National Life & Accident Insurance v. Falks

195 S.E. 463, 57 Ga. App. 384, 1938 Ga. App. LEXIS 606
Court of Appeals of Georgia·Decided February 24, 1938·No. 26688·Published·Cited by 13 cases

Opinion

Sutton, J.

Mrs. Alice Falks, as beneficiary, brought suit against National Life & Accident Insurance Company on a contract of life insurance issued on July 7, 1936, to her mother, Mrs. Annie L. Combs, in the principal sum 'of $350. The company defended on the. ground that the insured made false and fraudulent representations as to being in good health and fraudulently concealed material facts as to illness. It was set up that in answer to the question, “Are you in good health?” the insured answered “Yes,” and that in response to the question, “What illness, injury or accident have you ever had?” the applicant answered “Pneumonia twenty-five years ago, fully recovered,” whereas for six months before the making of the application for insurance she had suffered from pellagra, which had manifested itself for practically two years, the disease being manifested by a type of dysentery, and that she had also suffered from a serious swelling of her hands, the skin being ruptured and a watery substance issuing therefrom, for many months prior to the date of the written application. The answer also set up that the insured had consulted in June, 1936, a Dr. Hackney, a physician for the City of Atlanta, in an effort to have her trouble diagnosed; that he had prescribed for her; and that such facts had been concealed from the defendant. The jury returned a verdict in favor of the plaintiff. The defendant filed a motion for new frial on the general grounds, and the exception here is to the judgment overruling the motion.

The application for insurance was not attached to the policy or made a part of the contract, and, consequently, representations or concealments, although false and material to the risk, would not defeat recovery unless the conduct of the insured was fraudulent. The only pertinent inquiry now before this court is whether or not, under any part of the evidence, the jury was authorized to find that the insured acted in good faith, and not fraudulently. It ap[386] pears from the evidence that the insured, a woman of 58 years of age at the time she made the application, had, according to the testimony of a physician, been afflicted with pellagra for more than a year. This condition, however, was not known to her or any one else, and this physician who attended her in the illness which resulted in her death on January 7, 1937, stated that in his opinion such a disease might not be detected by a layman. That the insured fraudulently misrepres'ented her condition in that respect must, therefore, be eliminated from the consideration of whether or not she knew she was in good health. But it is contended by the defendant that for more than a year she had also suffered from a looseness of bowels, with occasional discharge of mucous or blood, and that her hands were swollen and the skin cracked, with a watery fluid issuing therefrom, and that by the concealment of such facts a finding is demanded, as a matter of law, that her act was fraudulent. It is undisputed that for more than eight years, with the exception of a visit to Dr. Hackney, a city physician of Atlanta, the insured had not been attended by any physician. During the time áhe was afflicted as set out above, members of her family urged her to seek medical advice, but she protested that it was unnecessary, did no£ wish to be embarrassed with questions, that there was nothing the matter with her but “the itch,” although there was testimony that at times the condition of her hands was such as to prevent her from doing ordinary household duties and that she was often sleepless and interfered with the sleep of others in the same house with her. It is not shown that her visit to Dr. Hackney was for any purpose except to have her hands treated. He prescribed salve, which she used, and at the time of the application healing had taken place. Theretofore, the condition or manifestation had been intermittent.

As to the looseness of bowels with occasional discharge of mucous or blood, it was shown that such condition was also intermittent, its recurrence being brought about from time to time by consumption of rough foods. By proper dieting she was able to bring about temporary relief. As to her ability to perform household duties, there was testimony that at times she was incapacitated; but there was also testimony that generally she could perform the usual household duties for one of her years, and that a few weeks before making the application, and while visiting a daughter in [387] Newnan, Georgia, she cooked, milked, and kept house for seven or eight persons. The physician, who attended her in the illness leading to her death, had made many professional visits to members of her family, she being present at the time, but to him she never indicated that anything serious was troubling her. Although several members of her family advised her to consent to treatment or be placed in a hospital, it is clear that she never regarded her bowel condition seriously, never worried about it or complained except to refer to it as uncomfortable. It appears that she was at times morbid, but this state of mind seems to have been brought about by a realization that she had no regular home of her own and was forced to accept the hospitality of the several members of her adult family.

The agent who took her application for insurance testified that she appeared to be normal, free and willing to answer any questions without hesitation, and that he based his opinion that she was apparently in good health “on the fact that she was up and walking and apparently in good health.” A friend of the family testified that a month or two before the application was made she visited his office in connection with a business matter and appeared to be in normal health and spry.

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National Life & Accident Insurance v. Falks, 195 S.E. 463, 57 Ga. App. 384, 1938 Ga. App. LEXIS 606 (Ga. Ct. App. 1938).

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