Gozan v. Mutual Life Insurance

77 Misc. 2d 249, 353 N.Y.S.2d 137, 1974 N.Y. Misc. LEXIS 1118
CourtNew York Supreme Court
DecidedFebruary 27, 1974
StatusPublished

This text of 77 Misc. 2d 249 (Gozan v. Mutual Life Insurance) is published on Counsel Stack Legal Research, covering New York Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Gozan v. Mutual Life Insurance, 77 Misc. 2d 249, 353 N.Y.S.2d 137, 1974 N.Y. Misc. LEXIS 1118 (N.Y. Super. Ct. 1974).

Opinion

Edward J. Greenfield, J.

Arnold R. Krakower, an attorney and member of the New York County Lawyer’s Association, had previously been covered by a term policy with defendant under the association’s life insurance program. On May 9, 1968 he made application to defendant company to increase the coverage .on his life by an additional $40,000, naming his wife as beneficiary, and at the same time applying for $5,000 insurance on the life of his wife, with himself as beneficiary.

In the application, Mr. Krakower declared that he was in good health, regularly performing the duties of his occupation, without any health impairment, had not been hospitalized in the last five years, and had seen a physician in that period only for colds, virus, and annual checkups. He said the same for his wife. The defendant insurance company duly issued the additional insurance policy on June 27, 1968, which would have become incontestable after one year. Arnold Krakower, having paid all premiums due, died nine months thereafter, on April 4,1969.

Upon investigating the claim for the insurance benefits duly filed by the widow, the insurance company learned that the facts as stated in Krakower’s application had been untrue, and it disclaimed, tendering back the premiums paid. Far from being [250]*250in.good .health at the time, as represented, Krakower, the undisputed facts', show, had been suffering for over 20 years from . polycythemia an insidious disease resulting in marked proliferation of the red blood cells and internal bleeding, ultimately resulting in complications and death. Although on his medical examination on June 27,1968, he had reported a tonsillectomy in childhood, an . appendectomy in 1925, and a cholecystomy in 1952,-. he failed to" disclose a series of eight hospitalizations from ,1952 to .1968 for treatment of ■ the polycythemia and internal bleeding. The most recent hospitalization had been in New York Hospital, from june 7 to June 14, 1968, only two weeks before the medical examination and questionnaire, fot a worsening of his. condition. There can be little doubt that the insured was fully aware of his condition, and that that was the motivation for his attempting to procure additional insurance without disclosing his true state of health. If he survived for one year, the policy would become incontestable and his misrepresentations could not be called into question. He didn’t make it.

Despite the clear, case of fraud and misrepresentation by the insured, as part of a calculated gamble by him, the widow, in this ■ action for the proceeds of the policy, contends that the insurance company is precluded from raising the defense of fraud and misrepresentation because of alleged noncompliance by the company with section 142 of the Insurance Law. That section provides:

“ 1. Every policy of life, accident or health insurance, or contract of annuity, delivered or issued for delivery in this state shall contain the entire coútract between the parties, and nothing shall be incorporated therein by reference * * * No application for the issuance of any such policy or contract shall be admissible in evidence unless a true copy of such application was attached to such policy when issued.”

It is the plaintiff’s position that if any part of the copy of the application is illegible or difficult to read, it is not a true copy, and is inadmissible.

The application for the policy in suit was in three parts, photocopies of each of which were attached to the policy issued to the insured. The" first part was the application by Krakower for $40,000 in additional insurance-, naming his wife as beneficiary, and answering four questions as to the state of his health. The second part, on the reverse side of the first, is. an application by Krakower for a dependent’s rider on the life of his wife, in the sum of $5,000, designating himself as beneficiary, and answering four questions as to the state of her [251]*251health. The third part is the medical history and questionnaire, filled out by the insurance physician, the truth of the answers and statements being represented as true by' the insured. It was conceded that copies of all parts' of the application were annexed to the policy issued to the insured, and that the-first and third parts dealing with the application for insurance on Krakower’s life were clear, true and legible "copies, but the photocopy of the second part, dealing with the application for $5,000 insurance on the life of the wife was light and underexposed, raising a dispute as to its legibility. . . "..

Defendant moved for summary judgment on the ground that the misrepresentations were 'undisputed. Plaintiff opposed, urging that since the photocopy of one part of the application was underexposed, it had to be considered illegible, and hence not a true copy as required by section 142 of the Insurance Law, so that defendant would be precluded on the trial from raising the issue of misrepresentation in the application. Spiegel, J., held that a true copy of the application means a true, correct, legible and entire copy of the contract (citing 1 Couch, Insurance, 2d ed., § 4:18; Arter v. Northwestern Mut. Life Ins. Co., 130 F. 768; New York Life Ins. Co. v. Halpern, 57 F. 2d 200, affd. 61 F. 2d 1037; Adamos v. New York Life Ins. Co., 5 F. 2d 278, rehearing den. 5 F. Supp. 1019, affd. 71 F. 2d 997, revd. other grounds 293 U. S. 386; Enelow v. New York Life Ins. Co., 83 F. 2d 550, cert. den. 298 U. S. 680; and Ostrov v. Metropolitan Life Ins. Co., 260 F. Supp. 152). The question of legibility, he held, ¡was an issue of fact for determination by the jury.

The case thereafter came on for trial before me, and a jury. was asked to respond in a special verdict to the following question: “ Is the copy of the application for the dependent’s term rider a true, correct and legible copy of the original application?” The jury responded in the negative.

The copies of the application for insurance on the life of Mr. Krakower and the medical questionnaire relating to him concededly ¡were true and legible copies. Does illegibility of the copy of the application for insurance on the life of Mr. Krakower’s dependent, his wife, -prevent the insurance company from demonstrating the falsity of Ms application? .

Although this court may have a differing view as to the legibility of the copy of the application for the dependent’s insurance, the jury finding to the contrary does not dictate a judgment for the plaintiff. It is the contention of the plaintiff that the application must be treated as an indivisible whole (Prudential Life Ins. Co. v. Mittler, 266 App. Div. 952), [252]*252and that if any portion of it is illegible, no part of it can be considered admissible.

The purpose of the provisions of section 142 of the Insurance Law was to eliminate the evils of insurance companies defending against claims based on applications which were not made part of the policy. Only the providing of a true and correct copy of the application was deemed sufficient to advise the insured as to exactly what representations were made, so that corrections could be effected if any mistakes showed up. (Cutler v. Hartford Life Ins. Co., 22 N Y 2d 245; Archer v. Equitable Life Assur. Soc. of U. S., 218 N. Y. 18.)

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Related

Adamos v. New York Life Insurance
293 U.S. 386 (Supreme Court, 1935)
Archer v. Equitable Life Assurance Society of the United States
112 N.E. 433 (New York Court of Appeals, 1916)
Gerber v. Borderland Coal Sales Co.
5 F.2d 278 (Sixth Circuit, 1925)
New York Life Ins. v. Halpern
57 F.2d 200 (W.D. Pennsylvania, 1931)
New York Life Ins. v. Halpern
61 F.2d 1037 (Third Circuit, 1932)
Adamos v. New York Life Ins.
71 F.2d 997 (Third Circuit, 1934)
Enelow v. New York Life Ins.
83 F.2d 550 (Third Circuit, 1936)
Adamos v. New York Life Ins.
5 F. Supp. 1019 (W.D. Pennsylvania, 1934)
Enelow v. New York Life Insurance
298 U.S. 680 (Supreme Court, 1936)
Arter v. Northwestern Mut. Life Ins.
130 F. 768 (Third Circuit, 1904)
Ostrov v. Metropolitan Life Insurance
260 F. Supp. 152 (E.D. Pennsylvania, 1966)

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Bluebook (online)
77 Misc. 2d 249, 353 N.Y.S.2d 137, 1974 N.Y. Misc. LEXIS 1118, Counsel Stack Legal Research, https://law.counselstack.com/opinion/gozan-v-mutual-life-insurance-nysupct-1974.