Gipson v. Mutual Benefit Health & Accident Ass'n

230 S.W.2d 413, 33 Tenn. App. 167, 1950 Tenn. App. LEXIS 98
CourtCourt of Appeals of Tennessee
DecidedMarch 31, 1950
StatusPublished
Cited by3 cases

This text of 230 S.W.2d 413 (Gipson v. Mutual Benefit Health & Accident Ass'n) 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
Gipson v. Mutual Benefit Health & Accident Ass'n, 230 S.W.2d 413, 33 Tenn. App. 167, 1950 Tenn. App. LEXIS 98 (Tenn. Ct. App. 1950).

Opinion

HOWELL, J.

This is a suit upon a health and accident policy issued by the defendant to the plaintiff on August 26, 1946. The declaration alleges that the plaintiff has paid all the premiums required of him and that on May 16, 1947, he became wholly disabled by reason of high blood pressure and heart trouble and has been continuously confined within doors and required the attention of a physician and that he is therefore totally disabled. The declaration further alleged that the defendant knew at the time the policy was issued that plaintiff suffered with high blood pressure and charged an additional premium on this account. The declaration further alleged that plaintiff had complied with all the provisions, stipulations and requirements of the policy [169]*169and the defendant has wilfully and arbitrarily refused to pay any of the disability benefits to which plaintiff is entitled under the terms of the policy.

The defendant in its plea denied that it was indebted to plaintiff in any amount except the premiums paid and averred that the plaintiff had procured the policy involved by fraud and misrepresentation and it was therefore void.

The case was heard by the trial Judge and a jury and a verdict rendered in favor of the plaintiff for the total benefits provided in the policy, $2,400 and an additional $600 as penalty, in all $3,000 and the costs.

The defendant has perfected an appeal in error to this Court and has assigned errors.

Counsel for the defendant in their brief say: “The only question which the defendant raises on the evidence by this appeal is whether or not the plaintiff, by his answers to the above questions in his application, has been guilty of such fraud and misrepresentation as renders his policy void and, secondly, whether the heart trouble which plaintiff contends now disables him arose more than six months after the issuance of the policy, as required by the policy’s terms.”

These two questions therefore are the ones to be determined by this Court.

Question No. 14 in the application for the policy which was answered “None” is as follows: “14. Have you ever had any of the following diseases: Rheumatism, neuritis, arthritis, sciatica, epilepsy, appendicitis, diabetes, any kidney or bladder trouble, any disease of the brain or nervous system, heart disease, tuberculosis, bronchitis, gall bladder trouble, any stomach trouble, any intestinal trouble, hernia, cancer, syphilis, high or low blood pressure, tonsilitis, rectal trouble, malaria?”

[170]*170Question No. 15 answered “No” is as follows: “15. Have you received medical or surgical treatment or liad any local or constitutional disease not mentioned above within the last five years ? ’ ’

The applicable Code Section 6126, Code of Tennessee, is as follows: “Misrepresentation or warranty will not avoid policy, when. — No written or oral misrepresentation or warranty therein made in the negotiations of a contract or policy of insurance, or in the application therefor, by the assured or in his behalf, shall be deemed material or defeat or void the policy or prevent its attaching, unless such misrepresentation or warranty is made with actual intent to deceive, or unless the matter represented increase the risk of loss.”

The plaintiff testified in part:

“Q. Now, did you tell the agent anything about your condition or whether or not you had been to a doctor before talking to him? A. When he approached me to sell me some insurance, I told him, ‘ There is no need of you wasting your time and taking up my time because I have had a history of high blood pressure for ten or fifteen years.’ He said, ‘Ve sell risks on high blood pressure.’ I said, ‘If you do, I will be glad to buy a policy. ’
“Q. On the questions in the application for the policy, who filled in the answers, you or the agent? A. The agent.
“Q. He did all the writing?' A. Yes, sir.
“Q. And then you signed the policy application? A. Yes, sir.
“Q. He did not show, or do you know whether he showed that you had high blood pressure or not? A. I don’t know.
[171]*171“Q. Did tRe company refuse to issue a policy, Mr. Gipson, that you liad originally planned to buy? A. Yes, sir. Mr. Yates came back up there about September sometime and told me they turned that policy down, be bad something about the same thing, but it would cost me more money due to my high blood pressure and said, ‘You will be rated up as a man sixty-five years old’ and I asked him would that carry the same disability and be said yes it would carry the same disability. He said ‘If you get sick or disabled to work, you will receive one hundred dollars a month as long as you live.’ I said, ‘I will accept it.’
“Q. Was that policy then issued to you?' A. That policy was issued to me.”

The plaintiff further testified positively that be bad consulted doctors previously and bad been treated for high blood pressure and that these doctors never did tell him that be bad heart trouble.

Dr. Henry T. Kirby-Smith, the only witness for the defendant, testified that bis record of Jess Gipson showed that be saw him on January 26, 1946, and bis “impression” was angina pectoris, blood pressure was 180/100, be saw plaintiff again on March 22, 1946, and be bad pains in arms and legs and blood pressure was 190/120, again on May 27, 1946, “occasional spell of precordial pain. Blood pressure 210/100,” again on April 8, 1947, “can’t sleep well and is tired, blood pressure 210/120.”

Dr. Kirby-Smith testified from his record and said in bis letter to counsel for plaintiff, “Now whether I told Mr. Gipson be bad angina pectoris or not, I do not remember. But as it is my policy to tell people what I think is wrong with them I feel sure that I must have told him [172]*172that the pain was probably due to the heart when I examined him on January 26, 1946.”

The answer to question No. 14 above was “None.” The plaintiff had told the agent soliciting the policy that he had a history of high blood pressure for ten or fifteen years and the policy was written by the company with knowledge of his high’ blood pressure and a larger premium charged on that account. The defendant wrote its agent on September 5, 1946, in part as follows:

“Mr. F. E. Tates Ee — Jess Gipson
“Winchester, Tenn. Decherd, Tenn.
110-329998-46M
“Dear Mr. Yates:
“Enclosed find the above policy dated August 21, in lieu of the form 104S F applied for and owing to this change you will need to collect an additional $8.00 in premium from Mr. Gipson. The Home Office advise that it was necessary to make this change to 110 because of applicant’s high blood pressure and the 110 was the most liberal contract that could be issued . . .”

Thus it is seen that the defendant company was fully informed as to the high blood pressure of the plaintiff at the time the policy was issued.

Question No. 15 as to whether plaintiff had received medical attention for any disease “not mentioned above” was truthfully and correctly answered “No” so far as plaintiff was informed or advised.

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Bluebook (online)
230 S.W.2d 413, 33 Tenn. App. 167, 1950 Tenn. App. LEXIS 98, Counsel Stack Legal Research, https://law.counselstack.com/opinion/gipson-v-mutual-benefit-health-accident-assn-tennctapp-1950.