Shaw v. COMMERCIAL INSURANCE CO. OF NEWARK, NEW JERSEY

270 N.E.2d 817, 359 Mass. 601
CourtMassachusetts Supreme Judicial Court
DecidedJune 9, 1971
StatusPublished

This text of 270 N.E.2d 817 (Shaw v. COMMERCIAL INSURANCE CO. OF NEWARK, NEW JERSEY) is published on Counsel Stack Legal Research, covering Massachusetts Supreme Judicial Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Shaw v. COMMERCIAL INSURANCE CO. OF NEWARK, NEW JERSEY, 270 N.E.2d 817, 359 Mass. 601 (Mass. 1971).

Opinion

359 Mass. 601 (1971)
270 N.E.2d 817

ROBERT S. SHAW
vs.
COMMERCIAL INSURANCE COMPANY OF NEWARK, NEW JERSEY.

Supreme Judicial Court of Massachusetts, Suffolk.

May 4, 1971.
June 9, 1971.

Present: TAURO, C.J., SPALDING, CUTTER, QUIRICO, & BRAUCHER, JJ.

Robert J. Glass for the plaintiff.

Myer Z. Kolodny for the defendant.

CUTTER, J.

Dr. Shaw in this action of contract seeks to recover on two occupational insurance policies issued by the defendant (the insurer). A Superior Court judge, sitting without a jury, made findings (a) for Dr. Shaw on count 1, with respect to a 1954 policy, for $1,400, with interest, and (b) for the insurer on count 2 with respect to a 1963 policy. Dr. Shaw (by an outline bill of exceptions) presents exceptions to the denial of certain requests for rulings and to the allowance of rulings requested by the insurer.

Dr. Shaw was a vascular surgeon at Massachusetts General Hospital (M.G.H.). He took out an accident, health, and disability policy with the insurer in 1954 (the 1954 policy) and another dated September 3, 1963 (the 1963 policy). In pertinent respects, the two policies appear to *603 be essentially similar.[1] The application for the 1963 policy contained questions and answers as follows: Question No. 11. "Have you been disabled by ... illness or received medical attention or advice during the past five years?" Answer — "No." Question No. 12. "Are you now in sound condition physically and mentally?" Answer — "Yes." Part VI, sec. A, of each policy (relating to attendance by a physician) was relied on by the insurer, and that portion of the 1963 policy is quoted in the margin.[2] The 1963 policy contained a "time limit on certain defenses."[3]

The trial judge made the following voluntary findings, warranted by the evidence, "Dr. Shaw, in the spring of 1963, had consulted for psychotherapy a Dr. Vanderpol with regard to ... marital difficulties. On May 3, 1964, Dr. Shaw was voluntarily admitted to the McLean Hospital [McLean].... The admission diagnosis at ... McLean ... was, `Psychoneurotic depressive reaction, moderately severe, passive aggressive character disorder.' He was released [by Probate Court order, apparently because he was not so dangerously ill as properly to be held against his will] ... August 6, 1964, at which time the discharge diagnosis was [in part], `Schizophrenic reaction, paranoid type, chronic. Unchanged'.... Dr. Shaw was in fact *604 mentally ill in ... 1963 at the time he signed the [insurance] application and had been mentally ill for some time in the past, although he had been able to control his mental illness so it did not begin to interfere with his work until sometime in 1964. His mental illness, however, did manifest itself in ... problems with his wife.... [H]is schizophrenia had started long before 1963 but ... it had been controlled and was not readily apparent.... [I]n answering Questions 11 and 12 ... Dr. Shaw, to his own mind, answered ... truthfully. He never believed, even after the hospitalization at McLean, that he was or had been mentally ill."

"[U]pon his release ... [from McLean, Dr. Shaw] was advised by members of the ... [M.G.H.] staff and other doctor friends ... to seek psychiatric treatment. This he steadfastly refused to do, being of the opinion that the psychiatrists who diagnosed him as mentally ill were in error and that he was in no need of treatment.... [H]e was mentally ill [however] during and following his hospitalization ... and ... his ... illness continued at least until July of 1966.... [A]fter his release from McLean, he was not allowed to do surgery at ... [M.G.H.] and did not perform any of the duties of either a surgeon or a physician. Most of Dr. Shaw's time and efforts in this period were spent in attempting to get the opinions of the psychiatrists at McLean Hospital overruled ... by the [M.G.H.] staff.... [F]rom September 23, 1964 to November 1, 1964, Dr. Shaw was employed by the Army Air Force reviewing research studies, for which he received more than nominal compensation.... [D]uring this period he was performing duties encompassed in the general field of medicine, but not that of `surgery'"[4] (emphasis supplied).

*605 Other parts of the trial judge's findings, rulings, and order in large measure deal with requests for rulings.[5] These rulings are discussed below.

1. The judge ruled that two provisions in the 1963 policy, viz. (a) that the "policy is issued in consideration of the statements in the application" (fn. 1, supra), and (b) the provision (fn. 3, supra) under the heading "Policy Provisions[6] — Time Limit on Certain Defenses," constituted "the equivalent of making the statements in the application conditions precedent to the [effectiveness of the] policy" and "that such statements, being false, although not made fraudulently and with knowledge of their falsity" barred recovery on the 1963 policy. Dr. Shaw saved exceptions to the action of the judge in ruling, as requested by the insurer, in this manner.[7]

Ordinarily, truthful "answers to questions in an original application for insurance are either representations or warranties and not conditions precedent." See Sullivan v. John Hancock Mut. Life Ins. Co. 342 Mass. 649, 653-654. Interpretation of this written contract is a matter of law for the court. See Tri-City Concrete Co. Inc. v. A.L.A. *606 Constr. Co. 343 Mass. 425, 427; Quintin Vespa Co. Inc. v. Construction Serv. Co. 343 Mass. 547, 551; Charles L. Hazelton & Son, Inc. v. Teel, 349 Mass. 617, 621. As we read this policy (and we are in as good a position as the trial judge to interpret the contract), truthful statements in the application are not expressly made conditions precedent to the effectiveness of the contract nor is the policy to become void or voidable if the statements are untrue. Cf. Faris v. Travelers Indem. Co. 278 Mass. 204, 208; Lopardi v. John Hancock Mut. Life Ins. Co. 289 Mass. 492, 494-497; Paratore v. John Hancock Mut. Life Ins. Co. 335 Mass. 632, 634-635. The trial judge misinstructed himself in ruling as he did.

2. General Laws c. 175, § 186, reads: "No ... misrepresentation or warranty made in the negotiation of a policy... by the insured ... shall be deemed material or ... avoid the policy or prevent its attaching unless such misrepresentation or warranty is made with actual intent to deceive, or unless the matter misrepresented or made a warranty increased the risk of loss." This section applies only to representations and warranties and "does not apply to provisions in a policy which ... are made conditions precedent to the duty of performance on the part of the insurance company." See Krause v. Equitable Life Ins. Co. 333 Mass. 200, 203-204; Charles, Henry & Crowley Co. Inc. v. Home Ins. Co. 349 Mass. 723, 725-726. We thus must consider whether the statements in the application for the 1963 policy could have been found to pass the dual test of § 186.

Dr. Shaw's negative answer to the question whether he had "received medical attention or advice during the past five years" could be found not to have been true. He, as the judge found, "in the spring of 1963 ... consulted for psychotherapy a Dr. Vanderpol with regard to ...

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270 N.E.2d 817, 359 Mass. 601, Counsel Stack Legal Research, https://law.counselstack.com/opinion/shaw-v-commercial-insurance-co-of-newark-new-jersey-mass-1971.