New York Life Insurance v. Kuhlenschmidt

11 N.E.2d 673, 213 Ind. 212, 1937 Ind. LEXIS 382
CourtIndiana Supreme Court
DecidedDecember 17, 1937
DocketNo. 26,964.
StatusPublished
Cited by9 cases

This text of 11 N.E.2d 673 (New York Life Insurance v. Kuhlenschmidt) is published on Counsel Stack Legal Research, covering Indiana Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
New York Life Insurance v. Kuhlenschmidt, 11 N.E.2d 673, 213 Ind. 212, 1937 Ind. LEXIS 382 (Ind. 1937).

Opinion

Fansler, J.

This is an action by appellee, the sole beneficiary of a life insurance policy issued by appellant upon the life of appellee’s husband. Appellant sought to avoid liability on the ground that the insured had made false and fraudulent statements as to his health, and as to consultations with doctors concerning ailments and diseases, in his application for the insurance; and, by cross-complaint, prayed the cancellation of the policy on the ground of fraud, based upon the false statements in his application. The cause was tried by the court without a jury. There were special findings of fact and conclusions of law, and judgment for appellee.

Error is assigned upon the overruling of a motion for a new trial, and upon the conclusions of law.

The application for the insurance was made on April 24, 1930. The application contained the following questions and answers: “Question: Have you ever consulted a physician or practitioner for or suffered from any ailment or disease of the stomach or intestines, liver, kidneys or bladder? Answer: No. Question: Have you ever consulted a physician or practitioner for any ailment or disease not included in your above answers? Answer: Yes, flu. Question: What physicians or practitioners, if any, not named above have you consulted or been examined or treated by within the last five years? Answer: None other.” The insured had consulted a physician on the 17th and 19th days of July, 1929, and on the 26th day of July, 1929, relative to a pain in the region of his kidneys. The physician, believing that the insured suffered from a kidney stone, referred him to a specialist. On July 19, 1929, he consulted a specialist, *215 giving a history of his illness; that it had begun a month before with pain in the region of the left kidney, which grew in frequency; that he had lost 10 pounds in weight in six weeks. The specialist made an examination, including a cystoscopic examination of the urinary tract, dilation of the ureters, and the insertion of medicine into the kidneys and bladder. The specialist diagnosed the trouble as probably a stone in the ureter. He was again consulted on July 24th and August 2nd, and the insured reported that he had passed a stone. The specialist testified that these stones are believed to be due to focal infection somewhere in the body, usually above the neck, plus lack of drainage in the urinary tract, plus lack of fluids; that the same condition may or may not produce other stones; and that he could not tell whether there is a tendency toward recurrence.

The policy was delivered to the insured on April 28, 1930. He died on June 18, 1931. His death was due to mitral stenosis, with endocarditis as a secondary cause. Officers and agents of appellant, whose duty it was to pass upon the application, testified that they relied upon the statements of the insured in approving the application, and that they would not have approved the application if the facts concerning the consultations with the doctors and the treatment for the ailment of the kidneys had been disclosed; that, if the kidney ailment had been known, the application would have been disapproved and a further investigation made for the purpose of determining whether the company “could offer substandard insurance.”

Appellant contends that the false statements made in the application concerning the ailment or disease of the kidneys, and the consultations with physicians, were sufficient to constitute a cause for rescission of the contract of insurance; and that: “In order that the fact misrepresented should be material it is not necessary *216 that it should affect the physical risk. It is sufficient if it would have affected and influenced the judgment of the insurer in determining whether it would accept the application and issue the policy.”

Appellee contends that, under clause 5 of section 39-801 Burns’ Ann. St. 1933, section 9723 Baldwin’s 1934, which provides: “That all statements made by the insured in the application shall, in the absence of fraud, be deemed representations and hot warranties,” representations need only be substantially true, and that, “whether an applicant’s answer to a question as to whether he had consulted a physician for disease of the kidneys was false, or substantially true, will depend upon whether the ailment of the kidney for which he consulted a physician seriously affected the general soundness and healthfulness of his system.”

It would seem to be obvious that questions in an application for life insurance, which deal with the past health of the applicant, are intended to elicit information from which the company may determine whether or not to assume the risk and issue the policy, and that a deliberate false answer that the applicant had never consulted a physician concerning, or suffered from, any ailment or disease of the kidneys or bladder, and the false answer that he had never consulted any physician within five years, other than those named in the application, when, in fact, within a yéar he had consulted two physicians, one a specialist, and submitted to severe exploratory examinations, resulting in a diagnosis, afterwards confirmed, of a severe and painful ailment, are sufficient in themselves to establish fraud, which would make the statements warranties, and not representations, under the statute. It is inconceivable that the false answers could be accounted for by mistake or inadvertence, or misunderstanding of the plain, simple questions, or forgetfulness *217 of such a recent and painful experience. But, if it be assumed that there is no fraud shown, the effect of the statute is to make the statements representations, and if these representations are material to the contract, and are not substantially correct, it is a sufficient defense to the policy, regardless of whether they were made fraudulently or otherwise. There is no question as to whether the representations made were substantially true. They were admittedly false. There is no claim or contention, and no finding of facts or evidence, that the company was not deceived, or that it knew that the answers were false and waived the question. Were the answers material? The appellee says no, unless the ailment of the kidneys, for which he consulted a physician, seriously affected the general soundness and healthfulness of his system. In other words, it is appellee’s contention that, even though the facts misrepresented are such as would have affected the judgment of the insurer in determining whether or not it would issue the policy, the representations concerning them, though false, are not material.

In Mutual Benefit Life Insurance Co. v. Miller, Adm'x (1872), 39 Ind. 475, 483, 486, this court said: “A representation differs from a warranty; for while the latter must be true, the former need only be substantially true—true so far as the representation was material to the risk. A fact is to be deemed material, if a knowledge of it would have induced the insurer to have refused the risk or to have charged a higher rate of premium for taking it.” Because it was not in accordance with the law as thus stated, the following instruction was held to have been erroneously refused: “The contract between the insurance company and the insured is like a contract between two individuals.

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Bluebook (online)
11 N.E.2d 673, 213 Ind. 212, 1937 Ind. LEXIS 382, Counsel Stack Legal Research, https://law.counselstack.com/opinion/new-york-life-insurance-v-kuhlenschmidt-ind-1937.