Grace Turner v. The Manhattan Life Insurance Company, a New York Corporation

320 F.2d 553
CourtCourt of Appeals for the Ninth Circuit
DecidedAugust 31, 1963
Docket18272_1
StatusPublished
Cited by2 cases

This text of 320 F.2d 553 (Grace Turner v. The Manhattan Life Insurance Company, a New York Corporation) is published on Counsel Stack Legal Research, covering Court of Appeals for the Ninth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Grace Turner v. The Manhattan Life Insurance Company, a New York Corporation, 320 F.2d 553 (9th Cir. 1963).

Opinions

MADDEN, Judge.

This is a suit by the assignee of the beneficiary of a policy of life insurance. The suit was brought in the Superior ■'Court of the State of California, and was removed by the defendant, the insurance company, to the United States District Court for the Northern District of California, Southern Division. That court rendered judgment for the defendant, and the plaintiff took a timely appeal to this court. In this opinion the appellant will be referred to as the plaintiff, and the appellee will be referred to as the defendant.

In the district court, the defendant asserted that the insured had, in connection with the application for the insurance policy here in question, made false statements in response to questions asked him in his medical examination. The district court made findings that the insured had knowingly made false statements and that the statements were relied upon by the defendant to the degree that it would not have issued the policy if it had known the true facts. The plaintiff, in this appeal, urges that those findings are not supported by the evidence. She also asserts other errors, which will not be discussed in this opinion.

The insured was Nobel Andre, who, in 1959 when the policy was issued, was 48 years old. He was the president of the Andre Paper Box Co., Inc., and the defendant’s agent stated on the application for the policy that he had an income of $50,000 a year. Andre never approached any one connected with the defendant company for the purpose of purchasing insurance. The defendant’s agent, Mr. Crooks, had for five years, from time to time, sought to sell him insurance, before he succeeded in selling him the policy here in question. The Andre Paper Box Company was named in the policy as owner and beneficiary, and the premium notices were to be sent to that company.

The General Agent of the defendant in San Francisco was Mr. John Fixa, and Mr. Harold Horwitz was a member of his staff. Dr. L. Gordon La Pointe, M.D. was vice president and medical director of the defendant. As early as January of 1958 Crooks, through Fixa, submitted to [555]*555La Pointe a trial application for insurance on Andre. Fixa wrote La Pointe

“This applicant was rated by Pacific Mutual in 1956. If the situation can be improved we can place a nice case.”

By “rated” was meant that Pacific Mutual had issued insurance on Andre, but had charged a premium higher than normal because it did not regard him as a normal risk. Crooks testified that the rating was Class F plus $50 per thousand of insurance. The application to Pacific Mutual had been for $100,000 of insurance. Pacific Mutual had granted only $25,000 at the extraordinarily high premium, and even then had reinsured part of the risk with two other companies.

This 1958 application contained a copy of an electrocardiogram made in December, 1957, not in connection with an application for insurance. We shall have occasion to refer to that document hereinafter.

On April 2,1958 La Pointe wrote Fixa:

“Re Noble (sic) Andre
“The data received from the applicant’s attending physician is not very helpful and we doubt we could offer more than $20,000 of our Class F.
“We believe the applicant's status is worse than in August, 1956, but we are willing to review any old ECG’s besides the December, 1957, tracing as well as a new one without expense to the company.”

ECG, in the quoted letter means electrocardiogram. Hereinafter EKG, apparently more commonly used by the doctors, will be used as the abbreviation for electrocardiogram. It should be noted that attached to the trial application of January, 1958, was the medical examination of Andre by Dr. Leigh Rodgers, the defendant’s medical examiner, made for Pacific Mutual, for which company also Dr. Rodgers was the examiner. This examination had been made on July 27, 1956. That medical report showed that Andre had just been refused insurance by another company because of EKG findings. In that medical report Dr. Rodgers had said that there was no history to indicate heart disease “but EKG suggestive of past myocardial damage.”

On the basis of the above information,. La Pointe made his offer of $20,000 of insurance at a high rating, and Andre declined the proposal. But Crooks and Fixa did not abandon the effort to sell some insurance on Andre’s life. j

On January 23, 1959 Fixa sent to La Pointe an application, including a medical examination report and an EKG. He wrote:

“We are submitting this case on a con-current basis with Pacific Mutual. We will give a ‘target’ as soon as we know what Pacific Mutual is going to do.
“Harold Horwitz.”

The defendant had an authorization from Andre to request his physician tó furnish to defendant any information that he had. On January 29, 1959, the defendant wrote Dr. Victor Holliger of San Francisco, Andre’s personal physician, attaching a copy of its authorization from Andre, and saying:

“Please comment re. checkups including any data since your report to us of March 25, 1958.”

On the same day, January 29, Edward Sottolano, signing himself “Underwriter” for the defendant, wrote Fixa in San Francisco that the defendant was willing to consider $25,000 only at a potential rating of Class D plus $15 per thousand extra for three years, without features. He said further:

“It is essential that we hear from you as quickly as possible regarding our offer inasmuch as upon receipt . of the outstanding attending physician’s statement, we wish to be in a position of issuing or filing.”

On February 3, 1959, Fixa wrote to La Pointe:

“This looks like a good offer. Go ahead and send it down when you can.”

[556]*556Dr. Holliger wrote La Pointe on February 16, as follows:

“I have very little to add to the information that you already have regarding Mr. Andre.”
“I have insisted on seeing Mr. Andre at regular intervals, but I have failed to demonstrate any cardiac disease.” “When last seen, February 6, 1959, his blood pressure was 120/80. His heart had a normal rate, rhythm and tone. He had no complaints and presented no problems. In the course of the last several months he had been under treatment for a mild, epicondyletis, due to an injury to his elbow.”
“If there is any further information you may wish, I shall be most happy to supply it.”

Pacific Mutual having received the same report of medical examination by the same Dr. Rodgers, and the same EKG which La Pointe received, declined to write any insurance on the application. Crooks notified Horwitz, of the defendant’s general agent’s office, of that fact. It will be remembered that, on January 23, Fixa had written La Pointe that “We will give a ‘target’ as soon as we know what Pacific Mutual is going to do.”

On March 3, 1959 La Pointe wrote Fixa:

“The file on the above has been reviewed and we are approving the case for $25,000 only, rated Class D plus $15.00 per thousand extra for three years, without features.”

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Related

Jefferson Standard Life Insurance v. Anderson
236 Cal. App. 2d 905 (California Court of Appeal, 1965)

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Bluebook (online)
320 F.2d 553, Counsel Stack Legal Research, https://law.counselstack.com/opinion/grace-turner-v-the-manhattan-life-insurance-company-a-new-york-ca9-1963.