Harrell v. North Carolina Mutual Life Insurance

213 S.E.2d 792, 215 Va. 829, 1975 Va. LEXIS 234
CourtSupreme Court of Virginia
DecidedApril 28, 1975
DocketRecord 740292
StatusPublished
Cited by17 cases

This text of 213 S.E.2d 792 (Harrell v. North Carolina Mutual Life Insurance) is published on Counsel Stack Legal Research, covering Supreme Court of Virginia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Harrell v. North Carolina Mutual Life Insurance, 213 S.E.2d 792, 215 Va. 829, 1975 Va. LEXIS 234 (Va. 1975).

Opinions

Compton, J.,

delivered the opinion of the court.

The narrow issue presented by this appeal is whether the defendant insurer sustained its burden to prove clearly that untrue statements made in an application for a policy of life insurance were material to the risk assumed.

At the time of her death on October 10, 1971, Ethel H. Foxx was the insured in an ordinary life policy in the amount of $15,000 issued by defendant, North Carolina Mutual Life Insurance Company, in which plaintiffs, Elisha A. Harrell and [830]*830William H. Harrell, brothers of the insured, were the primary beneficiaries. The Harrells were denied recovery of the face amount of the policy by the court below, sitting without a jury, on the ground that the decedent had made representations of fact in her application for the insurance which were material to the risk and untrue.

Mrs. Foxx was a resident of Hampton, Virginia, and Dean of Women at Hampton Institute. On June 6, 1970, she made application for the life insurance policy in question through the company’s agent, Daniel J. Jordan, of Newport News. The required medical examination of Mrs. Foxx was performed on June 13, 1970, by Dr. George Stephens who was retained and paid by the company. The physician reported nothing abnormal or unusual except for a “midline oper scar.” The doctor testified that, other than the scar, the condition of her health was good and she was normal in her anatomy. At the time of the medical examination certain questions, which formed Part Two of the application for insurance, were asked her by Stephens, and the answers were written and witnessed by him. She answered questions I, J and K as follows:

“I. Have you ever undergone a surgical operation? Yes Fibroid Ut[erus]
“J. Have you ever been a patient in any hospital, sanitarium, or asylum? No
“K. Have you consulted a doctor for any cause not included in the above answers? No”

In her application, and specifically referring to her answers to the questions asked by the medical examiner, Mrs. Foxx declared that her answers were full, complete and true; that she was a proper subject for life insurance; that she made the answers to obtain the insurance; and that she understood and agreed “that they are each material to the risk and that the Company believing them to be true will rely and act upon them.”

After the medical examination, the insured’s application for life insurance and the examining physician’s report were forwarded to the insurer’s home office in Durham, North Carolina, by its Newport News district office. In the home office the application was processed, and the policy was thereafter issued and delivered to Mrs. Foxx. She paid all premiums due thereon until her death.

[831]*831When the claim was made and the proof of death submitted, the accompanying death certificate showed that the decedent died of “respiratory arrest” due to “carcinomatosis — 1 year due to primary breast cancer — 2 years.” This information resulted in an investigation by the company and a denial of the claim on the ground that the insured had given false and untrue statements in her application for insurance and in response to the questions asked her by Dr. Stephens. This suit ensued.

The evidence disclosed that Mrs. Foxx had been hospitalized for carcinoma of the breast in 1965, 1969 and 1970. Prior to 1965, she had been hospitalized for fibroids of the uterus. During each hospitalization she had undergone a major operation of a serious nature. Within two weeks after being discharged from the 1970 hospitalization, she signed the application which is in controversy here.

Plaintiffs rely upon Code § 38.1-336 which provides, in pertinent part, that no statement in an application for insurance “shall bar a recovery upon a policy of insurance, or be construed as a warranty, anything in the policy to the contrary notwithstanding, unless it be clearly proved that such answer or statement was material to the risk when assumed and was untrue.” The insurer maintains that the evidentiary requirements of the statute have been met. The plaintiffs claim that the company failed to carry its burden to prove clearly that the foregoing answers were material to the risk when assumed. We agree and reverse.

One of the purposes of Code § 38.1-336 is to relieve against the rigorous consequences of the common law rule that answers to questions in applications for insurance imply that the subject matter of the questions and answers is material, and that if such statements and answers are not true the policy is voidable. Sterling Insurance Company v. Dansey, 195 Va. 933, 943, 81 S.E.2d 446, 451 (1954). Under the explicit mandate of the statute, the insurer had the burden of clearly proving that the insured’s answers in her application were material to the risk assumed and were untrue. Mutual of Omaha Insurance Company v. Echols’ Adm’rs., 207 Va. 949, 952, 154 S.E.2d 169, 171 (1967). Materiality of a misrepresentation is an affirmative defense. Hawkeye Security Insurance Company v. Government Employees Insurance Company, 207 Va. 944, 947, 154 S.E.2d 173, 175 (1967). Whether a representation is made and the terms on [832]*832which it is made are questions for the trier of fact; but when, as here, a misrepresentation is proved, its materiality is a question of law for the court. United States Fidelity and Guaranty Company v. Haywood, 211 Va. 394, 396, 177 S.E.2d 530, 532 (1970); Chitwood v. Prudential Insurance Company of America, 206 Va. 314, 318, 143 S.E.2d 915, 918 (1965). “A fact is material to the risk to be assumed by an insurance company if the fact would reasonably influence the company’s decision whether or not to issue a policy.” Mutual of Omaha v. Echols’ Adm’rs., supra, 207 Va. at 953-54, 154 S.E.2d at 172.

The insurer produced abundant evidence which showed that Mrs. Foxx answered falsely questions J and K in the application and that she gave a misleading answer to question I. But for some unexplained reason, it failed to offer evidence which clearly proved that truthful answers to questions I, J and K would reasonably influence its decision whether or not to issue the policy.

Fred Cook, district manager of the insurer’s Newport News office, testified that he received the application from Jordan, the agent, and the medical examiner’s report from Dr. Stephens, and forwarded them to the home office for issue. The trial judge asked this witness: “In receiving this in your office, did you place any reliance, or did you not place any reliance upon the application and the medical report? ” Cook answered: “No. We do not do that in the District Offices, Your Honor.” He said the home office passed on applications and medical reports.

Arthur J. Clements, claims supervisor of the company, received the claim following Mrs. Foxx’s death.

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Harrell v. North Carolina Mutual Life Insurance
213 S.E.2d 792 (Supreme Court of Virginia, 1975)

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Bluebook (online)
213 S.E.2d 792, 215 Va. 829, 1975 Va. LEXIS 234, Counsel Stack Legal Research, https://law.counselstack.com/opinion/harrell-v-north-carolina-mutual-life-insurance-va-1975.