James v. United States

185 F.2d 115, 22 A.L.R. 2d 830, 1950 U.S. App. LEXIS 3861
CourtCourt of Appeals for the Fourth Circuit
DecidedNovember 8, 1950
Docket6126_1
StatusPublished
Cited by24 cases

This text of 185 F.2d 115 (James v. United States) is published on Counsel Stack Legal Research, covering Court of Appeals for the Fourth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
James v. United States, 185 F.2d 115, 22 A.L.R. 2d 830, 1950 U.S. App. LEXIS 3861 (4th Cir. 1950).

Opinion

DOBIE, Circuit Judge.

This action was brought against the United States under 38 U.S.C.A. §§ 445, 817, to recover on a $10,000. policy of National Service Life Insurance. A motion for summary judgment for the United States was not ruled upon, and the case was tried on the merits before the United States District Court for the Western District of North Carolina, sitting without a jury. Judgment was entered for the United States 89 F.Supp. 330, and the plaintiff brought this appeal.

The issue here is the validity of an alleged contract of insurance held by Clara Fine James who was, at her death, the wife of plaintiff. This insured had served as a Wave in the United States Navy prior to May 24, 1946, on which date she was honorably discharged by reason of her *117 pregnancy. While on active duty in the Navy, insured held an admittedly valid $10,000 policy of term insurance of which the beneficiary was someone other than plaintiff. Premiums were paid by allotment, and this policy lapsed on July 1, 1946, for nonpayment of the premium first due after insured’s discharge.

At some time between this lapse and June 10, 1947, insured married the plaintiff. On June 10, 1947, insured applied for reinstatement of the lapsed policy and at that time she designated plaintiff as the new beneficiary.

The application for reinstatement contained the following questions:

“1. Are you in as good health as you were on the date of the first premium in default? (Answer ‘yes’ or ‘no’.)

“2. Have you been ill, or suffered or contracted any disease, injury, or infirmity, or been prevented by reason of ill health from attending your usual occupation, or consulted a physician, surgeon, or other practitioner for medical advice or treatment at home, hospital, or elsewhere, in regard to your health, since lapse of this insurance? (Answer ‘yes’ or ‘no’. If ‘yes’ give......particulars......)”.

To question 1, insured answered “yes”; to question 2 no answer was given. With the exception of the answers to these two questions, it is undisputed that the procedures of applying for reinstatement of the insurance policy were complied with, fully, truthfully and correctly.

However, insured’s condition on the date of application for reinstatement was very poor as compared with her health when the first premium was in default. Although her pregnancy resulted in a still birth on June 13, 1946, two weeks before default, no serious trouble was found. And another medical examination on November 9, 1946, four months after default, revealed no unusual circumstances or conditions. By the time of the application, though, an operation had been performed upon insured, and large amounts of tissue were removed from her abdomen. This occurred on April 9, 1947, two months before application, and the trouble was diagnosed as cancer.

On June 11, 1947, just one day after her application for the reinstatement of her National Service Life Insurance, insured prompted a doctor to set forth in writing a description of the cancer from which she was suffering. This statement was sent on June 25, 1947, to the Veterans’ Administration with an application for compensation for disability resulting from active service. This application for compensation was sent to the Winston-Salem, North Carolina, office of the Veterans’ Administration, whereas the application for reinstatement of the insurance policy was sent to the Richmond, Virginia office. By letter dated October 2, 1947, the Administration stated that it had found insured to be 100% disabled and that it had awarded her 100% disability payment from July 7, 1947, the date upon which application for disability compensation was received. Insured died of cancer on December 18, 1947, a little more than six months after she made the application for the reinstatement of her National Service Life Insurance.

At the time of insured’s death no> action had been taken on this application. Insured was entitled to reinstatement as a matter of right, if she met certain requirements. She could not meet these requirements. By 38 U.S.C.A. § 802 (c)(2) reinstatement may be denied on the grounds of total disability resulting from active service. And the ultimate decision of the Veterans’ Administration was to deny reinstatement for this reason.

The facts o f insured’s health were found by the District Court. And it is their relevancy, rather than their correctness, that is seriously disputed by plaintiff. Plaintiff argues that, in spite of these facts, he is entitled to recover for the reason that the application for reinstatement was approved either in fact or by estoppel, and that the insurance policy thereby became incontestable under 38 U.S.C.A. § 802 (w). Had the application been approved, we would agree; but it is our opinion that an approval of the application was never made.

*118 Plaintiff’s argument is predicated on alternative theories:

(1) The Veterans’ Administration indicated by inter-office memoranda, by correspondence referring to the insurance policy and to plaintiff as beneficiary, and by its failure to return premiums paid, that it had in fact approved the application; or

(2) Since the Veterans’ Administration acted neither to approve nor to deny the application between its submission and the death of insured, a period of six months, reinstatement occurred by operation of law as a result of this -unreasonable delay, and the United States is estopped to assert insured’s total disability.

There was no approval in fact. It is true that inter-office memoranda of the Veterans’ Administration indicate that some administrative officials at times thought that insured’s health would not prevent reinstatement, or that the policy had actually become reinstated. These, however, did not purport to constitute an approval of the application but merely represented tentative opinions. They are not inconsistent with a later inter-office memorandum dated April'14, 1948, stating the decision of the Disability 'Claims Division that insured was totally disabled on the date of application and ineligible for reinstatement, or with a letter sent to plaintiff on June 9, 1948, informing him of this decision, or with the position the United States now maintains.

Correspondence to insured before her death, and to plaintiff thereafter, referring to the policy, requesting information to facilitate identification of insured’s account, and referring to plaintiff as beneficiary, does not indicate approval of the application. This correspondence was relative to insured’s policy, whatever its status -may have been, and indicated an effort to set the records in order. This seems to be a reasonable course of action in all cases save where a final decision has been made to deny the application, and it bears no logical relevance to the issue of reinstatement before such a decision has been reached. For the same reason, the fact that the Veterans’ Administration did not return premiums is not indicative of approval. Although their return would evidence a denial of the application, the converse does not follow. These premiums were held in suspense as unapplied credits to the account pending action on the application.

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Bluebook (online)
185 F.2d 115, 22 A.L.R. 2d 830, 1950 U.S. App. LEXIS 3861, Counsel Stack Legal Research, https://law.counselstack.com/opinion/james-v-united-states-ca4-1950.