General Life & Accident Insurance Co. v. Handy

766 S.W.2d 370, 1989 Tex. App. LEXIS 337, 1989 WL 13793
CourtCourt of Appeals of Texas
DecidedFebruary 22, 1989
Docket08-88-00118-CV
StatusPublished
Cited by14 cases

This text of 766 S.W.2d 370 (General Life & Accident Insurance Co. v. Handy) is published on Counsel Stack Legal Research, covering Court of Appeals of Texas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
General Life & Accident Insurance Co. v. Handy, 766 S.W.2d 370, 1989 Tex. App. LEXIS 337, 1989 WL 13793 (Tex. Ct. App. 1989).

Opinion

OPINION

FULLER, Justice.

In a suit by a policyholder against his health insurer, the jury returned a verdict in favor of the policyholder. We affirm.

Appellee Melvin Handy (Handy) purchased a major medical expense policy issued by Appellant General Life and Accident Insurance Company (General Life). Handy later suffered a serious heart condition, resulting in open heart surgery. Appellant General Life denied coverage, asserting Handy’s condition was excluded from coverage under the policy because his condition manifested itself before thirty days after the effective date of the policy. In addition, the Appellant contended that the pre-existing clauses of the policy barred recovery because two years had not elapsed from the effective date of the policy. This lawsuit resulted in a verdict and judgment for the policyholder.

Appellee alleged a cause of action for breach of contract and also a cause of action for breach of duty of good faith and *372 fair dealing, a claimed violation of Tex.Ins. Code Ann. art. 21.21 (Vernon 1981). The jury found for Handy under both theories. The jury found Appellee had incurred medical expenses in the recoverable amount of $24,921.71; $7,500.00 was awarded for Handy’s past mental anguish suffered and exemplary damages in the amount of $100,-000.00. The jury awarded as attorney fees through the trial court, the Court of Appeals, and the Texas Supreme Court the respective amounts of $25,000.00, $5,000.00 and $5,000.00.

THE EVIDENCE

Handy applied for medical insurance with Appellant General Life on or about June 13, 1984. Handy asserted that Appellant’s sales agent, Ted Fina, inquired about four pre-existing conditions: cancer, heart disease, diabetes and high blood pressure. Handy and his wife answered “no” to Fina’s questions concerning these pre-exist-ing conditions. Fina explained to them that if a client answered “yes” to having any pre-existing conditions then a “rider” would be attached to the policy which would have the effect of not covering them for that particular illness for a period of twelve months. Appellant General Life did issue Appellee Handy a policy without a “rider” attached.

In November 1984, Handy developed chest pains and was given a resting electrocardiogram by Dr. Patterson who then assured Handy that he did not have a heart problem and advised him that the pains were related to something else. Handy returned to work (as a plumber) and had no further symptoms until June 1985, when he experienced pain in his arm. Handy consulted Dr. Woodward, who administered a stress test on June 17,1985. Handy failed the test. With the doctor’s recommendation, Handy underwent an angiogram which revealed a serious blockage in his left main coronary artery. Handy testified that this was the first time that doctors had diagnosed a blockage to his heart and this was the first knowledge of a heart problem. Appellant contended Handy had stated to a Dr. Lee, at the time of the angiogram, (June 24, 1985) that he had been experiencing chest discomfort and arm pains for over a year. Handy denied that he had made this statement to Dr. Lee.

Double bypass heart surgery was performed on Handy on July 22, 1985. In August, about a month after the surgery, Handy became aware that his medical bills were not being paid. General Life contended that the delay in payment of the bills was due in part to Handy’s medical records not being received from Dr. Shelton and from the hospital. General Life finally received Handy’s medical records. After reviewing the records, General Life denied Handy’s medical claim on December 2, 1985, based on the opinion of its medical director, Dr. Julian, an obstetrician/gyno-cologist. Handy filed suit on March 5, 1986.

Appellant denied any liability relying on the following provisions in the policy:

SICKNESS means illness or disease of any Insured which first manifests itself thirty (30) days after the Effective Date of insurance and while the policy is in force.

Appellant contended that the illness or disease with which Appellee was hospitalized had first manifested itself before thirty days after June 25, 1984, the effective date of the policy.

Appellant further claimed that in addition to the above contention, the pre-exist-ing clauses of the policy prevented recovery because two years had not elapsed from the effective date of the policy when Appellee was hospitalized.

APPELLANT’S POINTS OF ERROR

Appellant thoughtfully designated eighty-five instruments in his transcript designation, but chose not to designate the trial court’s charge. Appellant has asserted thirty-three points of error after being required to comply with Tex.R.App.P. 73(d). This Court denied Appellant’s request to supplement the transcript by filing the trial court’s charge. This request was untimely in that it was received ten days before submission. To allow this request would necessitate the postponement of the *373 date of submission due to the fact that the supplemental transcript had to be prepared and transmitted from Ector County, Texas. Rebriefing would also have to be ordered. The facts simply do not warrant the relief requested when the record shows a lack of valid objections to the trial court’s charge, as set forth in the trial court’s judgment.

We hold that Appellant’s Points of Error Nos. One, Two, Three, Four, Six, Seven and Nine through Twenty-one and Twenty-nine through Thirty-three that complain of the special issues submitted and/or answered are waived by the failure to include the trial court’s charge in the transcript. Tex.R.App.P. 74(f); Town of Lindsay v. Cooke County Electric Cooperative Association, 497 S.W.2d 406 (Tex.Civ.App.—Fort Worth 1973), rev’d on other grounds, 502 S.W.2d 117 (Tex.1973), cert. denied, 416 U.S. 970, 94 S.Ct. 1993, 40 L.Ed.2d 559 (1974). The burden is on the Appellant, or other party seeking review, to see that sufficient record is presented to show error requiring reversal. Tex.R.App. P. 50(d).

Points of Error Nos. Twenty-two through Twenty-four were withdrawn by Appellant from consideration by this Court when Appellant filed its supplemental points of error.

The transcript and statement of facts have been reviewed and do not show that Appellant requested any issues and/or instructions. Since the charge is not before us, we look only at the judgment which contains the eleven issues which were submitted along with the answers of the jury BUT NOT ANY INSTRUCTIONS that may have been given or what issues that were conditionally submitted.

The only objections made by Appellant to the trial court’s charge were to Special Issue No. Two, which complained of the submission of the question of whether Appellant breached the terms of the contract with Appellee by refusing to pay his medical bill. Appellant contends that this was a matter of law for the court, and even assuming Appellant is correct, we find that the trial court approval of the jury’s finding by entering judgment satisfies any objection. Further, no objection was made by Appellant to the submission of Special Issue No.

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Bluebook (online)
766 S.W.2d 370, 1989 Tex. App. LEXIS 337, 1989 WL 13793, Counsel Stack Legal Research, https://law.counselstack.com/opinion/general-life-accident-insurance-co-v-handy-texapp-1989.