Sheehan v. Northwestern Mutual Life Insurance Co.

103 S.W.3d 121, 2002 Mo. App. LEXIS 2360, 2002 WL 31749397
CourtMissouri Court of Appeals
DecidedDecember 10, 2002
DocketED 80693
StatusPublished
Cited by9 cases

This text of 103 S.W.3d 121 (Sheehan v. Northwestern Mutual Life Insurance Co.) is published on Counsel Stack Legal Research, covering Missouri Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Sheehan v. Northwestern Mutual Life Insurance Co., 103 S.W.3d 121, 2002 Mo. App. LEXIS 2360, 2002 WL 31749397 (Mo. Ct. App. 2002).

Opinion

SHERRI B. SULLIVAN, Judge.

Introduction

Donna S. Sheehan (Appellant) appeals from the judgment of the trial court entered upon a jury verdict in favor of Northwestern Mutual Insurance Company (Northwestern). We affirm.

Factual Background

Appellant is the beneficiary of a life insurance policy issued by Northwestern in December 1996, on the life of Thomas Sheehan, Appellant’s husband (Decedent). Decedent engaged Christopher Wright (Wright) as his insurance agent to procure the policy. Wright was an insurance agent for the John M. Qualy Agency and the Sheehans’ family friend. Wright had previously purchased various insurance policies for the Sheehans.

Decedent approached Wright about purchasing more life insurance after learning Appellant was pregnant. Wright advised, in a letter dated August 27, 1996, that he was enclosing application signature pages for Decedent to sign and that he would work out the details regarding submission of the forms. There is a dispute as to whether Decedent received the entire application or only the signature pages, and whether Decedent signed those pages in blank. Robin Hensley (Hensley), an associate of. Wright’s, testified that she filled out all of the information on the first five pages of the application, such as name, address, and other similar information.

After the application was completed, Decedent was scheduled for a paramedical examination. There is also a dispute as to whether Decedent actually participated in the paramedical examination or if the paramedical questionnaire was filled out after Decedent signed the form in blank. Michele Chiaramonte (Chiaramonte), a licensed practical nurse who conducts paramedical examinations for various insurance companies, including Northwestern, submitted an affidavit stating she had no specific recollection of Decedent’s exam. However, she further stated it is her cus *124 tom and practice during every paramedical examination to ask the applicant each question as it is printed on the questionnaire. The applicant responds, and she records the answers after each question by marking a box either “yes” or “no” consistent with the applicant’s answer. If an applicant answers “yes” to a question, Chiaramonte records details about that answer in the space provided based upon the information received from the applicant. After the questionnaire is completed, Chiaramonte gives it to the applicant to review and sign.

The paramedical questionnaire was signed by Decedent and dated December 7, 1996, and the answers represented that Decedent was not taking any medication or drugs (legal or illegal, prescription or nonprescription) for any reason. Further, the answers represented that Decedent had not used any tranquilizers, sedatives or narcotic drugs in the last ten years, and that he had not been advised to have any test, consultation, hospitalization, or surgery that was not completed in the last five years. However, Decedent did reveal he had used “muscle relaxors” in 1995, had been treated by Dr. John Edelman, and had a single incident of cocaine use at a bachelor party in 1995.

After submission of all of the insurance materials, Northwestern’s underwriters evaluated Decedent’s application. Due to Decedent’s age and amount of coverage requested, Decedent needed to submit to a full medical examination. The underwriters concluded that regardless of the results of the medical examination, Decedent would not be insured by Northwestern based on the prior positive drug test and his elevated liver enzymes. Therefore, after initially declining coverage, Northwestern submitted Decedent’s application for reinsurance with several companies, including Business Men’s Assurance Company (BMA).

In February 1997, BMA advised Northwestern it would reinsure a life insurance policy on Decedent. Thereafter, Northwestern issued a life insurance policy to Decedent and delivered it to him in March 1997, with an effective date of December 6, 1996. Enclosed with the policy was a personal health and status declaration, identified as a supplement to the application, that was signed by Decedent stating since the date of the original application, he had not used illegal drugs or legally prescribed drugs except as stated in the original application.

Decedent died on April 17, 1997, from acute morphine intoxication as stated on his death certificate. Northwestern submitted a claim packet to Wright, who in turn forwarded the packet to Appellant with a letter explaining the claim packet had to be completed in order to obtain payment of the policy benefits. In addition to providing proof of death, Appellant provided a signed authorization that enabled Northwestern to obtain Decedent’s medical records for the purpose of evaluating the insurance claim. Northwestern used this authorization to obtain medical records from several of Decedent’s treating physicians to process the claim.

The medical records revealed Decedent had a history of drug use that was not disclosed on the paramedical questionnaire. According to the medical records and the testimony of three of Decedent’s physicians, Decedent had been prescribed and was taking vicodin, valium, percodan, and other prescription drugs for several months before completing the paramedical questionnaire in December 1996. The records also revealed Decedent took these drugs in excess of their prescribed dosages. Moreover, Decedent continued to take these prescription drugs after signing the *125 paramedical questionnaire and after signing the personal health and status declaration form in March 1997. After reviewing the medical records, Northwestern notified Appellant on October 30,1997, that in light of the misrepresentation in Decedent’s application as to his prior drug use, it rescinded the life insurance policy.

Procedural Background

On November 20, 1997, Appellant filed suit against Northwestern. Appellant alleged Northwestern breached the life insurance contract and vexatiously refused to pay the benefits. Northwestern asserted two affirmative defenses, material misrepresentation and fraudulent misrepresentation. The material misrepresentation affirmative defense was struck as a discovery sanction.

On November 24, 1999, the trial court granted Northwestern’s motion for summary judgment based upon the misrepresentations made in Decedent’s application. Appellant appealed the summary judgment and this court affirmed in part and reversed in part, in a two to one decision, finding that there was a material issue of fact precluding summary judgment on Northwestern’s claim of fraudulent misrepresentation in application. Sheehan v. Northwestern Mut. Life Ins. Co., 44 S.W.3d 389 (Mo.App. E.D.2000). On remand, a jury trial was held, and the jury returned a verdict in favor of Northwestern and against Appellant. The trial court entered judgment on that verdict, from which Appellant now appeals.

Points Relied On

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Bluebook (online)
103 S.W.3d 121, 2002 Mo. App. LEXIS 2360, 2002 WL 31749397, Counsel Stack Legal Research, https://law.counselstack.com/opinion/sheehan-v-northwestern-mutual-life-insurance-co-moctapp-2002.