Ginn v. American Heritage Life Insurance Co.

173 S.W.3d 433
CourtCourt of Appeals of Tennessee
DecidedJanuary 24, 2005
StatusPublished
Cited by24 cases

This text of 173 S.W.3d 433 (Ginn v. American Heritage Life Insurance Co.) is published on Counsel Stack Legal Research, covering Court of Appeals of Tennessee primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Ginn v. American Heritage Life Insurance Co., 173 S.W.3d 433 (Tenn. Ct. App. 2005).

Opinions

D. MICHAEL SWINEY, J„

delivered the opinion of the court,

in which HERSCHEL P. FRANKS, P.J., and CHARLES D. SUSANO, JR., J., joined.

OPINION

Pamela K. Ginn (“Plaintiff”) purchased a $50,000 life insurance policy on her husband through American Heritage Life Insurance Company (“American Heritage”). When applying for the insurance, Plaintiff told the insurance salesman, Daryle Gross (“Gross”), that her husband was in “basic good health.” Plaintiffs husband died a few weeks after the life insurance went into effect. American Heritage denied Plaintiffs demand for the life insurance proceeds, claiming Plaintiff had materially misrepresented her husband’s health. Plaintiff sued American Heritage and Gross (“Defendants”). The jury found Defendants breached their contract with Plaintiff. The jury also found that the refusal to pay was done in bad faith, assessing a 25% bad faith penalty. The jury also concluded Defendants had violated the Tennessee Consumer Protection Act (“TCPA”) and assessed compensatory damages under the TCPA at $110,000, which was remitted by the Trial Court to $73,855.15. Pursuant to the TCPA, the Trial Court then trebled the damages and awarded attorney fees. When all was said and done, the amount of the judgment awarded to Plaintiff totaled $284,980.60. Both Plaintiff and Defendants appeal various aspects of the Trial Court’s Judgment. The Judgment of the Trial Court is reversed in part and affirmed in part, and judgment is entered in favor of Plaintiff in the total amount of $73,415.15.

[436]*436 Background

This lawsuit involves a claim for life insurance proceeds with the threshold issue being whether Plaintiff misrepresented her husband’s health when applying for the insurance. Plaintiff knew her husband, Mr. Tony Ginn, had been diagnosed with diverticulitis in 1991 before they were married in 1992. Her husband was prescribed antibiotics and the diverticulitis “cleared up and he was fine.” The diverticulitis flared up again in 1998. This time, Mr. Ginn, who was 5'6" and weighed 190 pounds, lost approximately 60 pounds. Mr. Ginn was treated by Dr. Kozawa who prescribed antibiotics and instructed Mr. Ginn to eat a lot of fiber. Unfortunately, the fiber seemed to make matters worse and, according to Plaintiff, her husband’s health went “downhill.” Mr. Ginn nevertheless continued to work at a paint and body shop and engage in recreational activities with his three children. Mr. Ginn eventually went to the emergency room when his symptoms did not improve. By that time, he was unable to keep food down and when he did, he had diarrhea. After being treated by various physicians, Mr. Ginn was instructed by Dr. McDonald to quit taking fiber. Mr. Ginn then started to improve and regained approximately 20 pounds. Mr. Ginn stopped taking antibiotics in January of 1999 and seemed to be feeling fine, although he continued to take five milligrams of diazepam every day for stomach spasms.

Plaintiff has a seventh grade education and was employed as a sewing machine operator at DCB Rothco (“DCB”). While employed at DCB, Plaintiff occasionally observed defendant Gross, an insurance salesman, come into the plant. February 24, 1999, was the day Plaintiff first spoke with Gross. According to Plaintiff, Gross “just walked up to my [sewing] machine and approached me” about purchasing insurance. Plaintiff asked Gross how much life insurance would cost, and he responded that it would be deducted from her payroll check and the combined cost for Plaintiff and her husband would be $9.47 per week. Gross quoted her the price after he asked Plaintiff if she and her husband were smokers, to which Plaintiff responded that they were. Gross then asked Plaintiff if she or her husband had AIDS, and Plaintiff said that they did not. Plaintiff testified that Gross then stated: “So, in other words, you’re in basic good health.” Plaintiff responded in the affirmative. Plaintiff claims Gross did not ask her any other questions, took no notes, and she never saw the application for life insurance. Gross did, however, set up his laptop computer on her sewing machine and was entering information during their conversation. Plaintiff claims Gross asked no other questions about her husband’s health. Plaintiff then signed what “looked like [an] Etch-a-Sketch type board, a little square box.” Plaintiff testified that Gross asked her to sign her husband’s application as well. The next day Gross brought her a folder with medical injury claim forms, but nothing related to life insurance. Plaintiff noticed premiums being withheld from her paycheck on March 9, 1999. Plaintiff received the life insurance policies issued through American Heritage on March 29, 1999. Mr. Ginn died the next day of a myocardial infarction.

Plaintiff received a letter dated August 11, 1999, from Claudia Osborne (“Osborne”) in the Claims Department for American Heritage. Osborne expressed her condolences to Plaintiff for the loss of her husband. Osborne then stated that had American Heritage been apprised of Mr. Ginn’s actual medical condition, it would have “postponed” issuing a policy until “a definite diagnosis had been made and it [was] determined we would have accepted that risk. Accordingly, we regret [437]*437we will be unable to honor your request for benefit. A refund of all premiums paid to date will be sent to you under separate cover.”

Plaintiff filed this lawsuit in January of 2001 asserting claims based on breach of contract, bad faith refusal to pay the insurance proceeds, as well as violations of the Tennessee Consumer Protection Act, TenmCode Ann. § 47-18-101, et seg. Defendants denied any liability to Plaintiff, claiming Plaintiff had materially misrepresented the state of her husband’s health when she applied for the insurance.

A trial was held in September of 2003 and much of Plaintiff’s testimony on direct examination is set forth above. In addition to that testimony, Plaintiff also was asked about the medical questions on the insurance application. These questions ask whether the applicant has certain specific ailments or diseases. Plaintiff testified she never was asked any of these questions. She also testified that other than questions about AIDS and smoking, the only other medical question asked by Gross was whether she and her husband were in basic good health, to which Plaintiff responded in the affirmative. When asked about her husband’s health at the time the application for life insurance was completed, Plaintiff explained:

Q. Compared with the entire rest of the time that you had known Tony Ginn, what was the state of his health on February the 24th.
A. In good health.
Q. Was there anything remarkable about his health, physical condition, or treatment between then and the day that he died?
A. No.
Q. Did he go back for any additional treatment or examination?
A. He had a [colonoscopy ... on] the 22nd of March.... [After the colonosco-py] Dr. Gholson did come out and hand me some pictures of — I guess of his colon and said that everything looked fine.

Plaintiff went on to add that after the colonoscopy on March 22nd, her husband returned to work the next day. The following Monday he became sick, “hurting in his chest, throwing up.” Mr. Ginn went to work and called Plaintiff later that day telling her he still was feeling bad. Mr. Ginn died in his sleep that night.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Cox v. Erie Insurance Exchange
W.D. Tennessee, 2019
Tamarin Lindenberg v. Jackson Nat'l Life Ins. Co.
912 F.3d 348 (Sixth Circuit, 2018)
Nylander v. Unum Life Ins. Co. of Am.
309 F. Supp. 3d 526 (M.D. Tennessee, 2018)
McKinnie v. State Farm Fire & Cas. Co.
298 F. Supp. 3d 1138 (M.D. Tennessee, 2018)
Lindenberg v. Jackson National Life Insurance
147 F. Supp. 3d 694 (W.D. Tennessee, 2015)
Keith Patterson v. Shelter Mutual Insurance Company
Court of Appeals of Tennessee, 2015
American General Life Insurance v. Underwood
85 F. Supp. 3d 944 (E.D. Tennessee, 2015)
Wilson v. State Farm Fire & Casualty, Co.
799 F. Supp. 2d 829 (E.D. Tennessee, 2011)
Wynne v. Stonebridge Life Insurance
694 F. Supp. 2d 871 (W.D. Tennessee, 2010)

Cite This Page — Counsel Stack

Bluebook (online)
173 S.W.3d 433, Counsel Stack Legal Research, https://law.counselstack.com/opinion/ginn-v-american-heritage-life-insurance-co-tennctapp-2005.