Flaherty v. Gulfco Life Insurance Company

327 So. 2d 436
CourtLouisiana Court of Appeal
DecidedApril 13, 1976
Docket5371
StatusPublished
Cited by6 cases

This text of 327 So. 2d 436 (Flaherty v. Gulfco Life Insurance Company) 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
Flaherty v. Gulfco Life Insurance Company, 327 So. 2d 436 (La. Ct. App. 1976).

Opinion

327 So.2d 436 (1976)

Mrs. Emmett R. FLAHERTY, Plaintiff-Appellee,
v.
GULFCO LIFE INSURANCE COMPANY, Defendant-Appellant.

No. 5371.

Court of Appeal of Louisiana, Third Circuit.

February 18, 1976.
Dissenting Opinion February 19, 1976.
Rehearing Denied March 11, 1976.
Writ Refused April 13, 1976.

*437 Bennett & Wilson by Ben C. Bennett, Jr., Abbeville, for defendant-appellant.

Riddle & Bennett by Charles A. Riddle, Jr. and Darrel Ryland, Marksville, for plaintiff-appellee.

Cravel, Roy & Burnes, by Chries J. Roy and Robert L. Royer, Alexandria, for defendant-appellee.

Before MILLER, WATSON and CUTRER, JJ.

CUTRER, Judge.

Plaintiff, Mrs. Emmett R. Flaherty, brought this action to recover all benefits due on a credit life insurance policy issued for a term of one year in the amount of $10,000.00. The action was brought against Gulfco Life Insurance Company (hereinafter sometimes referred to as *438 "Gulfco"). A third party demand was made by Gulfco against the Mansura State Bank and/or Nathan Ducote. After trial on the merits judgment was rendered in favor of plaintiff against Gulfco. The third party demand was dismissed. Gulfco has appealed from that judgment, and plaintiff has answered the appeal, arguing that the trial court erred in denying her penalties under LSA-R.S. 22:656 as prayed for in her petition. We affirm the judgment of the district court.

The basis of this suit is a policy of credit life insurance written by Gulfco insuring the life of plaintiff's husband, Emmett R. Flaherty, made payable to Mansura State Bank, as first beneficiary, in the amount of $10,000.00. The policy sued on was issued October 3, 1973, with Nathan Ducote, an officer of the Mansura State Bank, acting as agent for Gulfco. The policy was issued in connection with a loan by the Mansura State Bank to plaintiff and her husband in the amount of $9,923.51. The loan was secured by a mortgage on immovable property owned by the Flahertys. A premium of $200.00 was collected from the Flahertys, and a certificate of insurance was filled out by Ducote and a copy of the certificate transmitted to Gulfco, together with Gulfco's portion of the premium. On February 12, 1974, Emmett Flaherty died. Proof of death and a request for payment under the policy were sent to Gulfco. Gulfco denied coverage, and this suit followed.

Plaintiff filed suit on August 13, 1974, to recover the benefits due under the credit life policy, together with penalties under LSA-R.S. 22:656. In response to this suit, Gulfco, after the resolution of several exceptions, answered the suit denying coverage on the basis of a clause in the policy requiring the insured to be in sound health at the time the policy was issued, and alternatively naming as third party defendants Mansura State Bank and/or Nathan Ducote as agents acting outside their authority. Trial on the merits was had on May 30, 1975, and on the basis of written reasons rendered, a formal judgment was signed on July 11, 1975, in favor of plaintiff and third party defendants against Gulfco.

Gulfco alleges as error on the part of the trial court the failure to apply the "sound health" provision of the policy sued on. The policy states in pertinent part as follows:

"This policy shall not insure against loss of life unless assured is in sound health upon the date on which this policy is issued.
"Assured shall be presumed not to be in sound health on the date hereof should the assured have been treated for any disease, sickness or injury within six months prior to the date of this policy, which disease, sickness or injury shall be a substantial contributing cause of Assured's death while this policy is in force."

Gulfco contends that the medical evidence submitted at the trial clearly indicates that Mr. Flaherty was in extremely poor health at the time the policy was issued.

The record in this case reveals that several years prior to the dates in question Mr. Flaherty underwent surgery to remove a portion of his jawbone and upper palate. This operation was required due to the existence of a cancerous tumor. He subsequently had to be fed through tubes inserted through his nose. In the ensuing years he suffered from weight loss. The record also indicates that subsequent to this operation, which was performed in 1969, Mr. Flaherty was periodically examined to be sure the cancer had been arrested. These subsequent examinations revealed no recurrence of the cancer. Mr. and Mrs. Flaherty were told that the cancer had been arrested. Gulfco argues that the evidence indicates that Mr. Flaherty was not in sound health at the time the policy was issued, and that as a result the policy never took effect. Plaintiff argues that Gulfco *439 has failed to prove that at the time the policy was issued Mr. Flaherty was not in sound health. Plaintiff contends that following the surgery all tests indicated that Mr. Flaherty's cancer had been arrested.

The issue before this court is not whether the insured was in sound health at the time the policy was issued but rather whether the insurer can escape liability on the basis of a sound health clause in its policy where its agent was authorized to issue insurance to debtors who were not required to submit to a medical examination nor even asked about the health of the prospective insured. The evidence in the record indicates that Gulfco allowed Nathan Ducote to issue credit life insurance to Mr. Emmett R. Flaherty without any inquiry into the health of Flaherty, past or present. No medical examination was required of Mr. Flaherty prior to the issuance of the policy. At the time the policy was issued, Mrs. Flaherty made application on her husband's behalf because he was in the hospital and unable to go to the bank himself. This information was communicated to Ducote. Mrs. Flaherty had to take the papers prepared in connection with the loan to the hospital for her husband to sign them. This information was also communicated to Ducote. Ducote testified that he did not know Mr. Flaherty personally and had no knowledge of his present or prior health. He further stated that he asked no questions with regard to the health of the prospective insured. He stated that he was never instructed by either Gulfco or the bank to ask any questions relating to the health of the prospective insured.

It is also important to note that Mrs. Flaherty never received a copy of the insurance certificate which was filled out on the date of issuance. She did not even have to sign the form, and her testimony is that she never saw the form. The certificate, which contained triplicate copies, was to be filled out by Ducote with the name of the insured and his age, the date of issuance, the term of the policy, the premium due, the name of the first and second beneficiaries and the amount of coverage. The form was filled out by Ducote and signed by him. The signature of Robert Eddy, President of Gulfco, also appears on the certificate. When the certificate was filled out by Ducote in connection with the loan taken out by plaintiff and her husband, it was intended that plaintiff receive a copy for her records. In fact, the copy intended for plaintiff was sent to Gulfco. Plaintiff received no copy of the certificate.

Under the circumstances of this case, we find Gulfco liable to plaintiff for the face value of the policy. There was no allegation of fraud or misrepresentation on the part of plaintiff or her husband. Nor does the record support a finding of fraud or misrepresentation.

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327 So. 2d 436, Counsel Stack Legal Research, https://law.counselstack.com/opinion/flaherty-v-gulfco-life-insurance-company-lactapp-1976.