Solez v. Commercial Travelers Mutual Accident Ass'n of America

244 A.D. 143, 278 N.Y.S. 549, 1935 N.Y. App. Div. LEXIS 5780
CourtAppellate Division of the Supreme Court of the State of New York
DecidedApril 1, 1935
StatusPublished
Cited by1 cases

This text of 244 A.D. 143 (Solez v. Commercial Travelers Mutual Accident Ass'n of America) is published on Counsel Stack Legal Research, covering Appellate Division of the Supreme Court of the State of New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Solez v. Commercial Travelers Mutual Accident Ass'n of America, 244 A.D. 143, 278 N.Y.S. 549, 1935 N.Y. App. Div. LEXIS 5780 (N.Y. Ct. App. 1935).

Opinion

Hagarty, J.

On the 23d day of January, 1924, the defendant issued an accident insurance policy to one Chester Solez, who died on the 25th day of October, 1929, as the result of a fall. Plaintiff is the widow of the insured and the sole beneficiary denominated in the policy. Defendant writes casualty insurance on the co-operative or assessment plan, pursuant to the provisions of article 6 of the Insurance Law. This action, based on the policy, is to recover the stipulated amount of $10,000. The complaint was dismissed after the jury had rendered a verdict in favor of plaintiff, and this appeal is from the order setting aside the verdict of the jury and dismissing the complaint, and the judgment entered thereon.

This appeal concerns itself solely with a defense of breach of warranty, which, it is claimed, was established as a matter of law. That it was so established the learned trial court held. The substance of that, defense is that the insured, in his application, dated the 11th day of January, 1924, warranted that no life, health or accident insurance company or association had ever rejected his application for insurance. It is alleged that that warranty was false in that the insured had been previously rejected by the Mutual Life Insurance Company in 1922, and by the Security Mutual Life Insurance Company in 1923. No proof was offered on the trial as to a third alleged rejection, by the Metropolitan Life Insurance Company, in 1924.

[145]*145Concerning the transaction between the insured and the Mutual Company, the facts, briefly, are that Solez made application to it on the 8th day of June, 1922, for a $2,000 twenty-payment life insurance policy. Two medical examinations were had, the result of the first of which was not disclosed on the trial, but on the second it appears that the examining doctor advised postponement for six months.” That determination was reviewed by an associate medical director of the company to see if there would be any change in the decision of declining the risk,” and it was marked by him at that time “ No change ” and he testified on the trial that “ the case was declined.” Subsequently, the applicant was advised by the broker through whom he had made application that he had been rejected. Thereafter, however, and on the 14th day of May, 1923, the applicant again made application to the Mutual Company for a $5,000 twenty-payment life insurance policy. In that application it appears that, in answer to the questions relating to rejection by any company or association, the deceased answered “ None.” The examiner on that occasion recommended him for $5,000 in mod; fife 20.” Thereupon, a policy was issued by that company to the deceased on the 29th day of May, 1923, which is characterized as a modified or “ sub-standard ” policy. That policy was in force on the 11th day of January, 1924, when Solez made application to the defendant.

The transaction with respect to the Security Mutual Company grew out of an application made by the insured to that company on the 15th day of May, 1923, for a $5,000 twenty-payment life insurance policy. Another application,, which is somewhat confusing, was made by the insured to the Security Mutual Company nine days later, or on the 24th day of May, 1923. As to that application, the deceased noted thereon as follows: 27. A. When were you last examined for life insurance? May, 1923. B. Give name of Company. Mutual Life — rejected.” In passing, it will be observed that this admitted rejection does not concern itself with the alleged rejection by the Mutual Company on the earlier application of June, 1922, but with his application to that company in May, 1923, determination upon which was still pending at the time of his application to Security Mutual Company, and, as aforesaid, instead of rejecting him, the Mutual Company did accept his application and issue a policy on the 29th day of May, 1923. The Security Mutual Company, however, did reject the application or applications made to it, but there is no proof that the deceased was ever advised of that rejection. On the contrary, its agent at the time testified positively that he did not inform Solez of the [146]*146rejection and later modified this testimony by saying that he did not remember whether he had told him or not.

Although respondent argues that the disposition of the deceased’s application to the Mutual Company in June, 1922, was a rejection of which he had knowledge, and that his warranty to the contrary in the application under consideration was false, in the light of the subsequent relationship between the insured and the Mutual Company there was presented an issue of fact as-to the conclusiveness of that disposition as a rejection. In view of the acceptance of the insured's application by the same company within a year thereafter and the issuance of a policy, modified in form, it is true, but for a larger amount, there is substantial ground upon which a jury could find that the original application had been postponed, and eventuated in the issuance of the later policy. Another issue of fact which might well be resolved in favor of plaintiff is that, even though the earlier disposition did amount to a rejection as a matter of law, the insured was led to believe that it was only a postponement, or at least had been revoked by the subsequent favorable action, and hence that he was not guilty of a willful misstatement in warranting to the contrary.

The element of scienter, or guilty knowledge, is of prime importance in considering the effect of the undoubted rejection by the Security Mutual Company. The jury could find on the proof that this rejection was never communicated to the insured. While it may be argued that the fact that Solez did not receive a policy from that company operated to bring home to him the realization that he had been rejected, that feature belongs to the realm of fact and does not involve the question of law which we must determine.

That question is whether or not it was incumbent upon the insurer, as a company admittedly authorized to carry on its business upon the co-operative or assessment plan under article 6 of the Insurance Law, to prove knowledge of the rejections in question on the part of the insured so as to establish that he had willfully and fraudulently falsified. In the absence of statutory regulation, respondent’s contention that the answer constituted a warranty and that its falsity was the only issue for the jury, even though innocently made, would of necessity be sustained. Over the signature of the deceased is the statement, “ I do hereby warrant each of the foregoing answers to be true,” and that was his warranty as to the absence of any previous rejections. Under such circumstances, Baumann v. Preferred Accident Ins. Co. (225 N. Y. 480) would be conclusive. There, as here, the applicant for a policy of accident insurance warranted that no application of his for accident, health or life insurance had ever been declined. That was not true. For reasons which are not material here, it was decided that sections 58 and 107 of the Insurance Law were inapplicable. It was there [147]*147held that the falsity of the warranty was fatal to the plaintiff's cause of action.

In the case at bar, however, the provisions of section 210 of the Insurance Law are applicable, and that section, in so far as material, reads:

§ 210. Payment of maximum amount of policy; agreements for benefits; notice of assessment.

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Nigro v. Commercial Travelers Mutual Accident Ass'n of America
267 A.D. 915 (Appellate Division of the Supreme Court of New York, 1944)

Cite This Page — Counsel Stack

Bluebook (online)
244 A.D. 143, 278 N.Y.S. 549, 1935 N.Y. App. Div. LEXIS 5780, Counsel Stack Legal Research, https://law.counselstack.com/opinion/solez-v-commercial-travelers-mutual-accident-assn-of-america-nyappdiv-1935.