Hughes v. John Hancock Mutual Life Insurance

88 N.W.2d 557, 351 Mich. 302, 1958 Mich. LEXIS 515
CourtMichigan Supreme Court
DecidedMarch 5, 1958
DocketDocket 60, Calendar 47,059
StatusPublished
Cited by29 cases

This text of 88 N.W.2d 557 (Hughes v. John Hancock Mutual Life Insurance) is published on Counsel Stack Legal Research, covering Michigan Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Hughes v. John Hancock Mutual Life Insurance, 88 N.W.2d 557, 351 Mich. 302, 1958 Mich. LEXIS 515 (Mich. 1958).

Opinion

Black, J.

This suit was brought upon a policy of life insurance in the amount of $1,000, issued February 1,1951, by defendant to Grace Teall. The defense is what is known to the profession as medL cal fraud. The policy names plaintiff Mildred Hughes, daughter of Grace Teall, as beneficiary. Grace Teall died September 17,1952, at age 53. The immediate cause of death was rupture of an ulcer of the stomach, causing peritonitis. A contributory cause of death, according to testimony offered by defendant, was hypertension, or high blood pressure.

Application for the policy was made at Muskegon. Mrs. Teall, a resident of Muskegon, was visiting friends in Indianapolis at the time. The application was sent to Indianapolis for medical processing. A Dr. Cayley, defendant’s medical examiner at Indianapolis, went to the home where Mrs. Teall was staying and proceeded with the required medical examination including filling out of answers to health and medical questions- as contained in part “B” of the application. The medical examination, the part “B” question and answer interview, and the signature of part “B” by Mrs. Teall, took place in *305 the presence of surviving witnesses. * Dr. Cayleydied prior to trial, absent deposition on his part.

Part “B” of the application contains this question and answer:

“13. Have you, during the past 5 years, consulted any physician or other practitioner, or been confined to or treated in any hospital, sanatorium, dispensary, clinic or similar institution not stated in answers to questions 11 and 12?
“Answer: No.”

Suit having been filed, defendant pleaded that the quoted answer (plus another answer to another question we need not consider) to question 13 was false and fraudulent; that such false answer materially affected acceptance of the risk, and that it was entitled to regard the policy as void for fraud. Due issue having been framed in such regard, the case came to jury trial. At close of the proofs and on motion a verdict was directed for plaintiff. Judgment for plaintiff thereupon entered, from which defendant appeals. The principal question brought here is whether an instructed verdict was proper.

First: The tables are turned in this typical case of alleged medical fraud in the making of application for life insurance. Here the insurer’s examining physician was not present to relate from the witness stand that which is usually found in reports of similar cases, namely, that the medical application as supervised by and signed before him fully and correctly portrays all disclosures, by the applicant, pertaining to the latter’s health and previous medical history. Instead, the 2 mentioned witnesses testified at length to full and material disclosures — not set forth in the application — by the applicant to defendant’s examining physician. Such *306 disclosures, if made as testified, vary substantially from the face of the application and supply, in substance, that which came to appraisal, in Pitcher v. World Insurance Company, 327 Mich 520, in conjunction with Mr. Pitcher’s answer to question 9 (see page 522 of Pitcher’s report). Thus, and if witnesses Brown and Burns are to be believed, Dr. Cayley indeed should have written a “yes” rather than “no” answer to said question 13.

We have, then, a case where defendant has adduced proof tending to show that Mrs. Teall consulted her physician (Dr. Durnell of Muskegon) on 15 occasions during the 5-year period preceding date of application and that the written answer to question 13 was therefore false. On the other hand, plaintiff has submitted proof that Dr. Cayley was given an honest and detailed answer to said question 13. The result was and is a jury question. We turn on these premises to steadfast reasons for ruling that a defendant as well as a plaintiff is entitled to have his case determined by the assembled triers of fact whenever questions of fact are testimonially made to appear.

Looking at defendant’s proof as outlined, we agree with counsel that the written answer to question 13, coupled with Dr. Durnell’s testimony that Mrs. Teall consulted him regularly during the 5-year period and received medical treatment in pursuance of such consultations, would ordinarily shift to plaintiff the burden of proving that Mrs. Teall’s consultations with and treatment by her physician were not for an ailment or ailments tending to seriously weaken or undermine her health (Rhode v. Metropolitan Life Insurance Co., 129 Mich 112; Bullock v. Mutual Life Insurance Co. of New York, 166 Mich 240, 247; Wohlfeil v. Bankers Life Co., 296 Mich 310, 319; and General American Life Ins. Co. v. Wojciechowski, 314 Mich 275). However, and in the *307 ■circumstances of claimed disclosure by Mrs. Teall, * the question of shifting of such burden cannot be resolved without jury appraisal of credibility of the testimony so given by Mrs. Brown and Mrs. Burns. This follows since there was no fraud if such disclosure was made. Here, then, is the difficulty with plaintiff’s motion for directed verdict. It called for resolution by the trial judge of an issue of fact, something quite beyond his authority in a jury case.

The trial judge, prefacing his decision that a verdict for plaintiff should be ordered, said:

“Those witnesses (Brown and Burns) were examined very extensively; the court had an opportunity to observe these witnesses on the stand. The court, from that observation, concludes that they were telling exactly what happened at the time of the examination in Indianapolis, at 1010 Shelby street. Each ■of the witnesses impressed the court with the integrity of their testimony. The only contradiction to the testimony is the signed statement on the application. The circumstances of the examination are such that it took place at a home. These 2 women who testified in the case, Blanch Brown and Grace Burns, were there all during the examination. * * $
“We have a situation in which a professional man, ■one who is in possession of greater knowledge than the ordinary person, physically examined and questioned the applicant. The applicant, according to the testimony, fully disclosed the fact of doctor visitations within a 5-year period of time of the disabilities which were apparent to her and the doctor who made the examination and filled out all of the answers to all of the questions, each and every single answer to each and every question, after such questions were put to and answers given by Grace Teall.
*308 “Now, all that was disclosed to the doctor, from the testimony, doesn’t appear in the application. Why it doesn’t appear is a matter that is for the judgment of the examining doctor. He reached, apparently, a professional conclusion.”

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Bluebook (online)
88 N.W.2d 557, 351 Mich. 302, 1958 Mich. LEXIS 515, Counsel Stack Legal Research, https://law.counselstack.com/opinion/hughes-v-john-hancock-mutual-life-insurance-mich-1958.