Marks v. Continental Casualty Co.

427 P.2d 387, 19 Utah 2d 119, 1967 Utah LEXIS 581
CourtUtah Supreme Court
DecidedMay 5, 1967
Docket10656
StatusPublished
Cited by8 cases

This text of 427 P.2d 387 (Marks v. Continental Casualty Co.) is published on Counsel Stack Legal Research, covering Utah Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Marks v. Continental Casualty Co., 427 P.2d 387, 19 Utah 2d 119, 1967 Utah LEXIS 581 (Utah 1967).

Opinion

CROCKETT, Chief Justice:

The plaintiff, Ruth Marks, sued for the cost of hospitalization and medical expenses for an operation on her back, claiming coverage by defendant, Continental Casualty Company. Neither the writing of the coverage, nor the payment of premium, in May, 1963, is disputed. Defendant based its refusal to pay on two grounds: (1) that plaintiff made misrepresentations in applying for the insurance; and (2) that the operation was. to correct a condition which existed prior to the insurance coverage. Upon a trial to the court it made findings against the defendant on both issues and gave judgment for the plaintiff in the amount of $1,783.70. Defendant insists that the evidence does not support the-findings and judgment.

At the time the insurance contracts were-entered into, Section 31-19-8, U.C.A.1953,. was in effect. 1 It provided in substance-that no misrepresentation would void the-policy unless it was made with intent to-deceive, but that if a misrepresentation was. in fact made, the burden of proving it was not made with intent to deceive is upon the-insured.

For the purpose of considering defendant’s first contention, we set aside for the-moment consideration of the nature and.' effect of alleged misrepresentations in plaintiff’s application, and direct our attention, to the question whether the evidence justifies the trial court’s findings that the rep-, resentations which were made, were not. made with intent to deceive.

The questions and answers which the-defendant asserts were false and the contrasting facts are as follows:

Q: Have you or any dependents named,, ever been medically treated for or-medically advised for any of the-following:
A * * *
B Paralysis, epilepsy, nervous: breakdown, or any other brain or-nervous disorder.
*121 A: No.

The contrasting fact: that she had been "in an automobile accident in 1957 in which ■she got a puncture wound in her arm, necessitating hospitalization and treatment, . and the examination showed “partial paral.ysis” of median, ulnar and radial nerves ■of her forearm. .v

Q: F Arthritis, rheumatism, back, spine, bone, joint or muscle disorder.
* * *
A: No.

The fact: that plaintiff had had a coccy-.gectomy (removal of the vestigial tailbone) in 1954; and also she had seen a doctor in 1955 regarding an accidental fall on her buttocks with resulting pain in her back ■and leg.

In support of her contention that she had no intent to deceive, the plaintiff testified to these facts: This insurance was purchased for her by her former husband from an agency in Tulsa, Oklahoma, through an agent who was also her brother-in-law. The agent had known her well and had been closely associated with her and her family for many years. She told him in a letter about her prior operation. He mailed her an application form with a note attached saying, “ * * * you can just sign it and mail it back if you want to, and I will take care of it from there.” Pursuant to his suggestion she had signed the application in blank and returned it to him.

The defendant places reliance on the recent case of Theros v. Metropolitan Life Insurance Co., 2 which held that the insured was presumed to have read the application and to know its contents. It will be noted that there are significant differences in the facts shown here. In the Theros case tlje agent was present with the insured in the latter’s home, filled out the false answers in his presence, and handed the application to the insured for his signature. The case held that under those circumstances the beneficiaries could not be heard to say that the insured was not aware of the false answers, particularly where just above his signature it stated:

I have read the foregoing answers before signing. They have been correctly written, as given by me, and are true and complete. There are no exceptions to any such answers other than as stated therein.

It is important that in the instant case there is no such provision in the application. This, together with the additional facts just recited, where this whole transaction was carried on through the mails, present a situation from which the trial court could reasonably believe that tlu plaintiff did not intend to deceive the defendant company. This is particularly so *122 when considered in connection with the next aspect of the evidence we discuss, which supplements what we have said above, and supports the conclusion just stated.

The plaintiff’s further position is that even if the transaction had been face to face with full opportunity to read the answers, she would not have regarded them as false or as misrepresenting the facts. Illustrative of this is her testimony relating to the claimed falsehood about paralysis of her arm resulting from the automobile accident six years before, in 1957:

Q: You understand what the word “paralysis” is?
A: My body wasn’t paralyzed.
Q: I didn’t ask you that. Was your arm paralyzed?
A: My fingers were not paralyzed.
Q : Was any part of your arm paralyzed by your nerve injury?
A: I don’t understand what you are trying to determine from me. I had no control of my wrist, and I had to keep my wrist in a cast to control it. I wouldn’t call that actually paralysis.

In regard to the question concerning whether she had had any back or bone disorders, plaintiff was asked on direct examination:

q . * * * The answer is “no” on that-Is that the answer which you considered to be accurate?
A: Well, I think that is an accurate answer, yes.
Q: And as far as you know at that, time was that an accurate answer?
A: Yes, it was.

When one is charged with a. falsehood or a misrepresentation, in order for it to be actionable or to deprive him. of a right, it must be done wilfully and knowingly. 3 It is true that in the technical, sense the word “paralysis” may mean the-inability of individual muscles and/or' nerves to function. But in common usage-it is also understood as meaning the non-functioning of an entire limb or part of the body. Plaintiff admits that she could, not control her wrist, which required support by a cast, but she could use her arm and her fingers. As a lay person she was-not obliged to know the technical meaning-of the terms used, but only to know the meaning in common usage.

This also applies to plaintiff’s-answer as to a “back or bone disorder.” The coccyx bone is the vestigial tailbone at the end of the spine.

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Cite This Page — Counsel Stack

Bluebook (online)
427 P.2d 387, 19 Utah 2d 119, 1967 Utah LEXIS 581, Counsel Stack Legal Research, https://law.counselstack.com/opinion/marks-v-continental-casualty-co-utah-1967.