National Life Accident Ins. Co. v. Hearn

1951 OK 60, 240 P.2d 83, 205 Okla. 661, 1951 Okla. LEXIS 734
CourtSupreme Court of Oklahoma
DecidedMarch 6, 1951
DocketNo. 33776
StatusPublished
Cited by2 cases

This text of 1951 OK 60 (National Life Accident Ins. Co. v. Hearn) is published on Counsel Stack Legal Research, covering Supreme Court of Oklahoma primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
National Life Accident Ins. Co. v. Hearn, 1951 OK 60, 240 P.2d 83, 205 Okla. 661, 1951 Okla. LEXIS 734 (Okla. 1951).

Opinion

DAVISON, J.

This is an action wherein the plaintiff, Harry L. Hearn, as beneficiary, seeks to recover from the defendant, National Life & Accident Insurance Company, upon the policy of insurance of the face value of $500 issued upon the life of his 17-year old daughter, Colleen M. Hearn. The parties will be referred to as they appeared in the trial court.

Plaintiff’s petition contains the usual averments, including that of the corporate existence of the defendant, the issuance of the insurance policy by defendant, a photostatic copy of which was attached as an exhibit, the payment of weekly premiums and the death of the insured January 26, 1947. The policy was dated September 9, 1946. Defendant [662]*662answered by way of general denial and then admitted all the essential facts set out in the petition, but specifically alleged the invalidity of said policy contract because of the serious bodily infirmities and disease of said Colleen Hearn at the time of the issuance of the policy, in contemplation of the following provision therein:

“(5) Effective Date' — This policy shall take effect on the Date of issue, provided the insured is then alive and in sound health, but not otherwise.”

Defendant then tendered a return of all premiums paid. The reply was a denial of all affirmative defenses and, in addition, alleged that, if insured was not in sound health at the time of the issuance of said policy, the defendant had waived the requirement of that provision above set out because, prior to the issuance thereof, a full and complete disclosure of her condition was made to defendant’s agent and defendant was now estopped to deny liability. Then followed a refusal of the tender of return of premium payments.

Upon the issues thus formed the case was tried to a jury. The evidence of plaintiff was to the effect that, late in the summer of 1946, defendant’s agent contacted plaintiff several times in an attempt to sell him life insurance on various members of his family. Plaintiff discussed at length with the agent the fact that Colleen was born with a leakage of the heart and also told him of her examination or check-up at Crippled Children’s Hospital in 1942. He then asked the agent if a policy could be written upon her life and was informed that the matter would have to be discussed with agent’s superior. Several days later, the agent returned to plaintiff seeking the name of the physician who had delivered the insured (the doctor was then deceased), and again told plaintiff that the supervisor would again have to be consulted. After learning that it was impossbile to discuss her condition with the doctor, he again conferred with his supervisor (Brady). The agent later told plaintiff he had been advised to use his judgment about writing the policy.

On the evening of August 19, 1946, the agent came to plaintiff’s home and there filled out the applications for three insurance policies including the one here sued upon. Plaintiff testified the agent told him that if any of the insureds died within one year the company could contest the policy if it desired. The agent wrote the answers to all questions in the application. Plaintiff did not read the applications at the time they were signed. Colleen Hearn, the insured, was called in and without reading the application, signed the same. Therein, in answer to the question, “Are you in good health?”, the agent had written “Yes” and in answer to the question, “Have you ever had heart disease . . .?” the agent had written “No.” the policy was issued and delivered without medical examination of insured. Insured died as a result of her congenital heart condition January 26, 1947.

The defendant’s agent testified to the facts surrounding the making of the application substantially the same as plaintiff, except that he further testified that at the time he was filling in the application, he told plaintiff he would have to fill in the answers to the questions, showing Colleen had never had heart trouble or the defendant would not issue the policy. (This was denied by plaintiff.) That he did it because he was a little overanxious for business. He also testified that his superior or supervisor, after the matter was explained, told him to use his own judgment and if he thought the girl had a chance to live several years to go ahead and write it. He further testified that he told plaintiff that, if the girl died within a year, an investigation would be made, and if it was then discovered she had died from a heart ailment the insurance would not be paid. Plaintiff’s testimony on this point was that the agent told him the defendant would probably contest the payment on any of the three policies [663]*663if death occurred to any of the insureds within the first year.

The jury returned a verdict in favor of plaintiff for the face amount of the policy. Defendant has appealed from the judgment rendered thereon, urging several propositions for reversal. They will be discussed in the order presented.

At the outset it is well to see definitely the question for determination here. Defendant’s answer raised the sound affirmative defense of ill health of insured at time of delivery of the policy which, standing alone, would have avoided it. The reply of plaintiff then raised the propositions of waiver and estoppel as affirmative responses to the answer. Thus, when the trial commenced, the burden was upon plaintiff to make out a case founded upon the affirmative matters in the reply as supplementary to the allegations of the petition.

As the evidence unfolded the proposition' relied upon by defendant and hereinafter discussed became the gist of the action. If false statements were written into the application by a soliciting agent with full knowledge of the state of health of insured, the defendant is estopped from setting them up unless the facts come within the exception to such rule as is hereinafter discussed. If the defendant issued the policy and subsequently accepted the premiums with notice, either actual or imputed, because of the agent’s knowledge, a waiver was effected. In either of these events plaintiff would be entitled to recover, but the foundation of each is knowledge of ór notice to the insurer. The early case of Federal Life Ins. Co. v. Whitehead, 73 Okla. 71, 174 P. 784, contains an extended discussion of the differences between estop-pel and waiver and also states several principles here controlling. There it was said that:

“It is contended by the defendant that the policy in this case is void because it was not delivered to the insured while he was in good health, the policy itself providing that it must be so delivered. But that provision of the policy, like other of its provisions, made for the benefit of the company, could be waived. . . .

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Bluebook (online)
1951 OK 60, 240 P.2d 83, 205 Okla. 661, 1951 Okla. LEXIS 734, Counsel Stack Legal Research, https://law.counselstack.com/opinion/national-life-accident-ins-co-v-hearn-okla-1951.