Manufacturers Life Insurance Co. v. Irizarry

34 P.R. 267
Supreme Court of Puerto Rico·Decided May 25, 1925·No. No. 3465·Published

Opinion

Mr. Chief Justice Del Toro

delivered the opinion of the court.

The plaintiff, an insurance company of Toronto, Canada, brought this action to annul a policy issued in favor of defendant Irizarry for the reason that Irizarry declared that he was in perfect health when he applied for the insurance, the fact being that he was then sick. The defendants alleged in their answer that the declarations made in the application were true, setting np various special defenses. After trial the court rendered judgment for the defendants and thereupon the plaintiff took the present appeal. We shall consider first the “defenses” of the defendants.

The first is that the plaintiff company is estopped from questioning the condition of the health of defendant Irizarry for the reason that his health was certified to as good by physicians freely chosen by the said company after the application had been made at the solicitation and request of the company acting by its agent.

We have examined the cases cited by the appellees in support of their contention and they are not exactly applicable. In our opinion the light by which we should be guided stands out clearly in the case of Mutual Life Insurance Company v. Hilton-Green, 241 U. S. 613, 60 L. ed. 1202, cited by the appellant.

After stating the facts concisely the Supreme Court of the United States, by Mr. Justice McReynolds, expressed itself as follows:

“Considered in most favorable light possible, the above quoted incorrect statements in the. application are material representations; and, nothing else appearing, if known to be untrue by assured [269]*269when made, invalidate the policy without further proof of actual conscious design to defraud. Moulor v. Am. Life Ins. Co., 111 U. S. 335, 345; Phoenix Life Ins. Co. v. Raddin, 120 U. S. 183, 189; Aetna Life Ins. Co. v. Moore, 231 U.S. 543, 556-557; May on Insurance, 4th ed., sec. 181.
“The general rule which imputes an agent’s knowledge to the. principal is well established. The underlying reason for it is that an innocent third party may properly presume the agent will perform his duty and report all facts which affect the principal’s interest. But this general rule does not apply when the third party knows there is no foundation for the ordinary presumption — when, he is acquainted with circumstances plainly indicating that the agent will not advise his principal. The rule is intended to prote.ct those who exercise good faith and not as a shield for unfair dealing. The Distilled Spirits, 11 Wall. 356, 367; American Surety Co. v. Pauly, 170 U. S. 133, 156; American Natl. Bank v. Miller, 229 US. 517, 521, 522; Mechem on Agency, 2d ed., see. 1815.
“Section 2765 of the Florida statutes, ante, undertakes to designate as agents certain persons who in fact act for an insurance company in some particular; but it does not fix the scope of their authority as between the company and third persons and certainly does not raise special- agents with limited authority into general ones possessing unlimited power. We assume Hogue, Torrey and the medical examiners were in fact designated agents of the company with power to bind it within their apparent authority; and in such circumstances the statute does not affect their true relationship to the parties. See Continental Ins. Co. v. Chamberlain, 132 U. S. 304, 310; New York Life Ins. Co. v. Russell, 77 Fed. Rep. 94, 103; Wood v. Firemen’s Insurance Co., 126 Massachusetts, 316, 319; John R. Davis Lumber Co. v. Hartford Fire Ins. Co., 95 Wisconsin, 226, 234-235.
“The assured at the least consciously permitted an application containing material misrepresentations to be presented by subordinate agents to officers of the insurance company under circumstances which he knew negatived any probability that the actual facts would be revealed; and later he accepted policies which he must have understood were issued in reliance upon statements both false and material. lie could claim nothing because of such information in the keeping of unfaithful subordinates. Moreover, the- false representations accompanied and were essential parts of the policies [270]*270finally accepted. He did not repudiate, and therefore adopted and approved, the representations upon which they were based. Beyond doubt an applicant for insurance should exercise toward the company the same good faith which may be rightly demanded of it. The relationship demands fair dealing by both parties. New York Life Ins. Co. v. Fletcher, 117 U. S. 519, 529, 533, 534; Assurance Co. v. Building Association, 183 U. S. 308, 361; U. S. Life Ins. Co. v. Smith, 92 Fed. Rep. 503.
“Considered with proper understanding of the law, there is no evidence to support a verdict against petitioner and the trial court should have directed one in its favor.
“Judgment of the Circuit Court of Appeals is reversed and the cause remanded to the United States District Court, Northern District of Florida, for further proceedings in accordance with this opinion. ’ ’

In this particular case under consideration it was alleged in the complaint and proved at the trial that in his application, which forms a part of the policy, defendant Irizarry said: “I hereby declare and convenant that at present and generally I am enjoying perfect health.” If the defendant knew that this was not true it is of no importance that the idea of insuring did not originate with him, but was suggested by a soliciting agent of the company, or that the company’s physician certified to his good health. Whether the defendant conspired with the agent and the physician of the company for the express purpose of defrauding the company, or acted on his own initiative, he necessarily knew that he was leading the head office of the company into error, because his good health was a requisite sine qua non for the issuance of the policy, and from the attitude of the agent in soliciting the insurance and of the physician in certifying favorably, considering his manifest condition of ill health that could deceive nobody, he necessarily had to infer that nothing contrary to his false statement of good health would be communicated to the officials of the company.

[271]*271The second defense pleaded is laches. It is contended that between the day on which defendant Irizarry made his. application and the day on which the policy was issued the plaintiff had time to investigate the condition of the applicant’s health and in not doing so voluntarily waived its right.

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Manufacturers Life Insurance Co. v. Irizarry, 34 P.R. 267 (prsupreme 1925).

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Related

The Distilled Spirits
78 U.S. 356 (Supreme Court, 1871)
Moulor v. American Life Insurance
111 U.S. 335 (Supreme Court, 1884)
New York Life Insurance v. Fletcher
117 U.S. 519 (Supreme Court, 1886)
Phoenix Life Ins. Co. v. Raddin
120 U.S. 183 (Supreme Court, 1887)
Continental Life Insurance v. Chamberlain
132 U.S. 304 (Supreme Court, 1889)
American Surety Company v. Pauly
170 U.S. 133 (Supreme Court, 1898)
Northern Assurance Co. v. Grand View Building Assn.
183 U.S. 308 (Supreme Court, 1902)
Aetna Life Insurance v. Moore
231 U.S. 543 (Supreme Court, 1913)