MacK v. Pacific Mutual Life Insurance

208 N.W. 410, 167 Minn. 53, 1926 Minn. LEXIS 1254
CourtSupreme Court of Minnesota
DecidedApril 9, 1926
DocketNo. 25,155.
StatusPublished
Cited by23 cases

This text of 208 N.W. 410 (MacK v. Pacific Mutual Life Insurance) is published on Counsel Stack Legal Research, covering Supreme Court of Minnesota primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
MacK v. Pacific Mutual Life Insurance, 208 N.W. 410, 167 Minn. 53, 1926 Minn. LEXIS 1254 (Mich. 1926).

Opinion

Wilson, O. J.

Defendant appealed from an order denying its motion for judgment non obstante or for a new trial. Plaintiff prosecuted this action to recover upon a health policy which defendant says was procured by false statements in the application. The statements of plaintiff in the application which constitute the basis for the defense are: (a) That he never had kidney or bladder disease; (b) that he never had fistula; (c) that during the last seven years he had not consulted or been treated by any physician except Drs. W. H. Valentine and Helen Hughes Hilscher; (d) that he had never received any compensation for accidental injuries or sickness. The application for insurance was made August 5, 1921, and the policy bears the same date.

(a) On January 1, 1917, the insured consulted Dr. Workman for the grippe. The doctor saw him on January 3, 5, 7, 8, 9, 10 and 24. On the last four dates the insured went to the doctor’s office. When the doctor first saw him he had a temperature and complained of *55 pain in the small of the back. From a urinalysis a trace of albumin and pus was found. He was kept in bed a few days. His bladder was irrigated. This treatment was painful. He was given medicine which produced alkalinity of the urine and was advised to drink large quantities of water to flush out the kidneys and bladder. The medicine was later changed to urotropin which is a urinary antiseptic. The doctor told him his ‘-‘kidneys were a little off” and would quickly clear up, as they did. On January 10- his condition was substantially normal, and on the twenty-fourth he was discharged. The doctor testified that during this period the insured had acute cystitis or infection of the bladder and acute pyelitis or infection of the kidneys, and that his condition was serious. On January 13, 1917, the attending doctor made a preliminary statement of sickness to the Interstate Business Men’s Accident Association with whom respondent then carried health insurance in which he termed the nature of the illness: “La grippe followed by a mild pyelitis and cystitis.” On January 24, 1917, the attending doctor made an affidavit as a final statement to the insurance company and referred to the nature of the illness as “la grippe, acute pyelitis and cystitis mild.” On January 26, 1924, the doctor wrote counsel for the insured, referring to the ailment as pyelitis and a mild cystitis and stated that “under rest and urinary antiseptics and irrigation of the urinary bladder he showed no trouble when last seen by me on January 24th, 1917.” When the insured ma-de a preliminary statement in reference to said illness to the insurance company he said the nature of the illness was “grip, kidney and bladder trouble.” The same statement was repeated in his final statement to the insurance company. This trouble 'has never recurred.

(b) Some time prior to February 26, 1917, plaintiff had an anal fistula and about that time Dr. Helen Hughes Hilscher performed a hemorrhoidectomy upon the plaintiff. Hemorrhoids are ordinarily known as piles. From a medical standpoint fistula is quite different from piles. Yet Dr. Hilscher testifying in the trial said: “This man, Mr. Mack, had the condition known as piles. I found piles (we use the word ‘piles,’ the condition generally known as piles), a fissure and fistula.” Dr. Hamilton testified that fistulas are a com *56 mon part of hemorrhoids. It would seem that fistulas are usually included by laymen in the term “piles,” which in a technical medical term is known as “hemorrhoids.” On March 22, 1917, plaintiff made a preliminary statement of sickness to the insurance company above mentioned, reporting the nature of his illness as “rectum trouble.” The record does not disclose that the insured knew the distinction between fistula and piles. The question was whether he ever had or been treated for gastric or duodenal ulcer, indigestion, appendicitis, piles, fistula. He answered: “Yes, piles.” He then mentioned the operation.

(c) On February 11, 1915, the insured consulted Doctor Workman about a sore mouth. This ailment was trivial. On August 1, 1916, the same doctor removed under cocaine what was probably a chicken bone lodged in a fissure in the rectum. Doctor Workman, in January, 1917, was consulted by plaintiff as above mentioned. Insured omitted to disclose Dr. Workman as one of the physicians consulted or treating him during the seven years immediately prior to making the application.

(d) Insured received from the above mentioned insurance company $13.57 covering the first 8 days of January, 1917. He also received $146 for 41 days confining disability and $20 for two weeks nonconfining disability, or a total of $166.40, incident to his operation of hemorrhoids. A portion of the answers in the application was written by hand but question No. 14: “Have you ever received or been refused compensation for accidental injuries or sickness?” was answered “no” in typewriting. Insured testified that the typewritten answer was not in the application when he signed it. He is corroborated by another witness. Insured and the corroborating witness testified that insured orally disclosed in detail the fact of his having received compensation as above mentioned.

A material misrepresentation in ithe application made with intent to deceive and defraud avoids the policy. Such misrepresentation will avoid the policy if the matter misrepresented increases the risk of loss, even though it was not made with intent to deceive or defraud. G. S. 1923, § 3370; Price v. Standard L. & A. Ins. Co. *57 90 Minn. 264, 95 N. W. 1118; Johnson v. Nat. L. Ins. Co. 123 Minn. 453, 144 N. W. 218, Ann. Cas. 1915A, 458; Olsson v. Midland Ins. Co. 138 Minn. 424, 165 N. W. 474; Ivanesovich v. N. A. Life & C. Co. 145 Minn. 175, 176 N. W. 502; First Nat. Bank of Duluth v. Nat. L. Ins. Co. 156 Minn. 1, 194 N. W. 6, 38 A. L. R. 380. The burden of proof is on the defendant.

The general questions in an application for insurance calling for information concerning former ailments do not require the disclosure of ailments of a trivial, temporary or unimportant nature but only those of a serious, dangerous or permanent character. Gruber v. German R. C. Aid Soc. 113 Minn. 340, 129 N. W. 581; Ames v. N. Y. Life Ins. Co. 154 Minn. 111, 191 N. W. 274.

If the evidence is conclusive in establishing a misrepresentation within the spirit of the law, as above stated, a question of law is presented. In Flikeid v. N. Y. Life Ins. Co. 163 Minn. 127, 203 N. W. 598, and Shaughnessy v. N. Y. Life Ins. Co. 163 Minn. 134, 203 N. W. 600, the matters concealed were so directly connected with glioma, the cause of death in each ease, and the evidence was so conclusive, we held that the defense was established as a matter of law. In the case at bar all former ailments were cured and had no connection with present ailments. Usually it is for a jury to decide whether a misrepresentation has in fact been made, whether it is material, whether it is made-with intent to deceive and defraud or whether the matter misrepresented, in fact, increases the risk of loss. Price v. Standard L. & A. Ins. Co. supra; Johnson v. Nat. L. Ins. Co. supra; Ivanesovich v. N. A. Life & C. Co. supra; Ames v. N. Y. Life Ins. Co. supra.

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Cite This Page — Counsel Stack

Bluebook (online)
208 N.W. 410, 167 Minn. 53, 1926 Minn. LEXIS 1254, Counsel Stack Legal Research, https://law.counselstack.com/opinion/mack-v-pacific-mutual-life-insurance-minn-1926.