Greene v. United Mutual Life Insurance

38 Misc. 2d 728, 238 N.Y.S.2d 809, 1963 N.Y. Misc. LEXIS 2179
CourtNew York Supreme Court
DecidedMarch 26, 1963
StatusPublished
Cited by15 cases

This text of 38 Misc. 2d 728 (Greene v. United 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
Greene v. United Mutual Life Insurance, 38 Misc. 2d 728, 238 N.Y.S.2d 809, 1963 N.Y. Misc. LEXIS 2179 (N.Y. Super. Ct. 1963).

Opinion

Charles A. Loreto, J.

This case was tried by the jury and the court. At the end of the plaintiff’s case, the defendant moved to dismiss the complaint. At the end of the trial, defendant moved for a dismissal of the complaint and for a directed verdict. After the jury rendered its verdict, defendant moved that it be set aside and for a directed verdict in its favor. The court reserved its decision on these motions.

Plaintiff is the beneficiary named in a policy of life insurance in the sum of $50,000 which was issued by the defendant on the life of one Thompson Greene to whom she was married; she has sued to recover double indemnity claiming accidental death under the terms of the policy. Application for the policy was made by the insured on June 21, 1960. It was issued on August 6, 1960, when the first quarter annual premium was paid. And on October 29,1960 the insured was found dead in his apartment submerged in the bathtub filled with water.

The defendant interposed a number of defenses to the action — misrepresentation in the answers to the questions on the application for the insurance made part of the policy, lack of good health of the insured when the policy was issued, misrepresentation of his age, suicide and self-destruction.

In view of the proof adduced the court submitted special issues for the jury to pass upon together with an instruction for a [729]*729general verdict. The jury returned its finding for the plaintiff on all the special issues but that as to misrepresentation of age. Upon the court’s instruction its general verdict was rendered in favor of the plaintiff in the sum of $67,478.92 representing double the amount of insurance that the premium paid would have purchased for the age of the insured, as found by the jury.

The defendant contends that the proof as to material misrepresentation and good health of the insured requires as a matter of law that the jury’s verdict be set aside and that a verdict be directed in its favor.

Three medical examinations of the insured were had by defendant prior to the issuance of the policy. These are incorporated in the application annexed to the policy and contain the answers of the insured to questions concerning his health.

On the two of them- — Dr. Topping’s and Dr. Danzig’s — to question 12 (e) Have you ever had, or been told you had, or been treated for any of the following: * =:;= * Any disorder of kidneys, bladder, male or female generative organs or syphilis 1 ”, the answer of the insured is “ No ”.

On the third examination by Dr. Winter to question No. 17 ‘ ‘ Have you ever had any signs of * * * syphilis ’ ’ the answer of the insured is also “ No ”.

Uncontroverted, unimpeached and uncontested documentary proof was given by the defendant showing that the insured had contracted syphilis on April 1, 1941 and again on May 1, 1942 for which he was confined to the United States Army Hospital from May 1, 1942 to May 17, 1942 and that he was treated for that condition approximately on 60 occasions until his discharge from the service on October 28, 1945. Also it was shown by the army medical records that he was confined to a United States Army Hospital on April 20,1945 with a complaint of a urethral discharge for six months, diagnosed as chronic urethritis, which was treated successfully with sulpha drugs.

And in answer to question No. 12 of the examination by Dr. Winter: Have you ever consulted a physician in the last five years 1 ” the insured answered Yes ”, stating for “ cold ” and giving the name of only one physician — Dr. Cecil Marquez.

On the trial the defendant produced a Dr. Alfred E. Nesbitt whose testimony was unimpeached and uncontradicted. He testified that he treated the insured from December 15, 1959 to August 1, 1960 (the date of the issuance of the policy) for complaints of pain in the back, an arthritic condition shown on X ray, loss of weight and loss of sexual potency, prescribing for these ailrqeiits.

[730]*730The uncontradicted finding of Dr. Michelstein who performed an autopsy of the insured states that he found an enlarged and cirrhotic liver.

The Insurance Law (§ 149, subd. 2) states: “No misrepresentation shall avoid any contract of insurance or defeat recovery thereunder unless such misrepresentation was material. No misrepresentation shall be deemed material unless knowledge by the insurer of the facts misrepresented would have led to a refusal by the insurer to make such a contract.” And subdivision 3 of this statute reads: “In determining the question of materiality, evidence of the practice of the insurer which made such contract with respect to the acceptance or rejection of similar risks shall be admissible. ’ ’

Therefore, the question posed is whether under this statute as construed by the court decisions, the misrepresentations of the insured were material.

There is hardly any room to doubt that an important part of any insurance company’s business is in evaluating and discriminately selecting risks which it would expect not to exceed the natural and average losses. Before accepting a risk and issuing a policy for an amount as specified in this policy, invariably the insurer makes inquiry of the applicant as to his prior habits and health, his prior consultations with physicians, requires his answers in writing to an application made part of the policy in which he attests to the truth of his answers. It also conducts, as is its right, its own physical examination of the applicant. The history given by the latter may be quite essential to supplement its own examination of him and any independent investigation or examination by the insurer would not infringe upon its right to avoid the policy because of a material misrepresentation unless its independent investigation or examination either uncovers the falsity of the representation or reveals facts which would reasonably place it under a duty to make further inquiry (29 Am. Jur., Insurance, § 706). Therefore, it cannot be gainsaid that acceptance of the policy is with the understanding that the insurer intends to rely upon the truth of the applicant’s statements.

What constitutes a material misrepresentation sufficient to justify an avoidance of the policy, has been the subject of much litigation with varying results depending upon the wording of the policy, applicable statutes and the jurisdiction passing upon the issue (29 Am. Jur., Insurance, § 702). It does not matter in determining materiality, absent a statutory pronouncement declaring otherwise, that no causal relation existed between the [731]*731loss or death and thé misrepresented condition. (45 C. J. S., Insurance, § 595, p. 408.)

On the subject of materiality Corpus Juris Secundum states the test to be “ whether knowledge of the true facts would have influenced a prudent insurer in determining whether to accept the risk or in fixing the amount of premiums” (45 C. J. S., Insurance, § 595, p. 406).

However, the test in New York has been laid down by its Court of Appeals in Geer v. Union Mut. Life Ins. Co. (273 N. Y. 261). It gives a narrower test, it is not the test of what any other insurance company would have done, but what the particular insurance company might have done.

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Bluebook (online)
38 Misc. 2d 728, 238 N.Y.S.2d 809, 1963 N.Y. Misc. LEXIS 2179, Counsel Stack Legal Research, https://law.counselstack.com/opinion/greene-v-united-mutual-life-insurance-nysupct-1963.