Sechrist v. Penn Mutual Insurance Co.

7 Pa. D. & C.4th 146, 1990 Pa. Dist. & Cnty. Dec. LEXIS 190
CourtPennsylvania Court of Common Pleas, York County
DecidedJuly 24, 1990
Docketno. 87-SU-02433-01
StatusPublished

This text of 7 Pa. D. & C.4th 146 (Sechrist v. Penn Mutual Insurance Co.) is published on Counsel Stack Legal Research, covering Pennsylvania Court of Common Pleas, York County primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Sechrist v. Penn Mutual Insurance Co., 7 Pa. D. & C.4th 146, 1990 Pa. Dist. & Cnty. Dec. LEXIS 190 (Pa. Super. Ct. 1990).

Opinion

CASSIMATIS, J.,

This matter is before the court pursuant to the motion for summary judgment of defendant Penn Mutual Insurance Company. For the reasons set forth below, the motion is granted and the complaint of plaintiff, Charlotte Sechrist, dismissed.

The relevant facts are as follows: Plaintiff’s decedent, Stanley Sechrist, signed an application for a life insurance policy issued by defendant. The application contained a question inquiring whether decedent had smoked cigarettes within the last 12 [147]*147months, the answer to which was “No.” By plaintiff’s own admission, Mr. Sechrist did not read the application before signing it. The application contained the following language just above where Mr. Sechrist signed it.

“I . . . represent that the statements and answers in this . . . application are written as made by me and are complete and true to the best of my knowledge and belief. I . . . agree that they will be part of the contract of insurance if issued; that I will be bound by such statements and answers and that Penn Mutual, believing them to be true, will rely and act upon them. I also understand and agree that: (1) . . . no insurance will be in force . . . while the health, habits, occupation and other facts relating to the proposed insured, are the same as described in this Part I of the application.”

Shortly thereafter, defendant issued a life insurance policy for Mr. Sechrist, which named plaintiff as the beneficiary. According to an affidavit filed by an employee of defendant, premiums under the policy were assessed at the lower non-smoker rate as opposed to the higher smoker rate. Less than one year later, Mr. Sechrist died as a result of respiratory failure caused by lung cancer. Plaintiff submitted a claim for benefits, which defendant rejected upon learning that Mr. Sechrist had misrepresented his smoking habits.

Plaintiff then filed a complaint, claiming benefits under the policy. In her reply to defendant’s new matter, plaintiff concedes that the answer on the application regarding Mr. Sechrist’s smoking was false and, in fact, Mr. Sechrist had smoked cigarettes in the 12 months prior to signing the application. Plaintiff had also filed an affidavit stating that she was present during the application process, did not recall any questions regarding smoking and that [148]*148Mr. Sechrist signed the application without reading it. Plaintiff further states that it was the agent of defendant, not her husband, who filled out the application. In addition, plaintiff recalls that at no time did the agent inform decedent that a lower premium would result from a non-smoker status.

In support of its motion, defendant argues that Mr. Sechrist’s representation regarding his smoking habits was knowingly false, material to the risk assumed by defendant, made in bad faith and relied on by defendant. As a result, defendant submits that plaintiff as a matter of law is barred from recovery under the policy. Defendant also contends that plaintiff is not entitled to recover the benefits he would have been able to recover had he disclosed that he was a smoker.

Plaintiff counters by asserting that the materiality of the risk assumed by defendant is a jury question not properly subject to summary judgment. Plaintiff also maintains defendant has not met its burden of proving, as a matter of law, that the representation of Mr. Sechrist was made in bad faith. Plaintiff further submits that the mere fact that a different rate schedule might have applied had Mr. Sechrist disclosed his smoking habit does not void the policy, but rather allows plaintiff to recover the benefits that would have been available to a smoker.

In order to avoid its obligations under an insurance policy, the insurer has the burden of proving that the statements made by an applicant on the application were false and material and that the applicant must have known that the statements were false and made in bad faith. In addition, the insurer must establish that it relied upon the misstatements in issuing the policy. Piccinini v. Teachers Protective Mutual Life Insurance Co., 316 Pa. Super. 519, 463 A.2d 1017 (1983).

[149]*149With regard to the first element of avoidance, namely, falsity, it is clear the answer regarding Mr. Sechrist’s smoking habits was false. As for the second element, materiality, normally the question of materiality is for the jury. Baldwin v. Prudential Insurance Co. of America, 215 Pa. Super. 434, 258 A.2d 660 (1969). However, where the answer is false and the matter involved manifestly material to the risk, the question is one of law which may be decided by the court. Baldwin, 215 Pa. Super. at 437, 258 A.2d at 662. In discussing materiality, the court in Baldwin stated:

“Generally, it has been held that ‘Every fact untruly asserted or wrongfully suppressed must be regarded as material if the knowledge or ignorance of it would naturally influence the judgment of the insurer in making the contract at all, or in estimating the degree and character of the risk, or in fixing the rate of the premium. ’ 7 Couch on Insurance 2d, §35:79, p. 94 (1961).” 215 Pa. Super. at 437, 258 A.2d at 662.

In the instant case, we have no problem concluding that the materiality of Mr. Sechrist’s representations regarding his smoking habits can be resolved by this-court as a matter of law. Defendant’s employee filed an affidavit stating that the rates defendant charged Mr. Sechrist for life insurance would have been more expensive had it been known that Mr. Sechrist smoked. Since Mr. Sechrist’s false representation regarding his smoking habits affected the rates charged by defendant, we are inclined to conclude that the representation was material. Additionally, we find that since the rates charged by defendant were affected by whether Mr. Sechrist smoked, defendant relied on his representations regarding his smoking habits.

[150]*150Turning to the issue of known falsity and bad faith, the .test of recovery is the good faith of the insured, and the burden of proving the answers given were known to be false is on the insurer who asserts it. Prevete v. Metropolitan Life Insurance Co., 343 Pa. 365, 22 A.2d 691 (1941). The court’s opinion in Prevete provides useful guidance to the dispute here.

The court stated:

“In the present controversy, plaintiff admits that the answers in the application are false. Then, in view of the insured’s unqualified certification that he had read these false answers before signing the application, that they were correctly written as given by him, and that they were true and complete, how can it be said that he did not know the answers were false and did not deliberately intend to deceive the company. In such a situation the necessary and inevitable conclusion is that insured did not act in good faith when he signed the application, and the policy should have been avoided without the intervention of a jury. His beneficiary should not have been heard to say that insured gave other answers than those set forth in the application. To permit such a thing would be to open wide the door to fraud.” Prevete, supra.

The teachings.of Prevete

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Related

Piccinini v. Teachers Protective Mutual Life Insurance
463 A.2d 1017 (Supreme Court of Pennsylvania, 1983)
Equitable Life Assurance Society v. McCausland
200 A. 85 (Supreme Court of Pennsylvania, 1938)
Applebaum v. Empire State Life Assurance Society
166 A. 768 (Supreme Court of Pennsylvania, 1933)
Prevete v. Metropolitan Life Insurance
22 A.2d 691 (Supreme Court of Pennsylvania, 1941)
Baldwin v. Prudential Insurance Co. of America
258 A.2d 660 (Superior Court of Pennsylvania, 1969)

Cite This Page — Counsel Stack

Bluebook (online)
7 Pa. D. & C.4th 146, 1990 Pa. Dist. & Cnty. Dec. LEXIS 190, Counsel Stack Legal Research, https://law.counselstack.com/opinion/sechrist-v-penn-mutual-insurance-co-pactcomplyork-1990.