Guardian Life Insurance Co. of America v. Tillinghast

512 A.2d 855, 1986 R.I. LEXIS 517
CourtSupreme Court of Rhode Island
DecidedJuly 17, 1986
Docket84-30-Appeal
StatusPublished
Cited by13 cases

This text of 512 A.2d 855 (Guardian Life Insurance Co. of America v. Tillinghast) is published on Counsel Stack Legal Research, covering Supreme Court of Rhode Island primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Guardian Life Insurance Co. of America v. Tillinghast, 512 A.2d 855, 1986 R.I. LEXIS 517 (R.I. 1986).

Opinion

OPINION

WEISBERGER, Justice.

This case comes before us on appeal from a judgment entered in the Superior Court following trial by jury in favor of The Guardian Life Insurance Company of America (Guardian). The case arose from an action brought by Guardian seeking rescission of an insurance policy covering income disability on the ground that Alfred E. Tillinghast (Tillinghast) had made material misrepresentations on his application. Tillinghast counterclaimed for benefits due under the policy. Guardian had tendered the premium to Tillinghast after concluding that he had failed to disclose pertinent information, but the tender was refused. We affirm. The facts of the case as pertinent to this appeal are as follows.

On June 22, 1976, Tillinghast applied for a disability-insurance policy to be issued by Guardian. In his application he responded to the examining physician, Dr. Barry Steinberg, that he had not been treated for any disease or disorder of the brain or nervous system and that he had not been treated for “rheumatic fever, elevated blood pressure, angina pectoris, chest pain or discomfort, shortness of breath, heart murmur, swelling of legs or ankles, or any disease or disorder of the heart or blood vessels[.]” The examining physician noted on the application that Tillinghast indicated that he had been admitted to Newport Hospital in 1966 with chest pain, that he was discharged the same day, and that he had no recurrence of such pain. The physician testified that no other treatments or conditions had been communicated to him by Tillinghast, otherwise he would have noted them on the application. Tillinghast signed the application beneath a representation that “all the statements and answers to the above questions are complete and true to the best of my knowledge and belief.”

During the trial, evidence was adduced that Tillinghast had been admitted to Day Kimball Hospital in Connecticut on May 31, 1975, complaining of chest pain. This pain was associated with the lifting of a five-gallon can of paint. However, the history given in connection with this hospital admission by Tillinghast included a statement by Tillinghast that he had suffered a “coronary” ten years ago in Newport but was in the hospital for only two days. The history further disclosed that Tillinghast supposedly had had an abnormal electrocardiogram during this hospital stay and had three to four admissions to the hospital for chest pain since that time. The hospital-discharge report noted a history of “arteri-osclerotic heart disease with previous myocardial infarction * * *.”

Evidence was further introduced to show that Tillinghast had applied for treatment at the Veterans Administration Hospital in 1975, complaining of headaches, memory lapses, and stomach and back problems. Tillinghast also stated that during 1975, he had received counseling from a social worker at the Veterans Administration Hospital for problems arising out of marital and job stress. In addition, Tillinghast further stated that on June 26, 1976 (four days after having completed the Guardian insurance application), he applied for treatment at Newport Hospital, complaining of left anterior chest pain, episodes of confusion, and headaches and dizziness, which he stat *857 ed had occurred over the previous few months.

Tillinghast and his former wife testified that he had made more disclosures to Dr. Steinberg than appeared on the application. Both Tillinghast and his former wife testified that during the year before signing the insurance application he had had chest pain and emotional problems, that Tillinghast had been seen regularly at the Veterans Administration Hospital for nervousness, and that he had prescriptions for Valium, Dalmane (a sleeping medication), and Tylenol for his aches and pains.

An underwriter employed by Guardian testified that if the company had known of TillinghasCs admission to Day Kimball Hospital in 1975, it would have ordered a current electrocardiogram before determining his eligibility for insurance. It would have postponed action on the policy until a more definite diagnosis could be obtained.

At the time of trial, which began November 1, 1983, both parties conceded that Til-linghast was totally disabled. The reason for the disability is not entirely clear. Til-linghast testified that he had been assaulted on December 23, 1976, while working at a campground in Chepachet, Rhode Island. The records of Newport Hospital where he received treatment following the incident stated that he had a “syncopal episode” and had fallen on his face. A syncopal episode may be defined as “[a] temporary suspension of consciousness due to cerebral anemia; a faint.” Dorland’s Illustrated Medical Dictionary 1484 (24th ed. 1965). Tillinghast testified that he did not remember giving such information to hospital personnel and that he had no real recollection of the events that occurred at the campground. Evidence indicated that he had been seen at the Veterans Administration Hospital in January 1977 and that he had a fainting spell and had fallen down a ravine on December 23,1976. Tillinghast testified that he only learned later that he had been assaulted by a man.

At the conclusion of the testimony, Tillin-ghast moved for a directed verdict. The trial justice reserved decision pursuant to Rule 50(b) of the Superior Court Rules of Civil Procedure and submitted the case to the jury, citing the provisions of G.L.1956 (1979 Reenactment) § 27-18-16, which provides:

“False statements in application. — The falsity of any statement in the application for any policy covered by this chapter may not bar the right to recovery thereunder unless such false statement materially affected either the acceptance of the risk or the hazard assumed by the insurer.”

The jury returned a verdict in favor of Guardian, whereupon the trial justice denied the motion for directed verdict. He later denied Tillinghast’s motion for a new trial. In support of his appeal, Tillinghast raises five issues that will be considered in the order of their significance to this opinion.

I

DID THE TRIAL JUSTICE ERR IN PRESENTING ISSUES OF FACT TO THE JURY BASED ON G.L.1956 (1979 REENACTMENT) § 27-18-16 IN LIGHT OF THE FACT THAT GUARDIAN HAD ALLEGED FRAUDULENT AND INTENTIONAL MISREPRESENTATION?

When the request for instruction was submitted to the trial justice, Tillinghast suggests that in effect Guardian amended its pleadings by requesting that the jury make only two determinations: (1) had Til-linghast made false statements? and (2) did those false statements materially affect the acceptance of the risk or the hazard assumed?

No mention was made in the request for instructions with respect to such elements of fraud as knowledge of falsity or intent to deceive. The trial justice submitted the questions to the jury in accordance with the requested instructions of Guardian. No formal motion to amend the pleadings was made pursuant to Rule 15(b) of the Superi- *858 or Court Rules of Civil Procedure. The provisions of § 27-18-16 were not set forth in Guardian’s complaint.

In effect, Tillinghast argues that one who alleges fraud in his pleadings must prove fraud or be precluded from recovery on his claim. This rule is one of considerable antiquity and was recognized by this court in Tillinghast v. Champlin, 4 R.I.

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Bluebook (online)
512 A.2d 855, 1986 R.I. LEXIS 517, Counsel Stack Legal Research, https://law.counselstack.com/opinion/guardian-life-insurance-co-of-america-v-tillinghast-ri-1986.