Hollinger v. Mutual Benefit Life Insurance

560 P.2d 824, 192 Colo. 377
Supreme Court of Colorado·Decided March 14, 1977·No. C-793·Published·Cited by 29 cases

Opinions

MR. JUSTICE KELLEY

delivered the opinion of the Court.

We granted certiorari to review the decision of the court of appeals in Hollinger v. Mutual Benefit Life Insurance Co., 36 Colo. App. 306, 541 P.2d 128 (1975).

Petitioner, Sherry Hollinger, beneficiary of a life insurance policy issued to her deceased husband, seeks reversal of a decision of the court of appeals which affirmed the trial court’s entry of a judgment in favor of Mutual notwithstanding the verdict. We affirm.

Beginning in 1971, the decedent, a military academy graduate, was employed by the respondent insurance company as a life insurance salesman trainee. The subject policy was purchased in connection with this employment on November 10, 1971. The application for insurance included inquiries as to any medical or psychiatric consultations or treatments within the past seven years.1 The form required the applicant to provide [379] detailed information for any consultation or treatment listed. In his response to the questions, the decedent stated that he had been treated for influenza, and he denied any treatment for mental disorders. The answers to the questions were filled in on the application by the respondent’s examining physician on the basis of a medical history obtained from the decedent. In signing the application, the decedent represented that he had made full disclosure concerning the questions in the application.2

In fact, a psychiatrist testified that he had been consulted on 11 occasions by the decedent during the summer immediately preceding the decedent’s purchase of the policy. He had first been consulted after an apparent suicide attempt and had finally advised the decedent that he was suffering from “anxiety depression.”3

Mutual’s examining physician testified that while information relating to marital and job problems might not always be included in application responses, information concerning psychiatric consultations was never omitted. Respondent’s medical director testified that if the decedent’s application had indicated any psychiatric consultation or treatment4 the policy would not have been issued without further inquiry. Moreover, he stated that if the information revealed by the psychiatrist’s testimony had been available to Mutual, the policy would not have been issued.

Mutual’s motion for a directed verdict, asserting that the evidence clearly established fraud by the decedent in answering application questions, was denied. Following the denial of Mutual’s motion, the trial court instructed the jury that in order to establish the affirmative defense of fraud, Mutual had to establish that Mr. Hollinger had knowingly made a false statement of a material fact, that the insurer was ignorant of the falsity, and that the insurer suffered damage from acting upon the false statement. In addition, the trial court instructed the jury as follows:

“That the representation or concealment was done with the intention that it be acted upon, that is to say that the applicant intended to deceive the insurer.” (Emphasis added.)

This instruction was in substantial conformity with leading Colorado insurance law cases relating to the affirmative defense of fraud,5 with the exception of the emphasized phrase of the quoted pprtion of the instruction, that the applicant “intended to deceive” the insurer, which was added by the trial court. The jury returned a verdict for the plaintiff.

[380] In granting Mutual’s motion for judgment n.o.v., the trial court recognized the error in the quoted portion of the instruction and concluded that it was not necessary for Mutual to establish a separate “intent to deceive” element. The court also determined that on the facts of this case the other elements of fraud were established as a matter of law, in particular that decedent’s misrepresentation was knowingly false.

Whether decedent’s misrepresentation was knowingly false would ordinarily be a jury question. Under the record in this case, however, the trial court was correct in holding that the failure to disclose constituted a knowing misrepresentation as a matter of law.

Petitioner argues that Colorado case law in the area of life insurance fraud is inconsistent on the question of whether an intent to deceive by the applicant must be shown by the insurer in order to avoid the policy when the applicant knowingly makes a false statement which is material to the risk.

Petitioner further argues that the appropriate rule should require the insurer to establish not only that the applicant knowingly made a false statement which was in fact material to the risk, but also that he did so with an “intent to deceive” the insurer. Petitioner views an intent to deceive as requiring knowledge on the part of the applicant that the nondisclosure or misstatement be of a material fact.

This court has consistently held that the question of materiality does not depend upon the opinion or upon the actual or subjective knowledge of the applicant. In Germania Life Insurance Co. v. Klein, supra, the applicant consulted a physician on several occasions but was not advised of the gravity of her condition. In her application for insurance, she stated that she had never consulted a physician. The court held that “the fact of the consultation of a physician or its materiality does not depend upon the gravity of the subject of the interview as regarded by the patient.” This proposition was reaffirmed in North American Life Insurance Co. of Chicago v. Korrey, supra, and Capitol Life Insurance Co. v. Thurnau, supra.

We have reviewed the cases cited by petitioner6 and agree that the statements in those cases concerning the applicant’s mental state at the [381] time of making the application cannot be wholly reconciled. However, a review of the facts in those cases leads us to conclude that where the evidence shows that the applicant has knowingly made false statements material to the risk undertaken by the insurer, the insurance policy can be avoided without establishing a separate element of an “intent to deceive.” We therefore disapprove the language of those Colorado cases to the extent that they are inconsistent with the holding herein.

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Hollinger v. Mutual Benefit Life Insurance, 560 P.2d 824, 192 Colo. 377 (Colo. 1977).

560 P.2d 824 (Hollinger v. Mutual Benefit Life Insurance) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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