Ricard v. John Hancock Mutual Life Insurance Co.

324 A.2d 671, 113 R.I. 528, 1974 R.I. LEXIS 1208
CourtSupreme Court of Rhode Island
DecidedAugust 2, 1974
Docket73-15-Appeal
StatusPublished
Cited by26 cases

This text of 324 A.2d 671 (Ricard v. John Hancock Mutual Life Insurance Co.) is published on Counsel Stack Legal Research, covering Supreme Court of Rhode Island primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Ricard v. John Hancock Mutual Life Insurance Co., 324 A.2d 671, 113 R.I. 528, 1974 R.I. LEXIS 1208 (R.I. 1974).

Opinion

*529 Paolino, J.

This is an action under a group life creditor *530 insurance policy. Originally the plaintiff filed two complaints, one against the defendant John Hancock Mutual Life Insurance Company (Hancock) for the amount allegedly due to the defendant Industrial National Bank of Rhode Island (Industrial) under the policy and the other against the bank for negligence in the processing of the application for the mortgage insurance and for failure to pursue available remedies after the death of the plaintiff's husband.

Both defendants filed motions to dismiss pursuant to Super. R. Civ. P. Rule 12(b). The motions were granted by a Superior Court justice on November 15, 1968, but plaintiff was given leave to amend her complaint. After she filed an -amended complaint, defendants renewed their motions to dismiss. The motions were heard by another justice -of the Superior Court and denied on June 9, 1969.

On June 22, 1972, the case was reached for trial before still another justice of the Superior Court. During the pretrial conference, Hancock again moved- to dismiss on basically the same grounds it had previously asserted. The plaintiff did not object and, notwithstanding Industrial's objection, the trial justice granted the motion to dismiss with prejudice.

The case proceeded to trial before a jury against Industrial -alone. At the conclusion -o-f plaintiff’s -case, Industrial, without resting, moved for a directed verdict under Super. R. -Civ. P. 50(a). That motion was denied and Industrial proceeded with its case. After making -an offer of proof -of certain evidence which the trial justice had ■ruled was inadmissible, Industrial rested and then renewed its motion for a directed ver-dict. The trial justice again denied the motion and submitted the case to the jury, which returned a verdict for plaintiff in the -amount of $11,266.85.

*531 After the denial of its motion for a new trial, Industrial filed an appeal from the judgment entered on the verdict. Later, it filed an amended appeal from the judgment entered on the verdict and from the trial justice’s ruling dismissing the action against Hancock. No appeal was filed by plaintiff or Hancock.

The Facts

In December 1965, plaintiff and her late husband, Donat Ricard, applied for and obtained a loan of $6,000 from Industrial, secured by a mortgage on a parcel of real estate owned by them jointly. At the same time the husband completed an application for mortgage insurance under a group policy issued to Industrial by Hancock on the lives of the bank’s mortgagors. Someone at the bank had told her husband that in order to get the mortgage loan he had to have insurance because of his age. Industrial denied this. The plaintiff signed the application for the purpose of guaranteeing the premium payments. A premium of $16.32 per month was added to the monthly mortgage payments to the bank. This was the monthly premium payable by a person 61 years of age. It appears that Industrial based the amount of the premium on a schedule of rates in its possession. Under the policy, Hancock insured the mortgage and agreed, in the event of the covered mortgagor’s death, .to pay to Industrial, the named beneficiary, the then outstanding balance of the mortgage loan, thereby discharging the indebtedness to the bank.

The arrangement between Industrial and Hancock provided that Industrial was to collect the premiums from its mortgagors for transmittal to Hancock. Upon a mortgagor’s death it was the bank’s responsibility to complete and transmit an application to Hancock for payment under the policy. Industrial received no commissions and played no part in -setting the standards for coverage or *532 making decisions regarding the payment of claims. Authority to do those things resided exclusively with Hancock.

Industrial had authority to issue certificates of insurance on behalf of Hancock to eligible applicants who answered t'he questions in the “Statement of Health Portions” of their application in a certain way, that is, “Yes” to questions one and five, and “No” to questions two, -three and four. If the questions were answered in any other fashion, Industrial was required to forward the applications to Hancock which would then determine eligibility itself. The answers furnished by Mr. Ricard fall into the former category. A copy of the application signed by Mr. Ricard, which contains the “Statement -of Health Portion of Individual Application,” is attached hereto as Appendix A. Mr. Ricard stated in the application that his date of birth was September 21, 1904. Acting in reliance on Mr. Rieard’s answers to the questions in the “Statement of Health Portion” of the application, Industrial issued a certificate of insurance to Mr. Ricard. In so doing Industrial admittedly overlooked the fact that Mr. Ricard was 61 years of age, -one year older than the limit fixed for eligibility under the terms of the group policy. 1

Donat Ricard died on December 17, 1966. Industrial filed a cl-aim for death benefits with Hancock, but the latter denied liability.

At the time of Mr. Rioard’s death the outstanding principal balance on the mortgage was $5,834.79. The hospital record indicates that death was -due to carcinoma of -the colon, bronchopneumonia, arteriosclerotic heart disease, *533 congestive -heart failure, diabetes mellitus and hypochromic microcy-tic -anemia.

The principal reason -cited by Hancock i-n refusing payment was that Mr. Ricard was 61 years old when he applied, and, therefore, was not eligible for coverage. After being asked by Industrial not to disclaim liability on the basis of Mr. Rioard’-s age, Hancock started an investigation -of the claim. Since Mr. Ricard died within the two-year contestab-le period pursuant to -the policy, it had -a right to do thi-s. The investigation revealed that during the five-year period preceding his application, Mr. Ricard had been regularly treated for diabetes mellitus, severe hypertension and -a heart condition, and that he w-as taking medication f-or those conditions. Hancock also learned that Mr. Ricard had been refused life i-n-surance by -another company several years before.

After the investigation, both Industrial and plaintiff were advised of the results. Hancock said that it was denying -the claim because of Mr. Ricar-d’s failure to disclose on the application his previous medical -history. Hancock also reiterated its previous denial because of Mr. Ricard’s -age -a-t the time he -applied for the mortgage insurance. However, the -record -indicates that Hancock l-a-ter waived the coverage -defenses.

When the -claim was denied, all of the premiums that had been paid by the Ricards were refunded. However, Industrial inadvertently continued including the premium charge of $16.32 per month on plaintiff’s monthly mortgage -statement. No o-ne noticed the error until February 1972 when Industrial called it to plaintiff’s attention and tendered her all -of th-e premiums -collected during that period. The plaintiff refused to -cash the check sent to her and instead included that sum in her claim for damages.

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Bluebook (online)
324 A.2d 671, 113 R.I. 528, 1974 R.I. LEXIS 1208, Counsel Stack Legal Research, https://law.counselstack.com/opinion/ricard-v-john-hancock-mutual-life-insurance-co-ri-1974.