Pons v. Tharp-Sontheimer Industrial Life & Burial Ins.

173 So. 205, 1937 La. App. LEXIS 141
CourtLouisiana Court of Appeal
DecidedMarch 22, 1937
DocketNo. 16479.
StatusPublished
Cited by2 cases

This text of 173 So. 205 (Pons v. Tharp-Sontheimer Industrial Life & Burial Ins.) is published on Counsel Stack Legal Research, covering Louisiana Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Pons v. Tharp-Sontheimer Industrial Life & Burial Ins., 173 So. 205, 1937 La. App. LEXIS 141 (La. Ct. App. 1937).

Opinion

JANVIER, Judge.

Lawrence Salez died on November 9, 1935. His niece, Mrs. Angel Pons Lay, had been named beneficiary in a policy of industrial insurance issued on his life by Tharp-Sontheimer Industrial Life & Burial Insurance Company. She made claim under the policy, but payment was refused and this suit has resulted. Defendant insurer admits the issuance of the p'olicy and the payment of all premiums, but refuses payment on the ground that, when Salez made application for the policy, he willfully misrepresented the condition of his health and fraudulently concealed the fact that for several years he had been suffering with syphilis and paresis. It was from these diseases that he died only a few months later. Defendant, conceding its liability for the return of the premiums paid, deposited the amount thereof, $4.80, in the registry of the court.

There was judgment for defendant dismissing plaintiff’s suit and ordering that the amount of the deposit, $4.80, be turned over to -plaintiff.

Plaintiff maintains that, since defendant issued the policy without requiring that the insured submit himself to medical examination and since the application, which is said to contain the misrepresentation and on which the charge of fraud is based was not attached to the policy, the defense relied upon is not available because of the provisions of Act No. 97 of 1908 and of Act No. 52 of 1906, as amended by Act No. 227 of 1916.

Act No. 97 of 1908 provides that, where such a policy is issued without medical examination, if the agent of the insurer knew, or might have ascertained by the 'exercise of reasonable diligence, the true condition of the applicant’s health, it shall be presumed that the agent had such knowledge, and, furthermore, that such knowledge shall be imputed to the said insurer.

Act No. 52 of 1906, as amended by Act No. 227 of 1916, provides that no statement contained in the application may be relied upon for the purpose, of showing concealment or misrepresentation “unless contained in a written application and unless a copy of such statement or statements be endorsed upon or attached to the policy when issued.”

It is said that, as a result of these statutes, the insurer may not be heard to claim that the insured misrepresented the true condition of his health and also that, whatever may have been the true condition of his health, it is to be presumed that the insurer knew of it, and, having issued the policy in spite of such knowledge, must be held to have waived the right to refuse payment on that ground.

Prior to the enactment of Act No. 134 and Act No. 160 of 1934 such a conclusion was many times reached. Eagan v. Metropolitan Life Ins. Co., 181 La. 16, 158 So. 575; Brennan v. National Life & Accident Ins. Co., 14 La.App. 598, 122 So. 147. But defendant maintains that, whatever conclusion may have been reached based on legislation prior to Act No. 134 and Act No. 160 of 1934, these two statutes now render such a defense available in spite of the fact that the application was not attached to the policy and although no medical examination was made. Act No. 134 of 1934 is an amendment of Act No. 97 of 1908 and the only provision thereof which has any possible bearing on the present discussion is that which appears in seption 2 and reads as follows:

“Nothing in this Act shall be construed to require an insurance company to cause a medical examination of an applicant to be made before issuing a policy.”

Act No. 160 of 1934 is of great importance in this controversy because it provides that the application “shall be a part *207 of the contract of insurance issued thereon, whether or not the application or a copy thereof be attached to or indorsed upon the policy when issued” (section 1), and because it further provides that (section 3) where there is willful misrepresentation on the part of the assured concealing facts as to ill health existing at the time of the application, payment under the policy may be refused, and because it -still further provides “that fraud shall always be a defense against any suit by the assured.”

In Fox v. Life Insurance Company of Virginia, 170 So. 55, 57, we considered the effect of these two statutes of 1934 and said :

“It is obvious that these two acts dispense with the necessity of attaching the application to the policy as a condition to its introduction in evidence in a suit upon the policy as was formerly the case, and that a medical examination is not essential as a prerequisite to the defense of fraud upon the ground of willful misrepresentation of the health of the assured at the time of application for insurance, whatever may have been the law previous to 1934.”

Let us, then,, examine the facts in order to determine whether there was willful misrepresentation concealing facts as to the ill health of Salez existing at the 'time of the application and let us also determine whether there was fraud.

That the assured, at the time he made the application, was, to say the least, in extreme ill health, is manifest. For many years he had suffered with syphilis and had been treated by various doctors and at many institutions. Between December 16, 1927, and August 16, 1934, he was confined in the State Penitentiary at Angola and during that period was sent to the hospital for one day or more on thirteen different occasions, usually for treatment for syphilis, and there is a note on his hospital record, made after one of the entries concerning syphilis, which note reads as follows:

“Subject received treatment at intervals between dates given. Was not actually confined to hospital.”

At another point it is shown that after the last date given he probably returned for other treatments. Having been released from the penitentiary on August 16, 1934, he next made his appearance at the City Hospital for Mental Diseases, where, on October 4, 1934, he was found to be suffering with “general paralysis of the insane.” On October 7, 1934, he, as a “non-recovered patient,” was delivered by the hospital to Alfred Salez and A. H. Pons, the latter the father of the plaintiff. He was taken to reside at 4618 South Car-rollton avenue, which is the residence of the plaintiff. The application for insurance was made at that residence on May 17, 1935, and twenty-one days later, on June 7, 1935, he again made his appearance in the City Hospital for Mental Diseases, where he was again found to be suffering from paresis and syphilis. On July 31 he was transferred to the East Louisiana State Hospital- at Jackson, La., where he died on November 9, 1935, from “general paralysis of the insane,” of which syphilis was given as the contributing cause.

It thus appears that, for more than seven years prior to the day on which he applied for the policy, the insured had suffered from syphilis, which had made such advances as to cause paresis, and that he was suffering from these diseases only a few months before and a few months after the day on which he made the application. We need no expert medical evidence to convince us that Salez knew, when he signed the application, that his condition was desperate.

Question No. 18 on the application reads: “What Dr.

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

Related

Geddes & Moss Undertaking & Embalming Co. v. First Nat. Life Ins.
177 So. 818 (Louisiana Court of Appeal, 1938)
Strudwick Funeral Home, Inc. v. National Life & Accident Ins.
176 So. 891 (Louisiana Court of Appeal, 1937)

Cite This Page — Counsel Stack

Bluebook (online)
173 So. 205, 1937 La. App. LEXIS 141, Counsel Stack Legal Research, https://law.counselstack.com/opinion/pons-v-tharp-sontheimer-industrial-life-burial-ins-lactapp-1937.