Marlowe v. Reserve Life Insurance

198 S.E.2d 267, 261 S.C. 23, 1973 S.C. LEXIS 211
Supreme Court of South Carolina·Decided July 16, 1973·No. 19663·Published·Cited by 2 cases

Opinion

Moss, Chief Justice:

The appellant, Reserve Life Insurance Company, on January 15, 1970, issued a hospital insurance policy to Helen S. Marlowe, the respondent herein. By the terms of said policy, appellant agreed to pay to the insured certain hospital expenses incurred by her.

The respondent instituted this action alleging that while the aforesaid policy was in full force and effect she was *25 hospitalized in Duke Hospital, in Durham, North Carolina, there receiving medical treatment from May 19, 1970, until May 28, 1970. She alleges that she has filed a claim for the benefits due her under said policy and the appellant has refused to pay said claim.

The appellant, by answer, admitted the issuance of the aforesaid policy of insurance and that the respondent had been hospitalized as above set forth, but refused to pay the claim upon the ground that there were misrepresentations in the application of the respondent as to her medical history, which was relied upon by it, such being material to the risk involved and had the truth been known the policy would not have been issued and it has elected to rescind said policy of insurance and declare same null and void from its inception.

The facts in this case are undisputed. The respondent contacted an agent of New York Life Insurance Company for the purpose of purchasing hospital insurance coverage for herself and her children. This agent informed her that his company could not insure her in view of her medical history, but he agreed to contact an agent of another company which might possibly provide coverage. Shortly thereafter, one John Rouse, an agent of the appellant, contacted her by telephone and made an appointment with her for January 7, 1970, at her home. The respondent had never heard of this agent prior to, his telephone call and his visit with her. Upon the arrival of the agent at the home of the respondent, he was advised by her that, “I think you are wasting your time by trying to fill out this application because I have been turned down because my medical record lopks like a dictionary.” To this Mr. Rouse replied, “Well, I’ve got plenty of time, and if you’ve got time, let’s go through with it because I think I can take care of it.” The application was filled out by the agent himself while asking the respondent questions with respect to the medical history portion of the application. She told the agent that her medical history was so long that she could not remember it all but if he would inquire of Dr. Shingleton at Duke Hospital and Dr. Smith of *26 Conway, South Carolina, they could make such history available to him.

The respondent testified that her application for hospital insurance was filled out by the agent of the appellant and that she made no entries thereon except the affixation of her signature on the bottom line thereof. She was then asked, “Did you read the application as completed before you signed it?”, and her answer thereto was, “No sir, he didn’t offer it to me. He just asked me to sign it, and he asked me for a check, and I told him I felt sure he was wasting his time.”

The policy in question was delivered to the respondent by mail and when asked if she read it she replied, “No, sir, because he (the agent) told me what it would be and I can tell you now.”

This case came on trial before the Honorable Claude M. Epps, Judge of the Civil and Criminal Court of Horry County, without a jury. The appellant admitted at the trial that the respondent advised its agents of her medical history and that she was uninsurable. The appellant further conceded that the respondent did not intend to deceive or defraud it. The appellant seeks to avoid liability under the policy and asserts that it is not estopped to rescind the contract by reason of statements or information given by the applicant to the soliciting agent which were not included in the application. The foregoing position is based upon the provision in the application limiting the agent’s authority as follows :

“* * * that the Company is not bound by any knowledge of qr statement made by or to any agent, unless set forth in this application, and no agent has authority to waive the answer to any question on this application, to modify this application, or to bind the Company in any way by making any promise or representation?”

The trial judge granted judgment to the respondent as prayed for in her complaint. This appeal therefrom followed.

*27 The general rule is that the knowledge of an agent acquired within the scope of his agency is imputable to his principal, and if an insurance company, at the inception of the contract of insurance has knowledge of facts which render the policy void at its option, and the company delivers the policy as a valid policy, it is estopped to assert such ground of forfeiture. Fludd v. Equitable Life Assurance Society, 75 S. C. 315, 55 S. E. 762, and Small v. Coastal States Life Ins. Co., 241 S. C. 344, 128 S. E. (2d) 175.

The appellant admits that if the foregoing rule was applicable it would be estopped to rescind the contract by reason of misrepresentations in the application. However, the appellant contends that the soliciting agent, Rouse, had no authority to waive any of the appellant’s rights by reason of the above quoted limitation contained in the application and that the insured was bound by such.

The rule in this State is that an insurance company cannot set up forfeiture on account of facts known by the agent of the company to be existing at the time of the making of the contract. A provision limiting the power of an agent has no sacrosanct character over any other provision, and like all of them is itself subject to waiver by the company. Cauthen v. Metropolitan Life Ins. Co., 189 S. C. 356, 1 S. E. (2d) 147.

In Rearden v. State Mutual Life Ins. Co., 79 S. C. 526, 60 S. E. 1106, we held that an insurance company, having knowledge through its soliciting agent of misrepresentations in the application, is estopped from asserting forfeiture for the misrepresentation, notwithstanding a provision in the application that the company is to be bound only by statements therein contained, and not by information given to the person soliciting or taking the application, unless it is reduced to writing in the application and presented to the officers of the company.

*28 In 43 Am. Jur. (2d), Insurance, Section 1106, at page 1026, we find the following:

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

Marlowe v. Reserve Life Insurance, 198 S.E.2d 267, 261 S.C. 23, 1973 S.C. LEXIS 211 (S.C. 1973).

198 S.E.2d 267 (Marlowe v. Reserve Life Insurance) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

Related

South Carolina Farm Bureau Mutual Insurance v. Mayer
441 S.E.2d 824 (Supreme Court of South Carolina, 1994)
Gavin v. North Carolina Mutual Insurance
217 S.E.2d 591 (Supreme Court of South Carolina, 1975)