Lampke v. Metropolitan Life Insurance

18 N.E.2d 14, 279 N.Y. 157, 1938 N.Y. LEXIS 813
CourtNew York Court of Appeals
DecidedNovember 29, 1938
StatusPublished
Cited by27 cases

This text of 18 N.E.2d 14 (Lampke v. Metropolitan Life Insurance) is published on Counsel Stack Legal Research, covering New York Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Lampke v. Metropolitan Life Insurance, 18 N.E.2d 14, 279 N.Y. 157, 1938 N.Y. LEXIS 813 (N.Y. 1938).

Opinion

Hubbs, J.

Plaintiff is the administratrix of the deceased insured, Veronica Schumacher. The action was brought to collect on two industrial life insurance policies issued by the defendant. The policies contained the *161 following provisions: If, (1) the insured is not alive or is not in sound health on the date hereof; * * * or has, within two years before the date hereof, been attended by a physician for any serious _ disease or complaint * * * the Company may declare this policy void.” The insurance company defended on the ground that it is admitted that within two years of the dates of the policies the deceased had been attended by a physician for high blood pressure which, it contends, was a serious disease or complaint.” The reply of the plaintiff was that the insured’s condition did not constitute a serious disease or complaint ” and' that the insurance company had waived or was estopped to set up the defense stated.

The trial court submitted to the jury the issue whether the condition in the policy had been breached and whether there had been a waiver or estoppel. The jury found for the plaintiff. The Appellate Division at first unanimously affirmed, then granted a reargument, and after reargument unanimously reversed on the law on the authority of Fortunato v. Metropolitan Life Ins. Co. (248 App. Div. 680, which affirmed 160 Misc. Rep. 918).

The basis of the Appellate Division’s decision was that since in the applications the deceased had stated that she was in good health there was no estoppel as a matter of law and no question for the jury was presented.

The notice to the insurance company upon which the plaintiff relies as constituting evidence of estoppel is contained in several conversations had between the deceased and Colichia, the insurance company’s agent. He appears to have been an agent to sell policies, deliver them and collect the premiums. The most direct evidence of notice to the company is contained in the testimony of Mrs. Tollner who testified that the deceased told the agent: Why, she said she had high blood pressure and she was subject to dizzy spells; that if she worked hard it excited her quite a bit and she had to take a rest during *162 the day.” This conversation took place about a year before the agent finally persuaded the deceased to take out the policies. However, there is evidence to the effect that on several occasions thereafter he had his attention called to the question of insured’s condition of health. The day he persuaded her to apply for the insurance she again told him that she was afraid that she would not pass the doctor’s test, and the agent told her to " just try.” Thus there is evidence upon which the jury could have found that the agent had knowledge of the insured’s condition of health. In the application the deceased stated that she was in sound health and had not been under the care of a physician for three years. This was the fact upon which the Appellate Division relied to hold, as a matter of law, that the insurance company was not estopped. We believe that holding to be erroneous.

Prior to the enactment of section 58 of the Insurance Law (Cons. Laws, eh. 28), a policy might, by stipulation or reference therein, make a part of itself statements of the assured which were not embodied in the policy and such material statements were warranties the falsity of which avoided the policy. The insured, as a part of his contract, did not have a copy of such statements. He could not, by reading his policy, know what the statements were. He had no opportunity to correct any error in the statements. By the enactment of section 58 the Legislature intended to and did change the situation by providing that the policy should contain the entire contract and that nothing could be incorporated therein by reference. Section 58 provides: "Any waiver of the provisions of this section shall be void.” After the enactment of section 58 the defense that the insured made false statements inducing the issuance of the policy ceased to constitute a valid defense unless such statements were made a part of the policy as provided in the section. The decisions previously made, *163 holding such defense to be valid, no longer represented the law of the State. By many decisions the law has been definitely settled to the effect that false material statements made to induce a company to issue its policy, whether made orally or in writing, no longer constitute a defense unless such statements are attached to or indorsed upon the policy. Not constituting a defense, no evidence can be received of such material false statements. (Archer v. Equitable Life Assur. Society, 218 N. Y. 18.) Since that decision a defense based upon alleged false statements, not made a part of the policy as required by section 58, no longer has existed in this State. It makes no difference whether such false statements be called representations or warranties.

Undoubtedly the insured had been attended by a physician within two years before the date of the policies. Her statement in the applications, standing alone, that she had not been under the care of a physician within three years, was false. It was not a warranty as the provision was not contained in the policies and the applications were not attached to the policies as required by section 58 of the Insurance Law. (Minsker v. John Hancock Mut. Life Ins. Co., 254 N. Y. 333.) If the application had been attached to the policies the false statement would have made them void within the decision last cited. In Fortunato v. Metropolitan Life Ins. Co. (supra) the application was not attached to or indorsed upon the policy; therefore, the false statements of the insured did not constitute a defense to the policy. The decision in that case is, therefore, disapproved.

We now consider another question — whether, under the express terms of the policies, an issue of fact was presented by the evidence to the effect that the agent knew the condition of the insured’s health at the time the applications for the policies were executed. The defendant relied upon the provision of the policies that they might be declared void if the insured had been *164 attended by a physician for a serious disease or complaint ” within two years and if she was not in sound health at the date of the issuance of the policies. Under those defenses the burden of proof was upon the defendant. Unless it established one of those defenses as a matter of law a question of fact existed for the determination of the jury.

What constitutes a serious disease or sound health is ordinarily a matter of opinion. A condition which in one person might constitute a serious disease or complaint ” in another person might not be considered serious.

It appeared that the insured, some time before she applied for the policies in question, had suffered from what she characterized as high blood pressure and had dizzy spells. A physician who attended her four months prior to the date of the policies testified that at intermittent periods she had systolic blood pressure between 190 and 200.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Smith v. Pruco Life Ins. Co. of N.J.
710 F.3d 476 (Second Circuit, 2013)
American General Life Insurance v. Salamon
483 F. App'x 609 (Second Circuit, 2012)
Corines v. American Physicians Insurance Trust
769 F. Supp. 2d 584 (S.D. New York, 2011)
One Beacon Insurance v. Old Williamsburg Candle Corp.
386 F. Supp. 2d 394 (S.D. New York, 2005)
Chase Manhattan Bank v. New Hampshire Insurance
193 Misc. 2d 580 (New York Supreme Court, 2002)
Massachusetts Casualty Insurance v. Morgan
886 F. Supp. 1002 (E.D. New York, 1995)
Contractors Realty Co. v. Insurance Co. of North America
469 F. Supp. 1287 (S.D. New York, 1979)
Tannenbaum v. Provident Mutual Life Insurance
53 A.D.2d 86 (Appellate Division of the Supreme Court of New York, 1976)
Gozan v. Mutual Life Insurance
49 A.D.2d 200 (Appellate Division of the Supreme Court of New York, 1975)
Lau v. Guardian Life Insurance Co. of America
78 Misc. 2d 332 (Civil Court of the City of New York, 1974)
Anderson v. Metropolitan Life Insurance
75 Misc. 2d 1003 (Appellate Terms of the Supreme Court of New York, 1973)
Helfaer v. John Hancock Mutual Life Insurance
51 Misc. 2d 869 (New York Supreme Court, 1966)
Wageman v. Metropolitan Life Insurance
24 A.D.2d 67 (Appellate Division of the Supreme Court of New York, 1965)
Holmes v. Nationwide Mutual Insurance
40 Misc. 2d 894 (New York Supreme Court, 1963)
Tyrnauer v. Travelers Insurance
15 A.D.2d 293 (Appellate Division of the Supreme Court of New York, 1961)
Concoff v. Occidental Life Insurance
152 N.E.2d 85 (New York Court of Appeals, 1958)
Pannunzio v. Monumental Life Ins.
168 Ohio St. (N.S.) 95 (Ohio Supreme Court, 1958)
Perkins v. John Hancock Mutual Life Insurance
128 A.2d 207 (Supreme Court of New Hampshire, 1956)
Metropolitan Life Insurance v. Goldberger
3 Misc. 2d 878 (New York Supreme Court, 1956)
Hyman-Michaels Co. v. Massachusetts Bonding & Insurance
132 N.E.2d 347 (Appellate Court of Illinois, 1955)

Cite This Page — Counsel Stack

Bluebook (online)
18 N.E.2d 14, 279 N.Y. 157, 1938 N.Y. LEXIS 813, Counsel Stack Legal Research, https://law.counselstack.com/opinion/lampke-v-metropolitan-life-insurance-ny-1938.