Massachusetts Mutual Life Insurance v. Tate

56 A.D.2d 173, 391 N.Y.S.2d 667, 1977 N.Y. App. Div. LEXIS 10041
CourtAppellate Division of the Supreme Court of the State of New York
DecidedFebruary 22, 1977
StatusPublished
Cited by11 cases

This text of 56 A.D.2d 173 (Massachusetts Mutual Life Insurance v. Tate) is published on Counsel Stack Legal Research, covering Appellate Division of the Supreme Court of the State of New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Massachusetts Mutual Life Insurance v. Tate, 56 A.D.2d 173, 391 N.Y.S.2d 667, 1977 N.Y. App. Div. LEXIS 10041 (N.Y. Ct. App. 1977).

Opinions

Shapiro, J.

On February 1, 1972 plaintiff issued a $25,000 insurance policy on the life of Patricia B. Tate in which her husband, the defendant here, was named as beneficiary. She died of pneumonia 23 months later. When the defendant demanded payment under the policy, the plaintiff made an investigation in which it learned that Mrs. Tate, in her application for the policy, had omitted the name of a psychiatrist whom she had seen. It thereupon commenced this action to rescind the policy. The defendant counterclaimed and demanded payment of the face amount of the policy. The court, [174]*174after a nonjury trial, rendered judgment in favor of the plaintiff. We reverse and grant judgment to the defendant.

The basis of the plaintiff’s right to rescind is predicated upon its contention that, if it had been given the withheld information, it would have refused to issue the policy. In its complaint the plaintiff alleged that, at the time the policy was issued, Mrs. Tate suffered from alcoholic addiction, including a mental condition, and that she had "consulted a physician or other practitioner for reasons not mentioned in the * * * application.”

In her application for insurance, dated January 31, 1972, decedent did not include the name of a Dr. Ferrell (a psychiatrist) in her "yes” answer to the question, "During the past ten years have you had (A) Advice from or attendance or treatment by physicians, other practitioners or psychologists?” In addition, decedent answered "no” to the questions which asked whether she had, during the past 10 years, been treated "for drug or liquor usage” and whether she had "at any time * * * had any known indication of or been told that * * * [she] had * * * apoplexy, epilepsy, mental illness, nervous breakdown or any disorder of the brain or nervous system?” She did, however, disclose, in answer to another question on the application, that she had, within three years, had "a physical or health examination” by a "Dr. F. Fry, Garden City, N.Y.”

What the record establishes is that decedent, during a maternity leave from teaching school, told her husband that she wanted a divorce. He, in turn, told this to his friend, Dr. Ferrell. The doctor offered to consult with Mr. and Mrs. Tate to see if he could be of some help in effecting a reconciliation. The visits, some 10 in number, took place between November, 1969 and May, 1970. Decedent was reluctant to go and Dr. Ferrell testified that he did not know why decedent came to see him. Defendant’s testimony on this point was that decedent agreed to the consultations on the representation that, if nothing was resolved after the visits, he would not contest a divorce. (A divorce action was never instituted and, apparently, Mrs. Tate returned to her teaching position in September, 1971.)

Dr. Ferrell had no notes on the visits, after the first two. His records do not even indicate, for three of the visits, which of the Tates was present, or whether they both were. He had no written diagnosis, nor had he otherwise formulated a [175]*175definite diagnosis. He had an idea, first voiced at the trial, that perhaps the difficulties between the parties came about because of a possibility that Mrs. Tate was suffering from postpartum depression. However, what his notes recorded" was that Mrs. Tate felt that her husband had been critical of her for six or seven years, that he was a loud and domineering man who would not get rid of the dog, and that there was a "lack of sex” and a "lack of communication.” His notes also bore the following notations: "No screaming. No criticism. Try to improve the sex life. Make an agreement on money. Decrease drinking.” These, thought the doctor, were recommendations he likely made to both of the Tates.

The word "alcoholism” was also noted in the doctor’s records. The doctor did not know whether he or one of the Tates had used that word. If the latter, he did not know which.

Sometime in March or April, 1972 decedent was hospitalized. (The date is indefinite because the hospital record, having been made after the date of the application for insurance, was excluded from evidence.) At that time Dr. Ferrell attended the insured. On May 13, 1972 he recorded the fact that the insured was suffering from involutional melancholia. According to his testimony, that was the first occasion on which he made a definite diagnosis that Mrs. Tate was suffering from melancholia, but it is remarkable to note that nowhere in his testimony did he ever medically define that term. (In Webster’s Third New International Unabridged Dictionary, that term is defined as "a disordered mental condition characterized by extreme depression of spirits, bodily complaints, and often hallucinations and delusions”.)

To establish the materiality of the omission of Dr. Ferrell’s name in the insurance application, the plaintiff’s associate medical director testified that "the general course of [plaintiff’s] business” is to make inquiry if an applicant lists a psychiatrist and that no action is taken on the application until a statement from the physician is received and a definite diagnosis is made. Involutional melancholia, he said, is listed in plaintiff’s underwriting manual as a serious psychosis. He also testified that either a psychosis or the use of alcoholic beverages at a certain level makes a policy, at the least, ratable, if not rejectable.

The Trial Justice determined that the plaintiff had proved a material misrepresentation as a matter of law. I disagree because the plaintiff utterly failed to prove that it was de[176]*176prived of information on the date the policy issued which, if disclosed, would have led to a refusal of the policy since the record contains no credible proof that Dr. Ferrell had diagnosed or treated the insured for either involutional melancholia or alcohol addiction.

A misrepresentation, in an application for insurance is material if knowledge by the insurer of the facts misrepresented would have led to a refusal of the policy (Insurance Law, § 149, subd 2). A failure to disclose is as much a misrepresentation as a false affirmative statement (Geer v Union Mat Life Ins. Co., 273 NY 261). For the purpose of determining materiality, the fact that an applicant failed to understand the significance of the omission is irrelevant (Leamy v Berkshire Life Ins. Co., 39 NY2d 271, 274).

"If an applicant misrepresents that he has not had 'previous medical treatment, consultation or observation’ [Insurance Law, § 149, subd. 4], he is then deemed to have represented that he has not had the disease, ailment or other medical impairment for which such treatment or care was given or which was discovered by any licensed practitioner as a result of such consultation or observation” (Tolar v Metropolitan Life Ins. Co., 297 NY 441, 447; accord Leamy v Berkshire Life Ins. Co., supra; Process Plants Corp. v Beneficial Nat. Life Ins. Co., 53 AD2d 214).

Thus, in order to be successful in its claim for rescission, plaintiff was required to establish its contention that, at the time the policy was issued, Dr. Ferrell, who described himself as a "sort of general psychiatrist” without a specialty, had previously treated the decedent for "a mental condition” or "alcoholic addiction”. It proved neither, for the testimony of the doctor did not establish treatment or diagnosis of either condition. To understand the purport of his testimony, a few extracts therefrom are most enlightening.

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Bluebook (online)
56 A.D.2d 173, 391 N.Y.S.2d 667, 1977 N.Y. App. Div. LEXIS 10041, Counsel Stack Legal Research, https://law.counselstack.com/opinion/massachusetts-mutual-life-insurance-v-tate-nyappdiv-1977.