Sandifer v. Louisiana Life Ins.

64 So. 2d 488, 1953 La. App. LEXIS 601
CourtLouisiana Court of Appeal
DecidedMarch 19, 1953
DocketNo. 3656
StatusPublished
Cited by1 cases

This text of 64 So. 2d 488 (Sandifer v. Louisiana Life Ins.) 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
Sandifer v. Louisiana Life Ins., 64 So. 2d 488, 1953 La. App. LEXIS 601 (La. Ct. App. 1953).

Opinion

ELLIS, Judge.

The plaintiff was named as the beneficiary, under.a burial policy dated March 12, 1951 issued by the defendant with Helen Williams, sister of the plaintiff as the insured. On April 13, 1951 Helen Williams, the insured, died suddenly due -to congestive heart failure and upon the refusal of the insurance company to pay the $200 called for by the policy, the plaintiff instituted the present suit.

The defendant relies upon the defense of willful misrepresentation or fraud on the part of the beneficiary in obtaining the policy and particularly upon the defense based on the provision of the policy in dispute that “No obligation is assumed by the Company prior to the date hereof, nor unless on said date the Insured be alive and in sound health.”

After trial judgment was rendered in favor of the plaintiff for the amount provided in the policy, viz., $200, and in the further sum of $100 attorney fees which was imposed as a penalty.

From this judgment the defendant has appealed.

That portion of the judgment awarding $100 attorney fees is unauthorized. 'See LSA-R.S. 22:656 and 22:657, and Grigsby v. First National Life Insurance Company, La.App., 7 So.2d 742. [489]*489Furthermore, the penalties imposed in this case are not deserved under the facts which will be discussed in full hereafter.

In this case, no medical examination was required or given in order to ascertain the condition of Helen Williams’ health prior to the issuance of the policy and, therefore, the statements of the plaintiff are taken to be representations and not warranties of 'her physical condition, and as to these statements the insurer’s only defense is that of willful misrepresentation or fraud on the part of the insured or beneficiary in obtaining the policy. There is no dispute as to the law applicable to a case of this kind, but the defendant contends that the facts support his defense.

In the case of Fox v. Life Insurance Company of Virginia, La.App., 170 So. 55, 56, 57, Judge Westerfield was the organ of the Court, and in discussing the word “willful” as used in the statute had the following to say:

“The word ‘willful’ as used in the statute must be reasonably interpreted. If, therefore, an applicant neglects to disclose a trivial ailment or medical consultation concerning such ailment, such concealment could not reasonably be regarded as ‘willful’ and have the effect of vitiating the contract of insurance because of fraud on the part of the assured.
“A statement in an application for insurance to .the effect that the applicant is in sound health and has not consulted a doctor within a given period is a representation and not a warranty; the difference between the two being that the falsity of the statement in the one case does not vitiate the policy unless material and of such character as may be presumed to have influenced. the insurer, whereas, in the other case, the falsity of the statement voids the policy whethe% material or not.
“ ‘A representation is material when knowledge of the truth as to the fact misstated might reasonably influence the company in determining whether or not to enter into the contract as made.’ 25 Cyc. 806.”

In the present case, the defense of willful misrepresentation is based mainly upon the answer of “no” in the application for the insurance policy by the plaintiff to the question as to whether Helen Williams, her sister, had ever suffered from heart disease. Under the above cited authority the plaintiff’s representation that her sister had not suffered from heart disease was material and if wilfully misrepresented by the plaintiff it would vitiate the policy. Only the facts can reveal whether or not there was any willful misrepresentation on the part of the insured or her sister, the plaintiff herein.

The record reveals that Helen Williams, the insured, was 20 years of age on the date of her death, and that on February 5, 1951 she had premature twins according to the hospital record as testified to by a doctor on the trial of the case. This doctor further testified that the deceased could have had eclampsia and had a delivery and recovered. The record did not indicate any previous history of heart trouble, and it was the opinion of this doctor that as Helen Williams had possibly delivered before without any history of heart or kidney disturbance, that he did not think it possible for her to have had organic heart. disease prior to the last pregnancy. He also definitely stated that it was his opinion that the woman died from' eclampsia, which is shown to be a toxemia of pregnancy, and which we gather from the testimony affected the heart.

It is further shown by this record that the agent of the defendant insurance company went by the home of the plaintiff on February 17 and he was told by the plaintiff that she wanted him “to write her sister up in the insurance” and he asked her if she meant now and plaintiff said “No, when you come back on the 24th,” and he went back on the 24th and that is when the application was filled out, the questions were answered by the plaintiff, and the insured’s name was signed by the plaintiff to the application, however, with the [490]*490full knowledge of the agent who was present. The plaintiff took a policy on all five of her sisters, three of whom were present at the time the application was signed, however, Helen Williams, the deceased, was not present. This application shows that the plaintiff in answering Question 13-B as -to the date of the last confinement for childbirth of Helen Williams gave the agent the correct date of February 5, 1951, but she did answer to Question 22 that her sister had no heart disease. The policy was issued on March 12, 1951, which would be 16 days subsequent to the application for the insurance policy.

The plaintiff testified that the agent of the defendant company, Rev. Parker, came to her house and requested her to obtain insurance on her family, which was after Helen Williams had had the premature babies at the hospital in Bogalusa. It is her positive testimony that she never knew and, in fact, denied that her sister Helen Williams ever had heart disease. The doctors did not tell her and to her knowledge had never told her deceased sister. There is nothing in the record to show that the deceased was aware of the fact that the plaintiff had taken out this burial policy. The hospital record shows that on February 14 the deceased “Appears well.” This is on the “Out Patient Department Progress Notice.” It is shown that on March 15 the deceased returned to the hospital in accordance with the request by her doctor to come back to the next GYN clinic. From the hospital records, at this time she was still sick, however, there is nothing in the record to indicate that the plaintiff or the insured knew the serious nature of the illness. The doctor testified that there was nothing in the record to indicate that the deceased had been examined by the doctor at the hospital on March 15th.

It is true that the deceased at the time of the birth of the premature twins on February 5, 1951 remained in a coma for three days and was given oxygen and the plaintiff visited her during that time.

In our opinion, the plaintiff disclosed all the information sought by the agent of the insurance company when he wrote up the application for the policy of insurance.

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Bluebook (online)
64 So. 2d 488, 1953 La. App. LEXIS 601, Counsel Stack Legal Research, https://law.counselstack.com/opinion/sandifer-v-louisiana-life-ins-lactapp-1953.