Independent Life Insurance Co. of America v. Downey

72 S.W.2d 1008, 255 Ky. 95, 1934 Ky. LEXIS 189
CourtCourt of Appeals of Kentucky (pre-1976)
DecidedJune 19, 1934
StatusPublished
Cited by7 cases

This text of 72 S.W.2d 1008 (Independent Life Insurance Co. of America v. Downey) is published on Counsel Stack Legal Research, covering Court of Appeals of Kentucky (pre-1976) primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Independent Life Insurance Co. of America v. Downey, 72 S.W.2d 1008, 255 Ky. 95, 1934 Ky. LEXIS 189 (Ky. 1934).

Opinion

OPINION OF THE COURT BY

GrEAL, COMMISSIONER

'Affirming.

On August 1, 1931, the Independent Life Insurance Company of America issued to Luther L. Downey a life policy for $5,000 which provided for payment to the in- *97 snred of monthly benefits for disability resulting from disease. One of the provisions related to nonconfining illness, and the other to illness which confined insured continuously within doors. These provisions read:

“The Company will pay, for one day or more, at the rate of Seventy-five [$75.00] Dollars per month, but not exceeding one month for disability resulting from disease, the cause of which originates more than thirty days after the date of this policy, and which does not confine the Insured continuously within doors, hut requires regular medical attention, provided said disease necessitates total disability and total loss of earnings or compensation from such loss of time.”
“The Company will pay, for one day or more, at the rate of One Hundred Fifty [$150.00] Dollars per month for disability resulting from disease, the cause of which originates more than thirty days after the date of this policy, and which confines the Insured continuously within doors and requires regular visits therein by a legally qualified physician, provided said disease necessitates total loss of earnings or compensation from such loss of time.”

By indorsements on the policy the disability benefits were made effective from the date of the policy and the company further agreed to pay the monthly benefits so long as the insured lived and suffered disability as therein described.

The insured instituted this action and by his petition, as amended, sought to recover disability benefits at the rate of $75 per month from February 1 to June 9, 1932, amounting to $322.50 for total disability and loss of time resulting from the disease of tuberculosis which did not continuously confine him within doors; and to recover the sum of $150 per month from June 9 to November 1, 1932, amounting in all to the sum of $705 for total disability and loss of time from the disease which continuously confined him within doors. It was further alleged that the insured had furnished the company with proof of his disability and had offered to furnish additional proof as required, hut the company had denied all liability under the policy and denied that the policy was of any force or effect.

By answer the company admitted that it issued tne policy containing the provisions set out in the petition *98 "but denied the allegations with respect to the disability of the insured. In a second paragraph and in avoidance of liability, it alleged that the policy was issued on an application made in writing which, among other things, represented that the applicant was' sound physically and mentally and that his average earnings from the occupation in which he was engaged exceeded the monthly indemnity provided for under the policy to be issued and under all other accident, health, and disability policies then carried by him; that these representations and answers made to questions in the application were material to the risk and were materially) considered by the company in passing upon the application; that at the time he made the application and representations the insured was not sound physically and his monthly earnings from the occupation in which he was engaged did not exceed the monthly indemnity payable under this and other accident and disability! policies carried by him; that if the true facts had been known to the company it would not have issued the policy nor have accepted the application, nor would any other reputable insurance company, acting upon the usual customs and practice employed by insurance companies, have accepted the application, or assumed the risk.

In a third paragraph it alleged that prior to February 1, 1932, it learned that plaintiff was not sound physically and that his average earnings were less than the monthly indemnity payable under the policy and other accident, health, and disability policies carried by him and declined to accept from him any .further premium thereon and that the policy lapsed on the 1st day of February because of nonpayment of premium and became null and void and of no effect after that date.

By amended answer, the company further affirmatively alleged that the written application made by plaintiff contained the following question: “Have you or any member of your family ever had tuberculosis?"’ The answer made by the insured was: “Ño.” .It also pleaded a provision in the application, to which the insured by his answer assented, to the effect that the policy was to be based upon the statements of fact in the application and that the falsity of any statement made with the intention to deceive or that would materially affect the acceptance of the risk or hazard assumed would bar the right to recover on the policy; 'that *99 tlie statement that no member of insured’s family had ever had tuberculosis was false and untrue, and in fact Sally Downey, a former wife of Luther Downey, died from tuberculosis on November 17, 1925, and at the time of her death and for a number of years prior thereto she and defendant had lived together as husband and wife and had occupied the same home; that such alleged false statement was made with the intent to deceive it and cause it to issue the policy sued on and does materially affect the risk and hazard assumed by them and that neither it nor any other reputable insurance company acting upon the usual and ordinary custom among insurance companies would have accepted the application or issued the policy.

A second amended answer sets out the provisions of the policy as to how and when premiums should be paid in order to keep the policy in continuous effect, in which it is in part stated:

“If any such premium be unpaid at the office of the company in Nashville, Tennessee, or an agent designated on premium notice in exchange for the company’s official renewal receipt, this policy shall terminate on the date such payment is due. Tire acceptance of any premium on this policy shall be optional with the company without waiving any right of insured as may be provided in part J.”

It averred that insured paid the premium on the policy up to February 1, 1932, and on that date tendered to the company the $16 by letter addressed to it at Nashville, Tenn., and that it, in the exercise of its option as set forth in the above-quoted provision, refused same and elected to terminate and avoid the policy as of February 1, 1932; that prior to February 1, it had paid claims to the defendant amounting to $165; and that on that date there were no claims filed with it which were unpaid and it had no notice of any claim of disability upon the part of insured.

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Bluebook (online)
72 S.W.2d 1008, 255 Ky. 95, 1934 Ky. LEXIS 189, Counsel Stack Legal Research, https://law.counselstack.com/opinion/independent-life-insurance-co-of-america-v-downey-kyctapphigh-1934.