Ramsey v. Penn Mutual Life Insurance

36 F. Supp. 3d 761, 2014 WL 3871024, 2014 U.S. Dist. LEXIS 109530
CourtDistrict Court, N.D. Ohio
DecidedAugust 7, 2014
DocketCase No. 1:12 CV 1738
StatusPublished
Cited by1 cases

This text of 36 F. Supp. 3d 761 (Ramsey v. Penn Mutual Life Insurance) is published on Counsel Stack Legal Research, covering District Court, N.D. Ohio primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Ramsey v. Penn Mutual Life Insurance, 36 F. Supp. 3d 761, 2014 WL 3871024, 2014 U.S. Dist. LEXIS 109530 (N.D. Ohio 2014).

Opinion

MEMORANDUM OPINION & ORDER

WILLIAM H. BAUGHMAN, JR., United States Magistrate Judge.

Introduction

This is a diversity case1 arising out of defendant Penn Mutual Life Insurance Company’s refusal to pay death benefits to plaintiff Barbara Ramsey on the death of her husband John Ramsey, the insured. Before me2 are cross-motions for summary judgment.3 In addition to briefing their respective motions,4 responding in opposition,5 and replying to such responses,6 the parties have participated in an oral argument on these motion's7 and submitted joint stipulations of fact before8 and after9 the oral argument.

For the reasons that follow, Ramsey’s motion will be denied and Penn Mutual’s motion will be granted.

Facts

A. Background facts

Although the parties have raised and argued many facts, the relevant facts underlying the present action are contained in the supplemental joint stipulation of fact.10

In February 2010, John Ramsey completed and signed an application for a life insurance policy with Penn Mutual.11 Part of that application was a “medical examiner’s report” that was prepared by an LPN working for Penn Mutual based on answers given by Ramsey, with the completed application signed by Ramsey.12 In that section Ramsey stated that he had been hospitalized for colitis in 1984 but that he had made a “full recovery” and had [763]*763last been seen for this condition in 2006, which examination yielded “normal findings.” 13

Also included in the application was a so-called “good health” representation whereby Ramsey agreed that insurance would not be issued unless the first premium was paid in full, the policy was delivered, and his “health, habits, occupation and other facts” are “the same as described” in the application, the medical examiner’s report attached, and in any subsequent amendments or supplements.14

Based on the disclosure of colitis, Penn Mutual determined that additional information was needed before a policy could issue.15 In that regard, Penn Mutual, with Ramsey’s approval, obtained various medical records and, after reviewing those records, offered to insure Ramsey at a higher than usual premium.16

Virtually contemporaneous with this event, Ramsey was examined by Ian Lav-ery, M.D., the physician who had treated him for colitis in 1984,17 because Ramsey was experiencing “diarrhea/blood in stool” and “having frequent bloody bms and feels bad.”18 A follow-up examination by Dr. Lavery a month later, in May 2010, revealed that medication had produced “some improvement” in Ramsey’s symptoms but that he was “still having 15 + loose stools a day.”19

Subsequent to these visits to Dr. Lav-ery, which were then unknown to Penn Mutual, Penn Mutual drafted amendments to Ramsey’s application for coverage.20 The amendments asked if Ramsey had “ever been treated for, or had any indication of: ... intestinal bleeding, ulcer, hernia, colitis, ... or other disorder of the stomach, intestines, liver or gall bladder?”21 In both cases, Ramsey, on June 1, 2010, answered, <cYes, I had a colon resection in 1984 due to colitis. My last colonoscopy was in 2004. I have not had a colonoscopy since 2004 and have had no gastrointestinal problems since that time.”22 Ramsey, however, did not disclose in this amendment that he had seen Dr. Lavery in April and May of 2010, despite, as noted above, having represented in the original application that he had not seen Dr. Lavery since 2006.

Contemporaneously with or shortly after Ramsey’s execution of the application amendments, Penn Mutual thereupon completed delivery of separate policies for term life insurance and whole life insurance to Ramsey.23

[764]*764Shortly thereafter, on June 24, 2010, during surgery to address five months of “rectal bleeding and diarrhea,”24 John Ramsey was discovered to have colon cancer,25 and died fifteen months later due to complications from that cancer.26 There is no dispute that Ramsey had continued to make all premium payments on the two life insurance policies from Penn Mutual from their issuance to the date of his death.27

Ramsey’s wife, Barbara, filed an application for death benefits with Penn Mutual, which was denied.28 In denying coverage, Penn Mutual in particular noted that Ramsey “knew of his treatments between the time of the application and the delivery of the policies, and knew that they rendered untrue the statement in the application that he ‘had no gastrointestinal problems since (2004).’ ”29 Barbara Ramsey, in turn, filed the present action.30

B. Parties’ arguments

In its motion for summary judgment Penn Mutual argues first that a condition precedent to formation of a valid contract of insurance was that Ramsey’s health be the same at the time the insurance policy was delivered as it was at the time of the application.31 Because the evidence from Dr. Lavery’s visits prior to delivery of the policy show that Ramsey was having serious gastrointestinal problems, including frequent, bloody stools, prior to delivery of the policy, Penn Mutual maintains that Ramsey’s health at the time the policy was delivered was not the same as when he made application for the policy, and so, as a matter of law, a necessary condition precedent to formation of an enforceable contract was not met.32

Alternatively, Penn Mutual asserts that any right to recover under these policies was precluded by statute when Ramsey willfully gave a false answer to the question in the application and the application amendment concerning whether he had indications of intestinal bleeding.33 Penn Mutual further argues that Ramsey’s signature on the relevant documents ratified and adopted that representation, regardless of who initially drafted the language.34 Thus, Penn Mutual contends, because Ramsey’s answers in both the application and the application amendment were willfully false, made without any knowledge by the insurer of their falsity, and induced the insurer to deliver insurance policies that but for the false, answers would not have been delivered, Ramsey violated Ohio Revised Code § 3911.06, which renders the policies void ab initio.35

Ramsey, for her part, argues that John Ramsey’s answers on both the application and the application amendment were not false nor willfully intended to defraud, and further that Penn Mutual had knowledge of the actual situation and so cannot claim ignorance.36 As concerns the question of [765]

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Bluebook (online)
36 F. Supp. 3d 761, 2014 WL 3871024, 2014 U.S. Dist. LEXIS 109530, Counsel Stack Legal Research, https://law.counselstack.com/opinion/ramsey-v-penn-mutual-life-insurance-ohnd-2014.