North Carolina Mut. Life Ins. Co. v. Coleman

26 So. 2d 114, 32 Ala. App. 287, 1946 Ala. App. LEXIS 397
CourtAlabama Court of Appeals
DecidedFebruary 5, 1946
Docket6 Div. 239.
StatusPublished
Cited by5 cases

This text of 26 So. 2d 114 (North Carolina Mut. Life Ins. Co. v. Coleman) is published on Counsel Stack Legal Research, covering Alabama Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
North Carolina Mut. Life Ins. Co. v. Coleman, 26 So. 2d 114, 32 Ala. App. 287, 1946 Ala. App. LEXIS 397 (Ala. Ct. App. 1946).

Opinion

*290 HARWOOD, Judge.

The appellee, Johnnie Coleman, brought suit against the North Carolina Mutual Life Insurance Company, the appellant, on a health and accident policy of insurance issued by said company on March 20, 1944, pursuant to the written application of appellee made on March 6, 1944. The complaint as amended is substantially in Code form and the trial court properly overruled the demurrers thereto. Appellant then pleaded in short by consent the general issue, with leave to give in evidence any matter which if well pleaded would be admissible in defense, including plea of tender of premiums.

The undisputed evidence shows that appellant, a miner, aged 31, had been injured about the head in a mine accident, and was hospitalized therefor from March 25 to April 3, 1942.

Again on December 1, 1943 appellee was involved in a mine accident and was hospitalized from that date until December 24, 1943. At this time the diagnosis of his injuries was: "Fracture second lumbar vertebra. Contusion right hip and chest. Patient injured in Lewisburg Mines. Caught in car between armature and side.”

According to appellee’s testimony he used crutches from the time of his discharge until about June, and then used a cane until he returned to work in February, 1945, having worked continuously since that date.

It is further undisputed that when appellee signed the application for the policy on March 6, 1944, he was visiting in a friend’s home, when Lula Menefee, an agent of appellant, came there on other business.

When the policy was delivered to appellee he was, according to his testimony, sitting in a chair on his porch, while Lula Menefee testified he was sitting in his automobile.

Lula Menefee testified appellant approached her concerning the application, and that at that time she did not know that appellee had suffered a broken back. This is denied by appellee who testified that he had known Lula Menefee for over ten years, and would see her when She was around the mines collecting insurance premiums, before and after he was on crutches. That every time he saw her after the accident she would ask him how he was getting along, and that at the time of signing the application he had his crutches with him.

In the application*appellee certified: “I hereby certify I am free from disease and *291 that all statements made above and in part A are true, that one of which being false, forfeits my rights to receive benefits under this contract.”

The application was not by reference made a part of the policy contract. Under such conditions the statements in the application are not considered warranties, but they may be received as evidence of such representations in support of a plea of fraud and deceit. Independent Life Insurance Company v. Butler, 221 Ala. 501, 129 So. 466.

There is in the policy itself the following provisions:

“Risks Not Covered
“(b) Sickness or accident resulting from injuries received, or diseases contracted before the delivery of this policy.
“No liability is assumed by the Company prior to the date hereof, nor unless on said date, and on the delivery of this policy the assured is alive and in sound health, and the premiums paid.”

The latter provision is in legal effect a warranty. Reliance Life Insurance Company v. Sneed, 217 Ala. 669, 117 So. 307.

Premiums on the policy were paid to and including November 6, 1944.

About September 17, 1944, appellee began to suffer excruciating pain in the region of his stomach. He was hospitalized because of this condition on September 21, 1944 and on October 4, 1944 was operated on by Dr. B. S. Lester. The operation disclosed that appellee’s disability resulted from an abscess of the omentum. Surgical relief of this condition was effected, and after two weeks in the hospital appellee left the hospital and was confined to bed at his home for two additional weeks thereafter.

Appellee duly filed claims with appellant for payment of benefits he alleged to be due under the policy. In the “Certificate of Attending Physician,” supporting the claims, five of which certificates appear in the record, it is noted that Dr. Lester in answer to question 6 as to how long prior to the date of the certificate the disease began stated “undetermined” on three of the certificates, “don’t know” on one, and “9-21-44” on another. In answer to question 12 “to what do you attribute the origin of the disease” he answered “don’t know,” and “undetermined” on two of the certificates, while the question was not answered on the remaining three. In answer to question 16, “Is the illness a primary condition” he answered “yes” on three of the certificates, leaving the space blank on the remaining two.

The appellee made out his prima facie case by introduction of the policy, proof of the happening of the event covered by the policy, and notice and proof thereof as provided by the policy. Pilot Life Insurance Company v. Hawkins, 222 Ala. 218, 131 So. 889; National Life & Accident Insurance Company v. Winbush, 215 Ala. 349, 110 So. 571; United Benefit Life Insurance Company v. Dopson, 232 Ala. 625, 169 So. 287.

The basic theories on which the defense relies is that the insured was not in sound health, so as to materially increase the risk of loss, at the time of the delivery of the policy contrary to the warrant} in the policy, and that he misrepresented the condition of his health in the application, with actual intent to deceive.

Section 6, Title 28, Code of Alabama, reads as follows: “No written or oral misrepresentation, or warranty therein made, in the negotiation of a contract or policy of insurance, or in the application therefor or proof of loss thereunder, shall defeat or void the policy, or prevent its attaching, unless such misrepresentation is made with actual intent to deceive, or unless the matter misrepresented increase the risk of loss.”

As to the interpretation of this section, Judge Rice, in Life Insurance Company of Virginia v. Mann, 28 Ala.App. 425, 186 So. 583, 584, certiorari denied, 237 Ala. 253, 186 So. 586, wrote:

“The Supreme Court of Alabama in con struing the above Section has said as follows : ‘To avoid the policy, unsound health must be misrepresented with intent to deceive and as being material to the risk, or as materially increasing the risk o'f loss (Independent Life Ins. Co. v. Seale, 219 *292 Ala. 197, 121 So. 714; Life Ins. Co. of Virginia v. Newell, supra (223 Ala. 401, 137 So. 16)). There are types of fatal maladies of which the courts take judicial knowledge such as “tuberculosis and cancer,” as being material to the risk of insurance; the courts take no judicial knowledge of or as to the several forms of diseases, such as syphilis, cirrhosis of the liver, or other ailments alleged in the pleas.’ Metropolitan Life Ins. Co. v. Chambers, 226 Ala. 192, 194, 146 So. 524, 525.
* * # * *

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Royal Family Insurance Co. v. Grimes
168 So. 2d 262 (Alabama Court of Appeals, 1964)
Globe Life Insurance Company of Alabama v. Howard
147 So. 2d 853 (Alabama Court of Appeals, 1962)
Ball v. Natl. Life Acc. Ins. Co. of Nashville
118 So. 2d 718 (Alabama Court of Appeals, 1959)
McLaney v. Turner
104 So. 2d 315 (Supreme Court of Alabama, 1958)

Cite This Page — Counsel Stack

Bluebook (online)
26 So. 2d 114, 32 Ala. App. 287, 1946 Ala. App. LEXIS 397, Counsel Stack Legal Research, https://law.counselstack.com/opinion/north-carolina-mut-life-ins-co-v-coleman-alactapp-1946.