Ruthie Davis, Acting as Administratrix of the Estate of Ellis Davis v. Integon Life Insurance Corporation

645 F.2d 494, 1981 U.S. App. LEXIS 13037
CourtCourt of Appeals for the Fifth Circuit
DecidedMay 21, 1981
Docket79-3919
StatusPublished

This text of 645 F.2d 494 (Ruthie Davis, Acting as Administratrix of the Estate of Ellis Davis v. Integon Life Insurance Corporation) is published on Counsel Stack Legal Research, covering Court of Appeals for the Fifth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Ruthie Davis, Acting as Administratrix of the Estate of Ellis Davis v. Integon Life Insurance Corporation, 645 F.2d 494, 1981 U.S. App. LEXIS 13037 (5th Cir. 1981).

Opinion

MARKEY, Chief Judge:

Ruthie Davis (Davis), administratrix of the estate of her husband, Ellis Davis (Decedent) appeals from a judgment of the United States District Court for the Middle District of Georgia granting summary judgment for Integon Life Insurance Corporation (Integon) and denying her claim for recovery of the proceeds of a mortgage life insurance policy issued by Integon on the life of Decedent (Count I) and for recovery of punitive damages in the amount of $500,-000 arising out of Integon’s allegedly wrongful refusal to pay benefits under the policy (Count II). We affirm.

Background

On September 6, 1977, Integon issued a mortgage life insurance policy for $27,000 on the life of Decedent. The policy, intended to pay off Decedent’s indebtedness on a home mortgage at his death, names the mortgagee, American Federal Savings and Loan Association (American) as beneficiary. The policy incorporates a contract, an application and a medical history questionnaire. Questions pertinent to Decedent’s medical history appear on the application and on the questionnaire. Both documents were completed by agents of Integon who read questions to Decedent and recorded his responses. It was stipulated that Decedent had less than a fourth grade education, was illiterate, and unable to read except that which he had written.

The application was completed on August 15, 1977, by Integon’s agent, Clements. It lists Dr. Johnson, an orthopedic surgeon, as Decedent’s personal physician. Decedent’s last consultation with Dr. Johnson is listed as a physical in 1974 at which time the application states he was in “Excellent Health.” A “no” response is listed to a question inquiring whether Decedent had ever had certain ailments, including heart, back, or spinal disorder and to a question inquiring whether Decedent had within the preceding five years consulted any other physician for any other illness or disorder.

On August 30,1977, Decedent was examined by Integon’s medical examiner, Janice Carter (Carter), an employee of Physical Measurements, Inc., a company under contract with Integon to provide such examinations. The medical history questionnaire completed by Carter shows a “no” response to questions 2 and 5:

2. Have you EVER been treated for or EVER had any known indication of:
(d) chest pain, palpitation, high blood pressure, rheumatic fever, heart murmer, heart attack or other disorder of the heart or blood vessels?
5. Other than above, have you within the past five years:
(a) had a checkup, consultation, illness, injury, surgery?
(b) been a patient in a hospital, clinic, sanitorium, or other medical facility?
*496 (c) had electrocardiogram, x-ray, other diagnostic tests?

Decedent’s responses on the questionnaire show a June, 1977 treatment by Dr. Robert Sears for injuries sustained in an automobile accident, and hospitalizations for a tonsillectomy in 1959 and for a spinal fusion in 1976. The questionnaire shows Dr. Sears as Decedent’s personal physician. 1

Decedent was in an automobile accident in March, 1977 and as a result suffered injuries to his cervical spine. In May, 1977, Decedent complained of chest pains and was hospitalized for three days. He was examined by Dr. Milledge Newton, a heart specialist. At least four electrocardiograms were administered during the hospitalization. Dr. Newton determined that the chest pains were referred from Decedent’s cervical spine and muscular in origin. Decedent was told that he had no heart trouble or heart disease.

Decedent died on June 14,1978. Because Decedent’s death occurred within the two year period of contestability of the policy, Integon instituted an investigation into Decedent’s medical history. Learning of the May, 1977 hospitalization, Integon denied Davis’ claim for benefits under the policy, saying the policy was void ab initio under Ga.Code Ann. § 56-2409 2 by reason of material and/or fraudulent misrepresentations in the responses to questions 2 and 5 and Decedent’s concealment of the May, 1977 hospitalization which Integon says was material to the risk it assumed. Integon tendered a refund of the $260.85 premium to the policy beneficiary, American, which tender was refused.

Davis then filed this action against Integ-on for recovery of the balance owing American at the time of Decedent’s death plus penalties and attorney’s fees (Count I) and for punitive damages in the amount of $500,000 arising out of Integon’s bad faith refusal to pay the benefits (Count II), which caused Decedent’s estate to lose the equity in the mortgaged property.

Integon moved for summary judgment. In support of its motion, Integon offered the deposition of Dr. Charles Burkhart, In-tegon’s Senior Medical Director who, after reviewing Decedent’s hospitalization records, concluded that the company would not have issued the policy had it been aware of the May, 1977 hospitalization. He based his opinion on statistics showing that individuals with chest pains resembling heart disease have a mortality rate double that of any other group, even where the electrocardiogram is normal, and on his view that the four electrocardiograms disclosed abnormal changes in the electrical output of Decedent’s heart. In opposition to the motion, Davis offered the affidavit of Dr. Newton who stated that the chest pains for which he examined Decedent in May, 1977 were not indicative of heart disease and would not have increased Decedent’s mortality rate. 3

The district court granted Integon’s motion on both counts. It found that Dece *497 dent’s statements were material misrepresentations as a matter of law. It further found those misrepresentations fraudulent as a matter of law. The statements were thus considered grounds under Ga.Code Ann. § 56-2409 for voiding the policy. Although not required to reach the merits of Davis’ Count II claim for punitive damages, because of its finding with respect to Count I, the district court went on to deny that claim as without foundation.

Issue

Whether the district court erred in granting summary judgment on Count I, based on a determination that certain statements made in Decedent’s application were fraudulent misrepresentations as a matter of law. 4

OPINION

The purpose of the summary judgment procedure is not to deny litigants a right of trial where there is a bona fide dispute of material fact. Its purpose is to avoid trial where no factual dispute exists and the moving party is entitled to prevail as a matter of law.

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645 F.2d 494, 1981 U.S. App. LEXIS 13037, Counsel Stack Legal Research, https://law.counselstack.com/opinion/ruthie-davis-acting-as-administratrix-of-the-estate-of-ellis-davis-v-ca5-1981.