Provident Life & Accident Ins. Co. of Chattanooga v. Flowers

91 S.W.2d 847
CourtCourt of Appeals of Texas
DecidedJanuary 30, 1936
DocketNo. 3323.
StatusPublished
Cited by17 cases

This text of 91 S.W.2d 847 (Provident Life & Accident Ins. Co. of Chattanooga v. Flowers) is published on Counsel Stack Legal Research, covering Court of Appeals of Texas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Provident Life & Accident Ins. Co. of Chattanooga v. Flowers, 91 S.W.2d 847 (Tex. Ct. App. 1936).

Opinion

HIGGINS, Justice.

This is a suit by Flowers to recover sick benefits alleged to have accrued upon an accident and health insurance policy in his favor issued by appellant dated November 8, 1933. The policy was issued without medical examination upon Flowers’ written application therefor bearing the same date as the policy, a copy of which was attached to and made a part of such policy. The application provides that the policy was not to be effective unless delivered while the applicant was in good health and free from the effects of any injury, disease, or bodily infirmity.

In bar of the suit defendant, among other defenses, set up that plaintiff was not in good health and free from the effects of injury, disease, or bodily infirmity on the date the policy was delivered. It also alleged the falsity of certain representations contained in the application; they being pleaded as representations and not as warranties. The alleged false representations *848 relied upon are sufficiently indicated by the issues submitted.

Briefly stated, the issues submitted and answers returned are as follows:

1. Was Flowers at any time during 1934 continuously and totally disabled from sickness? Answer: Yes.

2. For what period was he so disabled? Answer: April 14 to October 1,1934.

3. Was he at any time during said year continuously and necessarily confined within the house by reason of sickness ? Answer: Yes.

4. For what period was he so confined? Answer: April 14 to October 1, 1934.

5. Was he so confined as the result of sickness ? Answer: Y.es.

6. For what period was he so confined? Answer: April 14 to October 1, 1934.

7. (Need not be here stated.)

8. (Need not be here stated.)

9. (Need not be stated.)

10-a. Was Flowers in “good health” at the time the policy was delivered to him? Answer: Yes.

10-b. Was he “free from the effects of disease” at the time the policy was delivered to him? Answer: Yes.

10-c. Was he “free from effects of bodily infirmity” at said time? Answer: Yes.

10-d. Was he in a “sound condition physically” at the time the policy was delivered ? Answer: Yes.

11. Was he in “sound condition physically” at the time he signed the application for insurance? Answer: Yes.

12. Was the answer of Flowers to question 7-a, in the application, true or false? which question reads: “Have you ever had any of the following: Hernia, Epilepsy, Paralysis, Syphilis, Appendicitis, Diabetes, Tuberculosis, Mental Disorder, Disease of the Stomach, Heart, Brain or Nervous System, Disease of Tonsils, Nose or Throat, Rheumatism, or any other disease or ailment?” Answer: True.

Conditional upon answering question 12 “false,” the court submitted questions 13, 14, and 15, which inquired:

13. Did Flowers, with the intent and purpose of inducing defendant to issue and deliver the policy, make an untrue or false answer to said question 7-a?

14. Was the answer to said question 7-a material to the risk on which the policy became due and payable?

15. Did the answer to question 7-a contribute to the contingency or event on which the policy became payable?

16. Was the answer of Flowers to question 7-c, in the application: “Have you, within the past five years, had medical or surgical advice or treatment, or any departure from good health?” true or false? Answer: True.

Issues 17, 18, and 19 were submitted conditional upon the return of the answer “false” to question 16. These issues inquired whether the answers were material, etc., the same as in 13, 14, and 15.

20. Did plaintiff, with intent and purpose of inducing defendant to issue and deliver the policy, make an untrue or false answer to question 9 in the application which reads: “Have you ever received indemnity for loss due to accident or sickness?” Answer: “No.”

22. Was the answer to question 9 material to the risk on which the policy became due and payable? Answer: No.

23. Did the answer to said question 9 contribute to the contingency or event on which the policy became due and payable? Answer: No.

Issue No. 1, requested by defendant, reads:

“Do you find ffom a preponderance of the evidence, or any circumstances surrounding the issuance of the policy to Henry Horace Flowers, the same was induced through artifice or fraud practiced upon defendant’s agent at the time the.said plaintiff Henry Horace Flowers made his application therefor?”
Answer: “No.”

In connection with this issue, this instruction was requested and given:

“The term ‘fraud’ means such actions or statements on the part of the person alleged to have committed same which were untrue at the time of their making, and which led or induced the other party to enter into the transaction to defendant’s damage, without which misrepresentations the damaged party would not have entered into such transaction, and made for the purpose of deceiving or misleading the other party thereto.”

Instructions given in connection with the issues submitted in the general charge are as follows:

With issue 1: “By the term ‘totally disabled’ is meant the inability to do substantially all of the material acts necessary'to *849 the prosecution of the insured’s business or occupation in substantially his customary and usual manner.”

With issue 3: “The term ‘confined within the house’ does not necessarily mean a constant, literal restraint within the house; an occasional visit to the office of his physician for treatment, or taking exercise and walking as part of the plaintiff’s treatment, would not necessarily mean that he was not at such times confined within the house as contemplated by the policy or contract in evidence in this case.”

With issue 10: “The terms ‘sound condition physically’ ‘good health’ ‘free from the effects of disease’ and ‘free from effects of bodily infirmity’ mean a state of health free from any disease or ailment that affects the general soundness or healthfulness of the system seriously — not a mere temporary disability which does not tend to undermine or weaken the constitution of the insured, but rather means freedom from serious disease or grave, important, weighty trouble.”

With issue 11: “The term ‘sound condition physically’ means a state of health free from any disease or ailment that affects the general soundness or healthfulness of the system seriously — not a mere temporary disability which does not tend to undermine or weaken the constitution of the insured, but rather means freedom from serious disease or grave, important, weighty trouble.”

With issue 12: “In answering Question No.

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Bluebook (online)
91 S.W.2d 847, Counsel Stack Legal Research, https://law.counselstack.com/opinion/provident-life-accident-ins-co-of-chattanooga-v-flowers-texapp-1936.