Garrell v. Good Citizens Mut. Ben. Ass'n

16 So. 2d 463, 204 La. 871, 1943 La. LEXIS 1115
CourtSupreme Court of Louisiana
DecidedDecember 13, 1943
DocketNo. 37053.
StatusPublished
Cited by23 cases

This text of 16 So. 2d 463 (Garrell v. Good Citizens Mut. Ben. Ass'n) is published on Counsel Stack Legal Research, covering Supreme Court of Louisiana primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Garrell v. Good Citizens Mut. Ben. Ass'n, 16 So. 2d 463, 204 La. 871, 1943 La. LEXIS 1115 (La. 1943).

Opinion

PONDER, Justice.

The plaintiff, Sylvan Garrell, beneficiary in an industrial insurance policy for the sum of $113 issued on the life of his wife, Duetta Garrell, now deceased, brought this suit against the., defendant insurer, Good Citizens Mutual Benefit Association, Inc., seeking to recover the face value of the policy. In the lower court, the defendant denied liability on the ground that the decedent misrepresented the condition of her health at the time she applied for insurance and at the time the policy was issued to her. In the alternative, the defendant pleaded limited liability to the amount of one-fourth of the face value of the policy. On trial, *873 the lower court gave the plaintiff judgment for one-fourth the face value of the policy. On appeal, the Court of Appeal for the Parish of Orleans affirmed the judgment of the lower court. The matter now comes to us by way of review.

On May 1, 1938, Duetta Garrell applied to the defendant for insurance. On May 9, 1938, the defendant- issued a policy on the life of Duetta Garrell in the amount •of $113, wherein her husband, Sylvan ■Garrell, was made the beneficiary. The insured died on December 11, 1940.

The dispute herein arises over the interpretation of the" incontestability clause and a condition set out on the reverse side of "the policy

The incontestability clause reads as follows :

“This Policy shall be incontestible after two years from date except as stated in conditions and for nonpayment of Premiums.”

The condition in dispute provides as follows :

“If the Insured shall die from Heart diseases, Tuberculosis, disease of the lungs, Respiratory Organs, Cancer, Bright’s Disease, Liver Troubles, Pellagra, Cerebral Hemorrhage, Paralysis, High Blood Pressure, or any chronic disease contracted within twelve (12) months from date of Policy, only one-fourth the sum otherwise •provided for in this Policy will be payable.”

As we gather it, the Court of Appeal arrived at the conclusion that the deceased died of tuberculosis contracted prior to the issuance of the policy. However, it held that the defendant had abondoned the defense that the deceased misrepresented the condition 'of her health at the time she applied for and obtained the policy. The appellate court rested its decision on the ground that the defendant was liable for only one-fourth of the face value of the policy under the condition above set out. In interpreting this condition, the Court of Appeal [11 So.2d 259, 260] was of the opinion that the language, “within twelve (12) months from date of Policy,” merely qualified the words “any chronic disease” and did not apply to tuberculosis and the other diseases specifically stated in the condition. In the light of the decisions in the case of Geddes & Moss Undertaking & Embalming Co., Ltd., v. First National Life Ins. Co., La.App., 177 So. 818; Id., 189 La. 891, 181 So. 436, we withhold our opinion as to the correctness of this ruling. We prefer to rest our decision on other grounds in view of the positions taken by the opposing parties on this review.

The plaintiff relies on the incontestability clause in support of his contention that the judgment of the appellate court should be increased to the amount of the face value of the policy. The defendant stands on the judgment of the Court of Appeal and asks for its affirmance. Consequently, the sole question presented on this review is whether or not the decree of the Court of Appeal should be amended so as to allow the plaintiff the full amount of -the face value of the policy.

The defendant takes the position that the contract limits the coverage where death occurs from tuberculosis, and that the *875 incontestability clause does not preclude the .questioning of the correctness of the amount claimed, as the limitation of con-testability applies only to questions involving the validity of the policy and not to those pertaining to coverage. The cases of Metropolitan Life Ins. Co. v. Conway, 252 N.Y. 449, 169 N.E. 642; Allison v. Ætna Life Ins. Co., La.App., 158 So. 389; Lado v. First Nat. Life Ins. Co., 182 La. 726, 162 So. 579, are cited in support of this contention. In the alternative, the defendant takes the position that the limita tion of coverage where death occurs from tuberculosis is specially excepted in the incontestability clause.

In the case of Mutual Life Ins. Co. of N.Y. v. New, 125 La. 41, 51 So. 61, 62, 27 L.R.A.,N.S., 431, 136 Am.St.Rep. 326; Equitable Life Assurance Society v. First National Bank, 5 Cir., 113 F.2d 272, 135 A.L.R. 445, a policy was involved which contained the following provision and incontestability clause:

“Admission of Age:
“The company will admit the age of the insured upon satisfactory proof; failing such proof, if the age shall have been understated, the amount of insurance or other benefit will be equitably adjusted.
“Incontestability:
“After two years from the date of issue, this policy shall be incontestable if the premiums have been duly paid.”

Thi? jCourt construed the clauses togethe? and • effect was given to both • by holding that ,the company had ample time, two years, to make inquiry as to understatement of age by the insured in order to readjust the policy on the basis of her true age. But after two years, the incontestability clause became effective, and the provision as to age would be unenforcible. Thereby, .effect was given to both clauses. Otherwise, the second clause, the incontestability clause, would be entirely neutralized and made ineffective insofar as the proof of age was concerned.

From our appreciation of the case of Bernier v. Pacific Mutual Life Ins. Co. of California, 173 La. 1078, 139 So. 629, 632, 88 A.L.R. 765, the holding is to the effect that a defense is barred when the-policy becomes incontestable, except where-it is preserved in the incontestability clause* irrespective of whether it is based on a denial of coverage or a plea of breach of the conditions of the policy. In other words, all defenses not specially excepted in the clause making the policy incontestable are barred when the period of time fixed in the incontestability clause has elapsed.

' In the Bernier case, supra, the following pertinent observations were made:

“ * * * The provision in a life insurance policy, making the contract incontestable after a stated period, means something more than that the insurer cannot then contest the validity of the policy on the ground of breach of a condition; it. means that the company caiinot then contest its obligation to pay, on due proof of the death of the insured, the amount stated, on the face -.of the policy, except for a. cause of defense that is plainly excepted, from the provision making the policy, incontestable.”
*877

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Bluebook (online)
16 So. 2d 463, 204 La. 871, 1943 La. LEXIS 1115, Counsel Stack Legal Research, https://law.counselstack.com/opinion/garrell-v-good-citizens-mut-ben-assn-la-1943.