Nicholson v. Time Insurance Co.

496 S.W.2d 516, 1973 Tenn. App. LEXIS 305
CourtCourt of Appeals of Tennessee
DecidedFebruary 23, 1973
StatusPublished
Cited by4 cases

This text of 496 S.W.2d 516 (Nicholson v. Time Insurance Co.) is published on Counsel Stack Legal Research, covering Court of Appeals of Tennessee primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Nicholson v. Time Insurance Co., 496 S.W.2d 516, 1973 Tenn. App. LEXIS 305 (Tenn. Ct. App. 1973).

Opinion

OPINION

SHRIVER, Presiding Judge.

This is a suit to recover benefits under the terms of an insurance policy issued by defendant, The Time Insurance Company, to the plaintiff, Mabel Nicholson, as a result of her illness by reason of which she incurred hospital, medical and surgical expense in excess of $7,000.00. Plaintiff also sues for the 25% statutory penalty, insisting that defendant’s refusal to pay was in bad faith.

At the conclusion of the introduction of evidence in the case, the Trial Judge directed a verdict for the defendant and from the decree dismissing plaintiff’s suit, she has appealed and assigned errors.

The declaration avers that on May 1, 1970, defendant issued to plaintiff its Major Medical Policy No. 958313, providing for a maximum of $20,000.00 for each injury or sickness, with a deductible amount of $100.00, and maximum daily room benefits in a hospital of $25.00. The said policy provided for a monthly premium of $18.45.

Defendant denied recovery on the ground that the application signed by the plaintiff failed to disclose certain information about her health and treatment for disease, which information was germane to the risk involved and which information, if it had been disclosed to the defendant, would have resulted in refusal of the Company to issue the policy.

Under Rule 36.01, Tennessee Rules of Civil Procedure, a request for admissions was served on the attorney for defendant, and the answer thereto admitted:

(1) That James B. Adkisson was an authorized agent of the defendant;
[517]*517(2) That said agent, in his own handwriting, filled out the spaces in the application which was attached to and made a part of the policy, with the exception of the signature of the plaintiff;
(3) That, pursuant to this application and the information contained therein, the defendant issued its Policy No. 958313 to Mrs. Mabel Hudson Nicholson;
(4) That no investigation of the medical information set forth in the application was made by the defendant until a claim was submitted by the insured in 1971;
(5) That the policy was in full force and effect until the Company notified defendant of cancellation in October, 1971.
ASSIGNMENTS OF ERROR
There four assignments, as follows:
“1. The Court erred in sustaining defendant’s motion for a directed verdict on both counts of the complaint.
2.The Court erred in failing to direct the jury to return a verdict for the plaintiff, or the Court erred in failing to enter a verdict in favor of the plaintiff in the amount stipulated.
3. The Court erred in deciding a question of fact in dispute where a jury had been demanded.
4. The Court erred in finding as a matter of fact that the testimony of the defendant witness Adkisson was true and that the testimony of the plaintiff was false, a jury having been demanded.”

Most of the essential facts are not in dispute, as may be seen from the stipulations or admissions hereinabove set forth.

Mrs. Nicholson testified that she was 57 years old, worked as a clerk in her husband’s business, and that the agent of the defendant, James B. Adkisson, approached her for the purpose of selling her a policy of insurance. He filled out the application in his own handwriting in response to questions asked the applicant and her answers.

It will be noted by examining the application that the following questions were asked and answered, the answers being in the handwriting of the agent. For convenience, the answers, which were written with pen and ink, are designated herein by being enclosed in quotation marks:

Yes or No
10. To the best of your knowledge and belief have you or any dependent listed:
a. Been sick or injured, received treatment, taken medication, consulted a doctor, or been hospitalized within the past five years ? “.Yes”
b. Had an operation or been advised to have any operation at ANY TIME? “Yes”
c. Had a Thyroid disorder, Diabetes, or any Urinary Tract disorder? “No”
d. Had Rheumatism, Heart Disease, Heart Murmur, Gout, Stroke, or High Blood Pressure? “No”
e. Had Arthritis, back, spine, bone, joint, or muscle disorder? “No”
f. Had a female, stomach, intestine or rectal disorder? “Yes”

[518]*518In the column provided in the application form for details, dates, doctors’ names and addresses, the following was written in by the agent:

10. a. “Diverticulitis situation, perforated, drained, Dr. Cloyce Bradley, October, 1965, Medical Arts Building, Nashville, Tennessee (10 b.) (10 f.)
b. Hysterectomy, 1963
Dr. Chas. Hobdy, 2212 State Street Nashville, Tennessee”

In answer to question 13: “Have you a family physician? (Name and Address)”, the name and address of Dr. M. Rosen-blum, Medical Arts Building, Nashville, Tennessee, is written.

After the issuance of the policy on May 1, 1970, plaintiff, Mrs. Nicholson, had a conversation with an agent of another Insurance Company, in which she asked his opinion as to whether or not the policy issued by The Time Insurance Company was a good policy which would be honored in the event of a claim thereunder, and, as the result of this conversation, she got in touch with the Agent, Mr. Adkisson, who had taken her application, and, thereafter, received a letter from The Time Insurance Company, addressed to Adkisson Agency, Inc., in Nashville, Tennessee, concerning her policy, which letter is as follows:

“Dear Mr. Adkisson
RE: Mrs. Mabel Hudson Nicholson Policy 958313
I have just been informed by our Claim Department of your conversation with them the other day concerning Mrs. Nicholson’s policy.
I wish to advise you that if all her medical history was mentioned on the application, that she has had no other treatment not mentioned and has not seen a doctor since 1965, as indicated on the App., she should have full coverage under the contract.
It is our practice that once a condition is mentioned on the application and no action is taken by the Company, the Insured has coverage for that condition.
So, in this particular case, as I said, if Mrs. Nicholson has had no other treatment other than what is mentioned on the App., she should have no trouble should a claim arise.
If you have any further questions concerning this matter, please do not hesitate to contact me.
Sincerely yours,
/s/ C. R. Barbee C. R. Barbee, Manager Underwriting Department Assistant Secretary”
CRB :ks

After claim was made by Mrs. Nicholson under this policy, she received a letter dated October 25, 1971, as follows:

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Bluebook (online)
496 S.W.2d 516, 1973 Tenn. App. LEXIS 305, Counsel Stack Legal Research, https://law.counselstack.com/opinion/nicholson-v-time-insurance-co-tennctapp-1973.