Rutherford v. Prudential Insurance

234 Cal. App. 2d 719, 44 Cal. Rptr. 697, 1965 Cal. App. LEXIS 1058
CourtCalifornia Court of Appeal
DecidedJune 2, 1965
DocketCiv. 21768
StatusPublished
Cited by20 cases

This text of 234 Cal. App. 2d 719 (Rutherford v. Prudential Insurance) is published on Counsel Stack Legal Research, covering California Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Rutherford v. Prudential Insurance, 234 Cal. App. 2d 719, 44 Cal. Rptr. 697, 1965 Cal. App. LEXIS 1058 (Cal. Ct. App. 1965).

Opinion

BRAY, J.

Defendant appeals from a judgment, after jury trial, in favor of plaintiff for $34,800, and interest, and from an order denying defendant’s motion for judgment notwithstanding the verdict. 1

Questions Presented

1. Is defendant estopped from setting up as a defense any concealment or false representations by the insured?

2. Has defendant waived any misrepresentations. or concealments in the application for insurance ?

Record

On March 12, 1958, defendant executed a policy of insurance, insuring the life of Kenneth G. Rutherford for $34,800. He died of a heart attack on August 17, 1959. Plaintiff, the widow of Kenneth, filed claim for benefits under all the policies issued by defendant on his life. Defendant refused to pay *722 on the above mentioned policy, tendering return of premiums paid thereon by the insured. This action followed, resulting in a verdict in favor of plaintiff in the sum of $34,800. Defendant moved for judgment notwithstanding the verdict. The motion was denied.

Evidence

Rutherford was one of the partners in Ken Motors. He had several policies with defendant: two $500 policies on his life, a $3,000 policy taken to secure a loan and a group (ESI?) policy which included a policy on his life. On December 10, 1957, Leo Iaeoponi and Web E. Stevens, agents for Prudential, obtained an application from Rutherford for the policy in question. They knew about the other policies issued by defendant to Rutherford. In fact, Iaeoponi had sold the $3,000 policy to him and serviced the other policies, collecting the premiums thereon. Stevens filled out the application for the $34,800 policy having the other policies which he mentioned in the application before him. Iaeoponi certified that he had known Rutherford and that he was in good health.

On January 9, 1958, Rutherford was examined by Dr. Joseph Libbey, a medical doctor practicing in Antioch, who had examined for Prudential since 1941. The doctor filled out the required questionnaire and gave Rutherford a physical examination. There are two parts to the questionnaire, one requests a medical history, the other the results of the medical physical examination. On the medical history questionnaire there are numerous questions of a technical medical nature. Most of the questions require a “yes” or “no” answer. Dr. Libbey testified in effect that in writing down the answers he would interpret what he thought the applicant meant; that he was not interested too much in detail and if the applicant mentioned something not too serious he might ignore it. Rutherford did not read the questionnaire after Dr. Libbey filled it out, although he signed it. Rutherford received a copy of the application when he received the policy. Dr. Libbey testified that the entire examination of an applicant for insurance customarily takes about 25 minutes, the physical examination occupying less than one-half of that time.

Dr. Marvin Epstein, an internal medicine specialist, testified concerning his treatment of Rutherford from March 4, 1953, until December 12, 1958. In July 1957, Rutherford had been examined by Dr. David J. Dugan for hiatus hernia. There were certain questions on the medical application, the answers *723 to which were false or incomplete. These follow: Question No. 7a asked if the applicant had ever “applied for or received benefits, compensation, or a pension on account of sickness or injury?” The answer checked was “No.” Dr. Epstein’s records revealed, however, as did papers from Prudential’s files, that before January 9, 1958, Rutherford made a claim to defendant on his group policy for Dr. Epstein’s medical services rendered after an automobile accident in 1956, which claim was later paid.

Question No. 7b asked if the applicant had ever “been a patient in or advised to enter a hospital, sanatorium, or other institution for observation, rest, diagnosis, treatment, or any operation?” The answer checked was “Yes” and referred to No. 16 which is to contain the “full particulars” with respect to that answer.

No. 16 sets forth “Fissure in Ano 1954,” and states that Rutherford was disabled six weeks, fully recovered in 1954 and his doctor was Dr. Russell Klein of San Rafael; “Hernioplasty—left 1952” disabled six weeks recovered in 1952, and “Hernioplasty—right 1948” disabled six weeks, recovered in 1948, and the doctor was Dr. Virgil Jeans of Joplin, Missouri. No mention was made of Dr. Dugan or of his examination in July 1957 for hiatus hernia, nor of Dr. Epstein and his treatment of Rutherford from March 4, 1953 for shortness of breath, possible stomach trouble, and chest pain. Question No. 8 asked for the names of all doctors consulted by Rutherford in the last five years. The answer referred to No. 16, which was answered as above.

Question 7c asked if there had been any X-rays, electrocardiograms, blood or other medical tests. The answer was “No,” although Rutherford had had many X-rays, electrocardiograms, and other tests ordered by Dr. Epstein. Question 7d asked if Rutherford had had any injuries or surgical operations. The answer was “Yes,” and apparently referred to Question 16.

Question 9 asked if applicant had been treated for or had a number of specified ailments or conditions. To these the answers were “No”: to chest pains (Rutherford had complained to Dr. Epstein of chest pains); to ulcers of stomach or intestines or rectal disorders (Dr. Epstein diagnosed possibility of ulcers and Dr. Klein corrected a rectal disorder) to gall bladder disorder (Dr. Epstein diagnosed possibility of gall bladder disorder); to asthma, chronic cough, spitting of blood and to treatment for lungs or bronchi (10b) (Dr. *724 Epstein had found chronic cough and bronchitis and treated applicant therefor).

Mr. Oberdiek, defendant’s senior underwriting consultant, testified that if the application had shown that Rutherford had consulted Dr. Dugan, a chest surgeon; had suffered chest pains and chronic coughing spells; had been treated for a suspected ulcer and a hiatus hernia; and had reported consuming a fifth of alcohol a day, the policy would not have been issued, or the company would have rescinded the contract, the policy permitting rescission for misrepresentation within two years. Oberdiek did not underwrite the policy ; however, the application was reviewed by Arthur Peeler who was still with the company but who did not testify. Oberdiek reviewed the application after Rutherford’s death and then rejected the policy.

The assistant manager of debit underwriting division of defendant’s actuary department testified that all of the policies issued to Rutherford were part of the records in the case. The testimony showed that defendant has a complete indexing system of its files and electronic equipment to correlate indices.

Defendant’s file shows that on February 10, 1958, Dr. Libbey was requested to make an additional examination of Rutherford, to send a specimen of urine and make out a heart form. Both of these should have accompanied the application. The specimen was sent.

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Bluebook (online)
234 Cal. App. 2d 719, 44 Cal. Rptr. 697, 1965 Cal. App. LEXIS 1058, Counsel Stack Legal Research, https://law.counselstack.com/opinion/rutherford-v-prudential-insurance-calctapp-1965.