Osborne v. American Select Risk Insurance

414 F.2d 118
CourtCourt of Appeals for the Sixth Circuit
DecidedJuly 31, 1969
DocketNo. 18689
StatusPublished
Cited by1 cases

This text of 414 F.2d 118 (Osborne v. American Select Risk Insurance) is published on Counsel Stack Legal Research, covering Court of Appeals for the Sixth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Osborne v. American Select Risk Insurance, 414 F.2d 118 (6th Cir. 1969).

Opinion

JOHN W. PECK, Circuit Judge.

This diversity action was brought by plaintiffs-appellants (hereinafter “plaintiffs”) seeking recovery under an automobile liability insurance policy issued to Billie Osborne by the defendant-ap-pellee (hereinafter “defendant”).

Billie Osborne filled out an application for insurance on November 22, 1963, at the office of defendant’s agent, the Wilson Insurance Agency, of Murray, Kentucky. The premium was paid that day and the contract involved coverage for a period of six months. The policy was issued on December 3, 1963, insuring both Billie Osborne and anyone driving the insured automobile with his permission.

On December 14, 1963, Shirley Osborne, Billie’s wife, while driving the insured automobile with permission in Tennessee, negligently collided with an automobile in which Kenneth Hum-phreys, L. Yates Moore and Boyd Moore were passengers. The collision resulted in injury to Humphreys and in the death of both of the Moores and of Shirley Osborne. Notice of the accident was given to the defendant, but defendant notified Osborne in a letter of cancellation dated January 10, 1964, that it did not recognize any obligation or liability under the insurance policy since the policy was null and void from its inception.

Suits were subsequently filed in the state court of Tennessee against Billie Osborne individually, and as administrator of the estate of his wife, by the widows of L. Yates Moore and Boyd Moore and by Humphreys. Judgments were recovered in the amount of $58,000. This present suit seeks payment from the defendant under the insurance policy in order to satisfy the judgments recovered in Tennessee.

[120]*120In answer to the plaintiffs’ complaint that the defendant refused to defend under the policy provisions specifically providing therefor, the defendant alleged that there were fraudulent or material misrepresentations made in the application for insurance by Billie Osborne;1 that such answers were material to the risk; that defendant relied on said answers in issuing the insurance policy; and that had it known the truth to these answers, it would not have issued the policy. The plaintiffs’ reply set out the contentions that the defendant was estopped from relying on the insurance application since the clerk that was working for defendant’s agent filled in the answers to the questions for the applicant Billie Osborne and failed to ask him for his answers to the pertinent questions in the application.2 The defendant filed a motion for summary judgment.

The District Court relied on a case dealing with the issuance of life insurance based on misrepresentations in the application concerning an illness of the applicant. There, the Kentucky Court of Appeals (Mills v. Reserve Life Ins. Co., 335 S.W.2d 955 (1960)) sustained the granting of the insurance company’s motion for summary judgment even though the applicant averred that he was illiterate and unable to read the application, and further that the agent failed to ask him any questions concerning illnesses when the application was being filled out. Under the Mills decision the applicable law of Kentucky was that the applicant had a duty to read the information on the application, whether he filled it out or not, and was responsible for the truthfulness of that information. In regard to the materiality of false answers, the Court said:

“[A] false answer is material if the insurer, acting reasonably and naturally in accordance with the usual practice of life insurance companies under similar circumstances, would not have accepted the application if the substantial truth had been stated therein. See John Hancock Mutual Life Ins. Co. v. DeWitt, 259 Ky. 220, 82 S.W.2d 317; Chamberlain v. National Life & Accident Ins. Co., 256 Ky. 548, 76 S.W.2d 628, and Sovereign Camp, W. O. W. v. McDaniel, 251 Ky. 212, 64 S.W.2d 581.” 335 S.W.2d at 958. (Emphasis supplied.)

The District Court granted defendant’s motion for summary judgment when it found that the answers to the questions in Osborne’s application were misrepresentations (a fact admitted by the plaintiffs); that the disputed testimony as to whether defendant’s agent asked Osborne the questions was immaterial since Osborne signed the application; that the misrepresentations were material to the risk; and that had the defendant known the truth, it would not have accepted the risk. There was no finding that the misrepresentations were fraudulently made.

In considering the present case, we recognize that under the Erie doctrine (Erie Railroad Co. v. Tompkins, 304 U.S. 64, 58 S.Ct. 817, 82 L.Ed. 1188 (1938)) the substantive law of Kentucky controls in this diversity case.

[121]*121After the District Court disposition of the case based on Mills' v. Reserve Life Ins. Co., the Kentucky Appeals Court has had an opportunity to review the law in the area of fraudulent or material misrepresentations in the application for life insurance. In the cases after Mills (Kentucky Central Life Ins. Co. v. Combs, 432 S.W.2d 415 (Ky.1968) and Paxton v. Lincoln Income Life Ins. Co., 433 S.W.2d 636 (Ky.1968)), the Kentucky court had before it cases dealing with life insurance applications. Combs and Paxton reaffirmed the position of Mills and set out a new rule in regard to the person responsible for seeing that the correct information is in the application (as between the applicant and the agent for the insurance company). The Court in Paxton stated:

“[T]he rule is that as between the applicant and the insurance company it is the applicant’s responsibility to see that the application is correctly filled out.” 433 S.W.2d at 638.

Since Mills, Combs and Paxton dealt with life insurance applications, the law of Kentucky is clear as to the situation created by misrepresentation in a life insurance application. This left open the question of whether this rule applied to all types of insurance applications. Then, on March 25, 1969, the Kentucky Court of Appeals, in Pennsylvania Life Ins. Co. v. McReynolds, 440 S.W.2d 275, considered a ease dealing with misrepresentations in the application for non-medical accident and health insurance policies. There, the Court stated that the life insurance rule pertaining to misrepresentations in the application was not applicable to the applications for non-life insurance policies. The Court sought to balance the interests of the insurance company in getting true statements concerning the risk to be covered with the need of protecting the honest applicant against the “evil incidents of sales methods” employed by the insurance agents. The Court stated:

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414 F.2d 118, Counsel Stack Legal Research, https://law.counselstack.com/opinion/osborne-v-american-select-risk-insurance-ca6-1969.