Mona Rutherford, of the Estate of Josephine McConnell Rutherford v. John Hancock Mutual Life Insurance Company

562 F.2d 290, 1977 U.S. App. LEXIS 11847
CourtCourt of Appeals for the Fourth Circuit
DecidedAugust 24, 1977
Docket76-1659
StatusPublished
Cited by11 cases

This text of 562 F.2d 290 (Mona Rutherford, of the Estate of Josephine McConnell Rutherford v. John Hancock Mutual Life Insurance Company) is published on Counsel Stack Legal Research, covering Court of Appeals for the Fourth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Mona Rutherford, of the Estate of Josephine McConnell Rutherford v. John Hancock Mutual Life Insurance Company, 562 F.2d 290, 1977 U.S. App. LEXIS 11847 (4th Cir. 1977).

Opinion

*292 WIDENER, Circuit Judge:

This is an action brought on a policy of life insurance. 1 Mona Rutherford sues as executrix of the estate of Josephine McConnell Rutherford, the beneficiary of an insurance policy issued by defendant John Hancock Mutual Life Insurance Company on the life of Claude V. Grose. Following the death of Grose on April 22,1973, John Hancock refused to make payment on the policy on the ground that Grose had made material misrepresentations in his insurance application.

Plaintiff admits that the misrepresentations were made, but asserts that defendant is estopped from relying upon them to avoid the policy, and that defendant has effectively waived the defense of material misrepresentation. The bases of these claims are twofold: first, that John Hancock’s agent, at the time the insurance application was filled out, made a statement to another in Grose’s presence to the effect that disclosure of a prior hospital confinement for treatment of alcoholism was “immaterial” in completing the application; and, second, that waiver resulted from issuance of the policy by John Hancock with knowledge of sufficient facts to put it on inquiry as to the truth of Grose’s prior history of treatment for alcoholism. The issues were raised as questions as to whether or not the district court properly excluded evidence of the insurance agent’s statement, and properly granted defendant’s motion for a directed verdict at the conclusion of all the evidence. We look to the law of North Carolina to resolve these issues, 2 Erie R.R. Co. v. Tompkins, 304 U.S. 64, 58 S.Ct. 817, 82 L.Ed. 1188 (1938), and affirm the judgment of the district court.

Question No. 4 on the application form completed by Grose inquired, “Within the past 3 years, have you or any eligible dependent to be insured had an examination, treatment, or surgery by any physician, surgeon, or practitioner or been confined in any clinic hospital, or sanitarium?” Grose answered “Yes,” but in the space requiring elaboration simply stated, “Routine Physical, Good Health,” and provided the name of the treating physician and the date, July 1972. In fact, within the previous three years Grose had undergone three hospital confinements for treatment of alcoholism, the longest of which had lasted six weeks. And the treatment of July 1972, which the application represented to be a “routine physical” with a bill of “good health," was in fact a five day hospital stay with a diagnosis of “Acute alcoholic intoxication” and “Chronic alcoholic addiction.”

The district court excluded testimony offered by the plaintiff of one Keith Thomas, that Thomas, in the presence of Grose, had asked defendant’s agent whether, in filling out the same application form, 3 prior treatment at an alcoholic rehabilitation center should be indicated, and that the agent had characterized such information as “immaterial.” This evidence was properly excluded, because it consists of an oral representation contradicting the express provisions of the insurance application, which was made part of the policy. The application contained a specific provision that, “[t]he foregoing statements (1 through 4) are true and complete, and that every occasion and instance as to each item answered ‘yes’ has been disclosed.”

*293 North Carolina law is clear on this point. Evidence of prior parol representations will not be received to alter the terms of a written insurance contract. The writing is conclusively presumed to contain the full agreement of the parties, absent allegations of fraud or mistake, neither of which is alleged to be present here. Cavin’s Inc. v. Atlantic Mutual Life Ins. Co., 27 N.C.App. 698, 220 S.E.2d 403 (1975); Davenport v. Travelers Indemnity Co., 283 N.C. 234, 195 S.E.2d 529, 534 (1973); Floars v. Aetna Life Ins. Co., 144 N.C. 232, 56 S.E. 915 (1907). Moreover, under North Carolina law written questions relating to health and written answers thereto in a life insurance application are deemed material as a matter of law, Rhinehardt v. North Carolina Mutual Life Ins. Co., 254 N.C. 671, 119 S.E.2d 614 (1961).

Plaintiff’s waiver argument presents a much closer question, particularly in view of the district court’s grant of a directed verdict for the defendant. John Hancock’s agent met with Grose and a number of his fellow employees to discuss a group life insurance policy at the Flynn Home in Asheville, North Carolina, a home for ex-alcoholics of which Gross was assistant manager. There is testimony in the record from which a jury could have found that, as a result of remarks made, the agent knew or should have known that several of the prospective applicants present, including Grose, had a history of alcoholism. This occurred prior to the issuance of Grose’s policy.

The pertinent North Carolina law is stated as follows. An insurance company cannot avoid liability on a policy on the basis of facts known to it at the time the policy was delivered. Cox v. Equitable Life Ins. Co., 209 N.C. 778, 185 S.E. 12 (1936). And, absent fraud or collusion, any knowledge acquired by an agent while acting within the scope of his authority is imputed to the principal. Thomas-Yelverton Co. v. State Cap. Life Ins. Co., 238 N.C. 278, 77 S.E.2d 692 (1953). Thus, the rule in North Carolina is stated that, “[k]nowledge of facts which the insurer has or should have had constitutes notice of whatever an inquiry would have disclosed and is binding on the insurer. The rule applies to insurance companies that whatever puts a person on inquiry amounts in law to ‘notice’ of such facts as an inquiry pursued with ordinary diligence and understanding would have disclosed.” Gouldin v. Inter-Ocean Ins. Co., 248 N.C. 161, 102 S.E.2d 846, 849 (1958).

Applying these principles to the case at hand, we emphasize that we do not equate general knowledge of an alcoholic condition with specific knowledge of a condition as severe as that of Grose, who had, in the recent past, required hospital confinement on three separate occasions, one of them for a period as long as six weeks. It is not inconsistent that an insurance company might not broadly exclude from coverage all past alcoholics, but might refuse to insure an individual with Grose’s record of hospitalization. The questionnaire on its face admits of this conclusion, and nothing in the record serves to contradict it. It seems apparent that, had the doctor listed by Grose on the application been contacted by John Hancock, Grose’s prior hospitalizations would have been revealed. Nevertheless, we do not think that the facts of this case can justify the imposition of such a duty on John Hancock. In the Cox and

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Bluebook (online)
562 F.2d 290, 1977 U.S. App. LEXIS 11847, Counsel Stack Legal Research, https://law.counselstack.com/opinion/mona-rutherford-of-the-estate-of-josephine-mcconnell-rutherford-v-john-ca4-1977.