application. In our recent cases, however, it has been made very clear, at least since Suravitz v. Prud. Ins. Co., 244 Pa. 582, that, where the statements are made representations, the test of recovery is the good faith of the insured in making them: Skruch v. *552 Metro. Life Ins. Go., 284 Pa. 299; Livingood v. N. Y. Life Ins. Co., 287 Pa. 128; Kuhns v. N. Y. Life Ins. Co., 297 Pa. 418; Lilly v. Metro. Life Ins. Co., 318 Pa. 248; Stein v. W. Y. Life Ins. Co., 319 Pa. 225. 4 In the Suravitz case, at page 586, and again in Shrudh v. Metro. Life Ins. Co., supra, at page 302, we said: “In our opinion the change in the covenant from a warranty to a representation was intended to broaden the scope of inquiry in such cases so as to give relief to parties who in good faith take out policies of insurance, from the harshness, and in many instances the injustice, of the old rule applicable to warranties. If this be the correct view, and it is certainly the just and equitable one, we can see no reason for limiting the inquiry to the single question of the materiality of the answer. Whether true answers Avere made, and whether the answers as made Avere correctly written down by the agent of the insurance company, and the good faith of the party making the an *553 swers to the best of his knowledge and belief, are questions which go to the very essence of the insurance risk, and parties should not be denied the right to have such matters determined before a proper tribunal unless they have covenanted otherwise. As to warranties the general rule is that the insured is concluded by his answer as it appears in the application attached to the policy, but as to representations no Pennsylvania case has gone so far as to hold that the same drastic rule should be applied, and no case has decided that the inquiry is limited to the single instance where the materiality of the answer is raised by the issue.” And in Lwingood v. 27. 7. Life Ins. Go., supra, it was said by Mr. Justice Sadler, at page 131, with reference to a provision that insured’s answers were representations and not warranties : “Where the misstatement has been set forth inadvertently, or the narrative is incomplete in detail, and was made without intention of concealing the truth, a recovery is permissible, the question of good faith being for the jury.”

The insurer must thus establish, in order to avoid the policy in the case of representations, that the statements relied on were falsely and fraudulently made. It is sufficient to show that they were false in fact and that insured knew they were false when he made them (see Lilly v. Metro. Life Ins. Co., supra, page 251; Stein v. N. Y. Life Ins. Co., supra, page 227), since an answer known by insured to be false when made is presumptively fraudulent. 5 Fraud may also be assumed from a showing that insured made false statements although fully aware that he did not know whether or not they were true, and that they had a tendency to and did mislead the insurer. 6

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Bluebook (online)
186 A. 133, 322 Pa. 547, 1936 Pa. LEXIS 847, Counsel Stack Legal Research, https://law.counselstack.com/opinion/evans-v-penn-mutual-life-insurance-pa-1936.