St. Joseph's Hospital v. Reserve Life Insurance

742 P.2d 804, 154 Ariz. 303, 1986 Ariz. App. LEXIS 756
CourtCourt of Appeals of Arizona
DecidedMay 28, 1986
Docket2 CA-CIV 5707
StatusPublished
Cited by6 cases

This text of 742 P.2d 804 (St. Joseph's Hospital v. Reserve Life Insurance) is published on Counsel Stack Legal Research, covering Court of Appeals of Arizona primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
St. Joseph's Hospital v. Reserve Life Insurance, 742 P.2d 804, 154 Ariz. 303, 1986 Ariz. App. LEXIS 756 (Ark. Ct. App. 1986).

Opinion

OPINION

LACAGNINA, Judge.

United Chambers appeals from an adverse judgment awarding compensatory and punitive damages in favor of St. Joseph’s Hospital based on negligent misrepresentation, promissory estoppel and bad faith. On appeal, United Chambers claims that the evidence which supported verdicts in its favor on the insurance policy and express and implied contract was insufficient to support the jury verdict and judgment rendered against it. We agree, reverse and vacate the judgments. We affirm the refusal of the trial court to award attorney’s fees to either party.

The issues presented on appeal and cross-appeal which we will answer are:

1. Was there sufficient evidence to support a judgment for negligent misrepresentation, promissory estoppel, bad faith and punitive damages?

2. Does the duty of good faith implied in an insurance contract extend to third parties?

*305 3. Did the court abuse its discretion by failing to award attorney’s fees to either party?

FACTS

George Montney formed a business in August 1981. On September 1, 1981, he executed and filed an application for group health insurance from United Chambers and, later that day, went to see a physician. Since his group of employees consisted of less than five persons, he was required to answer health questions on his application. He failed to honestly answer the questions and, based on his reported, unremarkable medical history, his application was approved. In April of 1982, after receiving Montney’s complete medical records, United Chambers determined that the policy would not have issued had it known the truth about Montney’s health and true medical history for the months preceding September 1, 1981. Specifically, Montney would have been declined due to his height and weight alone if they had been correctly stated on his application. The policy was rescinded on May 5, 1982, and notice was received by Montney on May 10, 1982. St. Joseph’s learned of the rescission on May 11, 1982.

Between September 1, 1981, and May 10, 1982, St. Joseph’s treated and hospitalized Montney for leukemia as follows: 1) September 8, outpatient; 2) October 14 to 26, initial hospitalization; 3) January 4 to April 2, second hospitalization; 4) April 1982, outpatient services; and 5) May 10 to June 11, 1982, final hospitalization. During Montney’s hospitalizations, St. Joseph’s inquired of United Chambers regarding insurance coverage. United Chambers verified the issuance of the policy and its limits and repeatedly requested from Montney and his physicians medical reports of his condition and treatment. United Chambers initially received partial records; later, complete records were evaluated. St. Joseph’s never asked United Chambers to guarantee payment of Montney’s bills nor did United Chambers promise to pay the bills. Until the policy was rescinded, all statements made by United Chambers regarding the policy and its limits were true.

NO EVIDENCE OF NEGLIGENT MISREPRESENTATION

We recognize the tort of negligent misrepresentation in Arizona. Van Buren v. Pima Community College District Bd., 113 Ariz. 85, 546 P.2d 821 (1976); Arizona Title Insurance & Trust Company v. O’Malley Lumber Company, 14 Ariz.App. 486, 484 P.2d 639 (1971). The tort is defined by Restatement (Second) of Torts § 552 and governed by the principles of the law of negligence. Therefore, “there must be a duty owed and breach of that duty before one may be charged with negligent violation of that duty.” Van Buren v. Pima Community College, 113 Ariz. at 87, 546 P.2d at 823. As the jury in this case was instructed, the tort is committed by the giving of false information intended for the guidance of others and justifiably relied upon by them causing damages if the giver of the false information fails to exercise reasonable care or competence in obtaining or communicating the information. Restatement (Second) of Torts § 552(1) (1977).

United Chambers was under no obligation to comply with St. Joseph’s time table in completing its investigation and determining its liability to Montney for payment of his expenses. United Chambers had a right to complete its investigation which justified rescission of the policy based upon fraudulent representations in its inception. Nothing on Montney’s application as investigated by United Chambers could have alerted it to any fraud by Montney. Following his initial hospitalization, when claims were submitted, and United Chambers received medical history reports and physicians’ reports, it gained more information from which it eventually concluded that Montney had misrepresented his medical history, previous medical treatment and height and weight.

United Chambers’ verification of the existence of the policy prior to rescission is insufficient to create liability for negligent misrepresentation. Pursuant to the request by St. Joseph’s, the only duty owed by United Chambers was to give true infor *306 mation of existing facts known to it in response to the request. This it did. The evidence was undisputed that St. Joseph’s asked only if a policy existed and its benefits. St. Joseph’s did not request that United Chambers promise or guarantee payment of expenses incurred by Montney. The hospital’s assumption that payment would be made because a policy was issued was not justifiable reliance upon the information requested and obtained. Owning an insurance policy and receiving benefits from it are two different conditions. Employees of St. Joseph’s testified they knew that verification of benefits was not the same as confirmation of payment. If St. Joseph’s wanted assurances from United Chambers for payment, it should have asked, because if given, even though the policy was later rescinded, St. Joseph’s may have had sufficient evidence to support a judgment for negligent misrepresentation.

INSUFFICIENT EVIDENCE OF PROMISSORY ESTOPPEL

The jury was instructed on the issue of estoppel as follows:

If the defendants made express or implied representations which caused the hospital to treat Montney, and the hospital justifiably relied on any representation made by the defendants, to the detriment of the hospital, and if enforcement of the defendant’s representations is necessary in the interest of justice, then your verdict should be for the plaintiff. If any of these elements is missing, your verdict should be for the defendants (emphasis added).

The doctrine of promissory estoppel is based on the enforcement of a promise or representation justifiably relied upon to the detriment of the promisee where enforcement of such promise or representation is necessary in the interest of justice. For the jury to return a verdict in favor of St. Joseph’s, it necessarily should have had evidence regarding a promise or representation which should be enforced. Kersten v. Continental Bank, 129 Ariz. 44, 628 P.2d 592 (App.1981); 1A Corbin, Contracts

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Bluebook (online)
742 P.2d 804, 154 Ariz. 303, 1986 Ariz. App. LEXIS 756, Counsel Stack Legal Research, https://law.counselstack.com/opinion/st-josephs-hospital-v-reserve-life-insurance-arizctapp-1986.