Ryan v. Security Indus. Ins. Co.

386 So. 2d 939, 1980 La. App. LEXIS 3878
CourtLouisiana Court of Appeal
DecidedMay 21, 1980
Docket7548
StatusPublished
Cited by14 cases

This text of 386 So. 2d 939 (Ryan v. Security Indus. Ins. Co.) is published on Counsel Stack Legal Research, covering Louisiana Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Ryan v. Security Indus. Ins. Co., 386 So. 2d 939, 1980 La. App. LEXIS 3878 (La. Ct. App. 1980).

Opinion

386 So.2d 939 (1980)

Rosa Mae RYAN, Plaintiff-Appellee,
v.
SECURITY INDUSTRIAL INSURANCE COMPANY, Defendant-Appellant.

No. 7548.

Court of Appeal of Louisiana, Third Circuit.

May 21, 1980.

*940 Talbot, Sotile, Carmouche, Waguespack & Marchand, Victor L. Marcello, Donaldsonville, for defendant-appellant.

Camp, Carmouche, Palmer, Barsh & Hunter, Skipper Drost, Lake Charles, for appellant.

Cox & Cox, Rex D. Townsley, Lake Charles, for plaintiff-appellee.

Before SWIFT, STOKER and LABORDE, JJ.

STOKER, Judge.

This is a contract action. Plaintiff, Rosa Mae Ryan, instituted this suit against Security Industrial Insurance Company seeking recovery under two contracts of insurance. Following the trial, judgment was rendered for plaintiff in the sum of $4,600.00. Penalties were also imposed for the insurer's refusal to pay the claims. Defendant has perfected this appeal from the lower court's ruling.

The facts show that on October 14, 1977, Bill Brantley, an agent for defendant, visited Gracie Ryan at her mother's residence. Brantley's visit was in response to an inquiry from Ms. Ryan indicating an interest in securing policies of life insurance and burial insurance. In due course, Gracie Ryan applied for two policies, a policy of life insurance providing coverage of $4,000.00 and a policy of burial insurance providing coverage of $600.00. Gracie Ryan named her mother, Rosa Mae Ryan, as beneficiary of both policies. The following procedure was used to fill out the applications: Mr. Brantley posed questions to Gracie Ryan, and her responses were written on the applications by Brantley. After filling out the applications, Brantley presented the forms to Ms. Ryan for her signature. Gracie Ryan signed the applications but did not review the applications as completed by Mr. Brantley. After signing the applications, Ms. Ryan paid Brantley the initial premiums of each policy.

The life insurance policy was issued on October 15, 1977. The burial insurance policy was issued on January 15, 1978. All premiums were paid timely as they became due.

On January 4, 1978, Gracie Ryan died. The cause of death was listed as sepsis, acute renal failure, and disseminated intravascular coagulation. Following Gracie Ryan's death, Rosa Mae Ryan, the beneficiary of the policies, filed a claim for coverage under the policies. The plaintiff's claim was rejected. Thereafter, plaintiff instituted this action.

Defendant resists liability under the policies for several reasons. Defendant contends *941 that Gracie Ryan made material misrepresentations in both applications. Defendant resists coverage under a "good health" provision in both insurance contracts. Finally, defendant contends that it is not liable under the burial insurance policy because it was not issued until after Gracie Ryan's death.

MATERIAL MISREPRESENTATION

LSA-R.S. 22:619(B) provides,

In any application for life or health and accident insurance made in writing by the insured, all statements therein made by the insured shall, in the absence of fraud, be deemed representations and not warranties. The falsity of any such statement shall not bar the right to recovery under the contract unless such false statement was made with actual intent to deceive or unless it materially affected either the acceptance of the risk or the hazard assumed by the insurer. [Emphasis added]

In order for an insurer to avoid liability on the basis of material misrepresentations the insurer must meet a three-tiered burden. It must be shown that the statements were false. Second, the insurer must establish that the representations were made with an actual intent to deceive. Third, the insurance company must establish that these misstatements materially affected the risk assumed by the insurer. Martin v. Security Industrial Insurance Company, 367 So.2d 420 (La.App. 2nd Cir. 1979), writ refused 369 So.2d 1364 (La.1979).

In the present case, defendant alleges that Gracie Ryan gave false answers to questions 6 and 11 on both applications. Question 6 seeks information as to whether the applicant is in good health "without any impairment". Question 11 seeks information concerning any diseases or disorders, such as paralysis, which the applicant might have. It is not disputed that the answers to the questions, insofar as Gracie Ryan is concerned, were not accurate. At the time the applications were filled out, Ms. Ryan was paralyzed from the waist down. Ms. Ryan's paralysis is not mentioned in the form.

However, it is well settled that the acts of an insurance agent in filling out an application form falsely are the acts of his principal, the insurer, and they do not bind the innocent insured nor bar recovery by him or his beneficiaries. Cloud v. Security General Life Insurance Co., 352 So.2d 406 (La.App. 3rd Cir. 1977); Frugeé v. Woodmen of the World Life Insurance Society, 170 So.2d 539 (La.App. 3rd Cir. 1965); Morein v. American Physicians Insurance Company, 192 So.2d 887 (La.App. 3rd Cir. 1966).

In the instant case, Rosa Mae Ryan testified that Gracie Ryan informed the agent she was paralyzed from the waist down. Ms. Ryan's testimony was corroborated by her daughter and a disinterested witness who was visiting in the home of the Ryans at the time the application was completed. Bill Brantley, the agent who completed the form, was not summoned by the insurer to contradict this testimony.

An examination of the record reveals that, although the application form contained inaccurate information, it was the result of the agent falsely filling out the application. The agent's acts do not bar the beneficiary from recovery. In rejecting the insured's defense of material misrepresentation, the trial judge stated, "The court finds, likewise, that the defendant clearly failed to establish that the Ryans sought at any time to deceive the insurer." A thorough examination of the record reveals that the judge's finding is correct.

In support of its defense of violation of LSA-R.S. 22.619B, defendant relies heavily on Johnson v. Occidental Life Insurance Company of California, 368 So.2d 1032 (La. 1979) and Watson v. Life Insurance Company of Louisiana, 335 So.2d 518 (La.App. 1st Cir. 1976). Defendant's theory in this regard is that the deceased was guilty of misrepresentation and fraud in falsely answering certain questions on the application forms for the insurance. A similar defense was dealt with in Martin v. Security Industrial Insurance Company, supra, and we think the contentions of defendant on this *942 point are fully answered there. Nevertheless, we think the Johnson and Watson cases can be distinguished on their facts. In both of these cases, the applicants filled out the applications themselves.

In Johnson, the insured responded to a mail solicitation from the insurance company and was furnished with an application for mortgage cancellation group life insurance. The applicant, Mrs. Claray Smith, filled out the application herself. In Watson, the deceased insured did the same with reference to an application for credit life insurance. In both cases, the inference was clear that misrepresentations were made with the intent to deceive the insurer. Here, Gracie Ryan did not fill out the application. No false representation with intent to deceive has been shown.

GOOD HEALTH CLAUSE

The insurer resists liability on the life insurance policy on the grounds of a "good health" clause found in the policy.

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Bluebook (online)
386 So. 2d 939, 1980 La. App. LEXIS 3878, Counsel Stack Legal Research, https://law.counselstack.com/opinion/ryan-v-security-indus-ins-co-lactapp-1980.