Life & Casualty Insurance v. Carter

191 S.E. 153, 55 Ga. App. 622, 1937 Ga. App. LEXIS 433
Court of Appeals of Georgia·Decided March 3, 1937·No. 25822·Published·Cited by 19 cases

Opinions

MacIntyre, J.

This case was tried in the court below at the April term, 1936, and after introduction of evidence the court directed a verdict for the plaintiff in the amount sued for, to wit, the full amount of the principal named in the face of the policy. The defendant’s motion for new trial was overruled, and it excepted. The suit was brought by the plaintiff as the beneficiary in a policy issued by the defendant on the life of Arzell Carter. The policy was dated July 17, 1933. The insured died on May 5, 1935. The policy contained what is known as’ a “limitation-of-insurance clause,” the material part of which is as follows: [623] “Within two years from date of issuance of this policy, the liability of the company under same shall be limited, under the following conditions, to the return of the premium paid thereon: (1) If the insured before its date has been rejected for insurance by this or any other company, order or association; or has been attended by a physician for any serious disease or complaint; or has had before its date any pulmonary disease or chronic bronchitis, or cancer, or disease of the heart, liver, or kidneys.” On the date the policy was issued and for some time previously the insured was suffering from lukemia, a serious disease or complaint, for which he had been attended and treated -by his local physician and specialists of Atlanta, before the date of the policy, which attendance and treatment continued up to his death resulting from this disease or complaint. The evidence disclosed that the defendant’s agent who solicited and delivered the policy, and also its local manager, knew of the insured’s condition when the policy was delivered. The premiums paid under the policy were tendered before the suit was filed, and the offer to refund was refused by the beneficiary, the plaintiff. The only question in this ease is whether under the “limitation-of-insurance clause” (above quoted), the defendant is liable for any sum in excess of premiums paid; the insured having died within two years of the date of the ■ policy, and having been attended by a physician for a serious disease or complaint before the date of the policy, and these facts being known to the local agent and the local manager of the defendant.

This identical “limitation-of-insurance clause” was held valid and binding on the beneficiary of the insured, in Gray v. Life & Casualty Ins. Co., 48 Ga. App. 80 (supra). That decision suggests a distinction between Metropolitan Ins. Co. v. Hale, 177 Ga. 632 (170 S. E. 875), and the instant case, in that in the Hale case, which had a provision that “if the insured . . 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, and the liability of the company in the case of any such declaration in the case of any claim under this policy shall be limited to the refund of the premiums paid on the policy” (italics ours), the insurance company had the right to void the policy; whereas in the instant case the insurance company has [624] only the right of limiting the liability under certain conditions. In Chapman v. Life &c. Ins. Co., 25 Ala. App. 101 (141 So. 363), the identical clause of the defendant’s policy was under consideration; and the court stated the rule as follows: “Placed in the contract for the benefit of the insurer, it was none the less binding on the insured. Recognizing the limited liability, defendant pleads its tender and oiler to pay. Being a valid stipulation in the contract of insurance, it was immaterial whether the soliciting agent had knowledge or notice of the condition of insured or not. Assuming that both the agent and the company had such knowledge, the company admits the liability and offers to comply with the contract according to its terms." (Italics ours.) Under this same clause in the policy, knowledge or lack of knowledge on the part of the insured or the insurer, before the issuance of the policy, has been held by the courts of Tennessee not to be material, and that the “limitation-of-insurance clause” provides how much shall be due and payable under the circumstances named, and reliance by the company on this clause is not a contest, of the validity of the policy, but an insistence of the enforcement of the policy according to its terms. Russell v. Life &c. Ins. Co., 12 Tenn. App. 205; Scales v. Jefferson &c. Ins. Co., 155 Tenn. 412 (295 S. W. 58, 55 A. L. R. 537).

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Life & Casualty Insurance v. Carter, 191 S.E. 153, 55 Ga. App. 622, 1937 Ga. App. LEXIS 433 (Ga. Ct. App. 1937).

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