Pavia v. State Mutual Life Assurance Co.

116 A.2d 762, 179 Pa. Super. 272, 1955 Pa. Super. LEXIS 627
Superior Court of Pennsylvania·Decided September 28, 1955·No. Appeal, No. 100·Published·Cited by 4 cases

Opinion

Opinion by

Woodside, J.,

This is an appeal from the refusal of the court below to grant the plaintiff’s motions for judgment n.o.v. and a new trial after a verdict in her favor in the amount of $846.50 in an action in assumpsit brought against the defendant insurance company on a life insurance policy in which plaintiff was named beneficiary.

■ The beneficiary sued to recover $15,000, the face amount of the policy issued on her late husband’s life, but received a verdict for only the amount of the premiums paid to the insurance company, and interest thereon. As the insurance company admitted liability for the amount of the verdict, the judgment entered by the court below was in effect a judgment for the defendant.

[275] The appeal was taken originally to the Supreme Court, but remitted to this Court.

The fundamental question involved in the case is whether the deceased, to whom the policy was issued, made statements concerning his health in the original application for the policy and the application for reinstatement after it had lapsed, by virtue of which the company would not be liable on the policy.

Because dates are important the facts are stated chronologically as follows: On October 13, 1947 Ralph Pavia consulted Dr. John M. Conway concerning an infection in his nose and throat and for an enlarged gland which had caused a lump on the side of his neck about the size of a small egg. On November 6, 1947 Dr. Conway operated on Pavia in the Eye and Ear Hospital. He removed tonsil fragments and adenoid tissues, making access through the patient’s mouth. At the same time he made an external incision at the side of the patient’s neck and removed a section of the enlarged cervical gland for the purpose of a biopsy. The biopsy showed that Pavia had lymphosarcoma, a condition which a layman would refer to as cancer.

Dr. Conway did not tell Pavia the nature of his illness, but sent him to Dr. George W. Grier for a series of x-ray treatments. These treatments started November 13. During the treatments the enlarged gland subsided. Another gland on the other side of his neck then became enlarged, but also subsided under x-ray treatment. During these treatments Pavia continued to consult Dr. Conway and at one time ..when he complained, that the . x-ray. treatments -“-upset him-,” he was told by the doctor that if he, did-.not-continue the treatments his-condition might turn into-cancer.

During the course.of these x-ray- treatments by Dr. Grier, Pavia, at the .insistence of his sister, went to Dr. John S. Baling for a physical examination: Dr. [276] Saling saw hiña 4 or 5 times, the first time being shortly before January 20, 1948.

On that date Dr. Saling sent Pavia to Dr. John F. Suess for additional tests. Dr. Suess removed blood from Pavia’s finger and arm for the purpose of making these tests.

On January 31, 1948 Dr. Suess, in order to make further tests, extracted bone marrow from Pavia by means of a sternal puncture. Doctors Saling and Suess had learned of the diagnosis of lymphosarcoma made through the biopsy, but did not tell Pavia.

On February 2, 1948 Pavia signed an application of defendant company for $15,000 of life insurance. In the application the following questions and answers appeared among others above his signature:

“2. Are you in good health so far as you know and believe? Yes. 9. When and for what reason did you last consult a physician or practitioner? T. & A. 6 weeks ago. 10. What diseases, ailments or injuries have you had within the past five years? As above. 11. Have you ever had any of the following diseases or complaints? ... (f) Rheumatic fever, diabetes, cancer or any tuinor goiter, hyperthyroidism or enlarged glands? No. 17. Have you ever consulted or sought advice or treatment of a physician or practitioner for any reason not' already mentioned? No.” (T. & A. is an abbreviation for tonsil and adenoids frequently used by the medical' profession)

There is evidence that the company relied upon these answers in making their decision to issue the iife insurance policy upon which suit was brought.

The answers were in the handwriting of the examining ' physician-who had been; employed by the insurance company. This fact is immaterial. Prevete v. Metropolitan Life Insurance Company 343 Pa. 365, 369, 22 A. 2d 691 (1941).

[277] At the time Pavia was a well-developed, healthy-appearing 25 year old man. He had graduated from high school, attended two colleges, been in military service and was a construction foreman.

On February- 14, 1948 Pavia completed the series of x-ray treatments.

The policy of insurance having lapsed for nonpayment of a premium due in July, 1948, Pavia signed an application for reinstatement on August 25, 1948 in which he declared inter alia: “. . . For the purpose of inducing the Company to reinstate said policy, I do hereby declare that I am now in sound health and that during the past 12 months I have had no disease, injury, or impairment of health, whatsoever, neither have I consulted or been treated by any physician, surgeon or practitioner ... I further agree that truth of the foregoing statements shall be the basis of reinstatement of said.policy . . .”

On June 18, 1949 Pavia married the plaintiff, and had her named beneficiary in the aforesaid policy.

On November 28, 1949 he died from lymphosarcoma.

The beneficiary submitted proof of his death to the insurance company. It refused payment of the face amount of the policy,-but offered to return the premiums which had been paid and the interest thereon. The plaintiff then sued and the case was tried before a jury with the results mentioned above.

In her brief the- plaintiff does not seriously press her motion for judgment mo.v., but does urge upon us -that she is entitled to -a new trial because of 'errors in the trial' court’s charge;- particularly its action' on the points which were-submitted. -' - ' ," ' -

As stated by - the - court '.below, “Thé. 'theory upon which the trial judge submitted the case to the- .jurywhs such' that thé'defendant carried thé burden of proving:'^!-) that thé insured'made false statements iipon [278] Ms application for the policy and/or upon the application for reinstatement of that policy; (2) that at that time he knew the statements to be false; (3) that he intended by these false statements to. deceive the defendant; (4) that the defendant relied upon those false statements in issuing and/or reissuing the policy.”

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Pavia v. State Mutual Life Assurance Co., 116 A.2d 762, 179 Pa. Super. 272, 1955 Pa. Super. LEXIS 627 (Pa. Ct. App. 1955).

116 A.2d 762 (Pavia v. State Mutual Life Assurance Co.) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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