Mosely v. National Bankers Life Insurance Company

347 P.2d 755, 66 N.M. 330
CourtNew Mexico Supreme Court
DecidedDecember 17, 1959
Docket6541
StatusPublished
Cited by13 cases

This text of 347 P.2d 755 (Mosely v. National Bankers Life Insurance Company) is published on Counsel Stack Legal Research, covering New Mexico Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Mosely v. National Bankers Life Insurance Company, 347 P.2d 755, 66 N.M. 330 (N.M. 1959).

Opinion

MOISE, Justice.

This is an action upon three certain health and accident policies issued by appellant to appellee. They are described as a daily hospital expense policy, a medical and surgical policy, and an accident policy.

In November, 1956, appellee was employed as a saleslady by appellant. About two months later appellee applied for the policies in question and they were issued. Thereafter, on May 4, 1957, she was injured in an accident while getting out of her car. Upon appellant refusing to make payments as provided in the policies, this suit was' filed resulting in a judgment in favor of plaintiff-appellee.

The principal defense made by defendant-appellant to the complaint was one of fraud which was added at the time of trial, to the effect that plaintiff-appellee had given false information, and she was in fact uninsurable, and if true facts had been known the policies would not have been issued. The only point made on this appeal is that Findings of Fact II and VI are not supported by the evidence.

These findings read as follows:

“II. That the plaintiff completed all the applications for the insurance policies mentioned herein in good faith and supplied all information required by said applications to the best of her ability.”
“VI. That the plaintiff did not in any way (de) fraud the defendant in any of her applications for the insurance policies involved herein.”

Appellant recognizes that in a case such as this when the, attack is upon the findings, we will confine ourselves to determining if there is substantial evidence to support the same, and if so, to affirm the judgment, and by the same token if there is no substantial evidence to support the findings, we will Set the judgment aside. Lopez v. Townsend, 42 N.M. 601, 82 P.2d 921.

Having set forth its one point' for reversal, and then having stated the rule concerning the weight to be given to findings of the court, appellant reviews the evidence which it states “refutes the findings of fact Nos. II and VI.”

In summary this evidence has to do with appellee’s answers to questions 19 and 20 on the application for one of the policies. Question 19 asked her to name every physician or practitioner she had consulted for any purpose in the last five years. She named only Dr. Carr, whom she said she consulted in January, 1957, for bronchitis. Question 20 asked if she had ever had or been advised to have a surgical operation, to which she replied “yes, hysterectomy, 1951, Temple, Texas.”

Appellant points to evidence that appellee suffered from “hemorrhoids to the extent that it was necessary for her to use a pillow to sit on in order to drive an automobile.” How this enters into its claim that appellee’s answers to questions 19 and 20 were false is not clear.

Appellant states that appellee failed to advise in answer to question 20 that she had a bladder operation and a childbirth repair performed in 1954. Appellee explained this by saying that these operations were sequels to her hysterectomy of which she advised appellant, and they were done by the same surgeon at the same place. Evidently the .trial court accepted her explanation.

Next, appellant comments concerning evidence that appellee had a congenital back deformity and wore a brace, and further that numerous orthopedists had advised a back fusion. It is sufficient answer to this to point out that appellee denied any such deformity, and evidently the court believed her. Also, she denied any advice to have a fusion, except in 1948, some ten years before, she says a doctor suggested a spine operation and then changed his mind, and that she consulted two other “bone specialists” who said she didn’t need the operation, and further that her trouble with her back was cleared up when she had the hysterectomy.

Appellant complains that in the application no mention was made of an injury to appellee’s back and neck in a fall in a store in December, 1955, for which she received medical treatment. In answer the appellee points to another application form filled out by her some two weeks after the first one, and in which she states she consulted a doctor in December, 1955, and names him. Incidentally, it is interesting to note that the policy issued pursuant to this latter application is dated February 27, 1957, making it clear that appellant had this information when it issued the other policy on March 1, 1957.

Next, appellant points to foun doctors consulted by appellee and not named in her answer to question 19. One of these was consulted in 1951, more than five years before the application. One was consulted in May, 1957, in connection with the accident out of which the controversy arose. Appellee admits she failed to name one doctor she consulted in 1955 for pneumonia, and as to the fourth, she admitted seeing a doctor about a virus but she didn’t know his name. Evidently, the trial judge did not consider these omissions material, or that they indicated fraud.

Appellant argues that there were numerous inconsistencies in appellee’s story and that she was not worthy of belief. It is sufficient answer to this to point out that the learned trial judge who was much beN ter situated to pass upon the weight that should be given to the evidence of the various witnesses believed her, and it is not our function to reverse him in such a state of the record. Waters v. Blocksom, 57 N.M. 368, 258 P.2d 1135; Greene v. Esquibel, 58 N.M. 429, 272 P.2d 330.

Appellant, as authority for its position that the court erred in not finding the appellee guilty of fraud, in effect argues that false statements in an ápplication for'insurance is fraud per se, and cites certain statements of the note writer in an annotation in 131 A.L.R. commencing at page 617 on the general subject of “Materiality of false representations, in application for policy of insurance, as to whether ápplii cant has consulted physicians.” This note sets forth many cases holding a,s material a failure to advise of doctors consulted and thus voiding policies issued thereon, hut at the same time points out that in many cases and under certain circumstances the rule is otherwise.

In the instant case we are constrained to hold that the court did not err. This Court has stated many times that fraud will not be presumed, but must be proved by clear and satisfactory evidence. Greene v. Esquibel, supra; Jones v. Citizens Bank of Clovis, 58 N.M. 48, 265 P.2d 366; Mason v. Salomon, 62 N.M. 425, 311 P.2d 652. From our narration of the evidence, the weakness therein to clearly establish fraud should be apparent. On the other hand, that there was substantial evidence to support the findings attacked is equally clear.

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Bluebook (online)
347 P.2d 755, 66 N.M. 330, Counsel Stack Legal Research, https://law.counselstack.com/opinion/mosely-v-national-bankers-life-insurance-company-nm-1959.