Metropolitan Life Insurance v. James

141 S.E. 500, 37 Ga. App. 678, 1928 Ga. App. LEXIS 563
CourtCourt of Appeals of Georgia
DecidedJanuary 17, 1928
Docket18071
StatusPublished
Cited by8 cases

This text of 141 S.E. 500 (Metropolitan Life Insurance v. James) is published on Counsel Stack Legal Research, covering Court of Appeals of Georgia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Metropolitan Life Insurance v. James, 141 S.E. 500, 37 Ga. App. 678, 1928 Ga. App. LEXIS 563 (Ga. Ct. App. 1928).

Opinion

Bell, J.

Mrs. Stella James brought suit against Metropolitan Life Insurance Company upon a policy of insurance issued upon the life of her husband, Benjamin A. James, in which she was named as beneficiary. The defendant defended the suit upon the grounds of fraud and material misrepresentations in the application for insurance. The verdict was in favor of the plaintiff, and the defendant excepted to the refusal of a new trial. The application was in parts A and B, and was attached to the policy as a part of the contract. In part A were the following stipulations:

“1. That the foregoing statements and answers are correct and wholly true, and, together with the answers to questions on part B hereof, they shall form the basis of the contract of insurance, if one be issued.

“2. That no agent, medical examiner, or any other person, except the officers of the company, have power on behalf of the company: (a) to make, modify, or discharge any contract of insurance; (b) to bind the company by making any promises respecting any benefits under any policy issued hereunder.

“3. That no statement made to or by, and no knowledge on the part of, any agent, medical examiner, or any other person as to any facts pertaining to the applicant shall be considered as having been made to or brought to the knowledge of the company, unless stated in either part A or B of this application.”

The policy contained the' following provision: “This policy and the application therefor constitutes the entire contract between the parties, and all statements made by the insured, in the [679]*679absence of fraud, shall be deemed representations and not warranties; and no statement shall avoid the policy or be used in defense of a claim hereunder, unless it be contained in the application therefor and a copy of such application is attached to this policy when issued.”

Parts A and B of the application both purported to have been signed b,y the insured. Part B contained, among others, the following questions and answers:

“6. Present condition of health? Good.

“7. (a) When last sick? March, 1920. (b) Nature of last

sickness? Influenza, (c) How long sick? 15 days.

“9. Any physical or mental defect or infirmity? If yes, give the particulars. No.

“18. Have you been attended by a physician during the last five years? If yes, give name of complaint, dates, how long sick, and names of physicians. No.

“19. Have you had any treatment within the last five years at any dispensary, hospital, or sanatarium? If yes, give date, duration, name of ailment, and name of institution. No.”

The policy was dated March 3 and delivered March 6, and the insured died on April 16, 1926.-

The evidence on the trial established that, although the insured had answered that his last sickness was .in March, 1920, that he had not been attended by any physician during the past five years, and that he had no treatment during this period at any dispensary, hospital, or sanatarium, the truth was that within less than twelve months prior to the application he had been attended by physicians, and had spent several days in the Atlantic Coast Line Hospital at Waycross, where he was treated for high blood pressure. It appears that he was advised to go to the hospital at the particular time by one Dr. Clay, to whom he had applied for additional benefits in the nature of insurance in the relief department of the Atlantic Coast Line Bailroad Company. Dr. Clay testified in part as follows: “As a physician I have not attended Benjamin A. James within five years prior to the 24th of February, 1926. He came to me for physical examination, August 31, 1925. At that time I found him suffering with high blood pressure, the exact points I do not recall, but something over 200, and advised him that it would be impossible to accept his application for addi[680]*680tidnal life insurance, that is, additional benefit in the Atlantic Coast Line Belief Department. I advised him that it would be necessary for him to see a physician at once and put himself under the careful attention of a doctor for some time, as his condition was rather serious. I am a physician for the Atlantic Coast Line Company. B. A. James was an employee of the Atlantic Coast Line Company. The benefit I spoke of was in' the Belief Department of the Atlantic Coast Line Bailroad Company, in which no one can be a member except employees or those who have been employees. I do not recall how much insurance he was applying for. I do not recall ever having treated B. A. James. I think he had what we call the second class, which would entitle him to $500 death benefit, and my impression is that he had come in to raise his insurance to the full amount of the fifth class, which would be $1250. I made blood-pressure test in my examination. I used that method in some cases, not in all. I recall seeing James subsequent to that time. He was working at the time I saw him, I think the 23d of September, 1925. He had been in the hospital of the Atlantic Coast Line Bailroad Company between those dates. He was anxious to go to work, and we did not want to keep him from work unnecessarily, and I gave him a permit to go back to work. August 31, 192.5, was the date T failed to pass him for additional insurance. I am the medical examiner for the Atlantic Coast Line Belief Department at this point. He came to me for his examination; that was the first examination made for the additional insurance. . . Yes, I would feel that he was a bad risk and should not be accepted for insurance so long at least as that condition existed ox possibly for several years after it had cleared up, to be sure that it would not recur. We do not know these causes always, what the cause of the high blood pressure is. If the point or focus causing that high blood pressure can be located and- eliminated, then we have some reason to anticipate an improved condition. If they can not be located, we do not.”

Dr. Williams testified: “I am a physician and have been a physician in Savannah for eighteen years. Benjamin A. James was not treated by me within five years. I examined him and advised him to be treated. It was February 20, 1926. That was when I first examined him. The date of my examination was February 20, 1926. He was complaining of headache and high [681]*681blood pressure. I took Ms blood pressure on account of continued headaches. I think the blood pressure was about 210, the best I can remember; I doMt remember exactly, but over 200. For a man of his age the normal is about 135 or 140. As stated in this report of mine, the cause of his death was cerebral hemorrhage, and the contributory or second cause was hypotentia, and that produced cerebral hemorrhage-. He came to me, I guess, for treatment. I examined him and told him he had better go to the hospital. I advised him to go to the hospital at Waycross, where he could get proper treatment, and better treatment than at home. He came to me with headache. I guess he was working at that time.”

According to the evidence of Dr. McCullough, he treated the insured for twelve days in September, 1925, for arterial hypertension, and this was a contributory or secondary cause of his death in the following April, the immediate cause being cerebral hemorrhage. As shown by the other evidence, it was during this period that the insured was at the railroad hospital.

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Cite This Page — Counsel Stack

Bluebook (online)
141 S.E. 500, 37 Ga. App. 678, 1928 Ga. App. LEXIS 563, Counsel Stack Legal Research, https://law.counselstack.com/opinion/metropolitan-life-insurance-v-james-gactapp-1928.