State Farm Fire & Casualty Co. v. Jenkins

305 S.E.2d 801, 167 Ga. App. 4, 1983 Ga. App. LEXIS 2373
CourtCourt of Appeals of Georgia
DecidedMay 24, 1983
Docket65472
StatusPublished
Cited by27 cases

This text of 305 S.E.2d 801 (State Farm Fire & Casualty Co. v. Jenkins) is published on Counsel Stack Legal Research, covering Court of Appeals of Georgia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
State Farm Fire & Casualty Co. v. Jenkins, 305 S.E.2d 801, 167 Ga. App. 4, 1983 Ga. App. LEXIS 2373 (Ga. Ct. App. 1983).

Opinion

Carley, Judge.

Appellant-insurance company appeals from a judgment entered on a verdict in favor of appellee-insured. The facts which gave rise to the instant appeal are as follows: On December 7, 1979 appellee’s home and contents therein were destroyed by fire. Pursuant to the terms of his homeowner’s policy issued by appellant, appellee submitted a proof of loss and, subsequently, an amended proof of loss. On June 17, 1980, appellant denied the claim by a letter to appellee’s attorney stating: “Based on our investigation into the origin of this loss and in reviewing the claim as presented by [appellee], I regret to advise you that we will be unable to make payment to [appellee] for this loss. For your information, the following is a quotation from the CONDITIONS Section of the insurance policy involved in this loss: ‘Concealment or Fraud. This entire policy shall be void if any insured has intentionally concealed or misrepresented any material fact or circumstance relating to this insurance.’ Our investigation reveals this fire loss was a result of incendiary origin, and [appellee] had both the motive and opportunity to set it. Our investigation has also revealed intentional concealment and misrepresentations of material facts regarding the circumstances and amount of this loss.”

Several weeks prior to this letter — but after the proof of loss and amended proof of loss had been submitted by appellee — appellant mailed to appellee a premium notice. Also, subsequent to appellant’s letter of June 17,1980, denying appellee’s claim, appellant mailed to appellee further notices stating that the policy would be cancelled if the premium was not paid. In response, appellee did not renew his policy with appellant, but did submit yet another amended proof of loss. However, appellant did not change its position and continued to refuse to pay the claim. Appellee then instituted the present suit and successfully obtained a recovery on the policy.

1. Throughout the case, appellant admitted that, at the time of *5 the fire, appellee’s homeowner’s insurance policy was in full force and effect. Appellant did, however, assert defensively that appellee had intentionally concealed and misrepresented material facts and circumstances concerning the fire in the statements contained in his proofs of loss, that the policy accordingly became void as of that time, and that no coverage therefore existed for any of appellee’s alleged losses. In asserting this defense, appellant relied on the following clause in the policy: “Concealment, Fraud. This entire policy shall be void if whether before or after a loss the insured has wilfully concealed or misrepresented any material fact or circumstance concerning this insurance or the subject thereof, or the interest of the insured thereof, or in case of any fraud or false swearing by the insured relating thereto.” Appellant specifically contended that the proof of loss and amended proof of loss forms submitted by appellee contained statements that certain items were destroyed by fire when actually such items had been removed by appellee prior to the fire. Appellant also asserted that appellee’s statements in the proof of loss forms contained gross overexaggerations as to the value of items destroyed by fire.

At the close of the evidence, appellee moved to strike all portions of appellant’s answer relating to the defense that because appellee’s misrepresentations and concealments in the proof of loss forms voided the policy, no coverage existed. Appellee asserted that, by mailing to him premium notices subsequent to the submission of his allegedly misrepresentative proof of loss statements, appellant had acted inconsistently with its “void” policy defense and had thereby waived it. Also, appellee contended that even after appellant had advised on June 17, 1980, that it would not pay the claim, appellant mailed him an “inconsistent” cancellation notice which, by its terms, still would have provided appellant continuous coverage if he had paid the premium. Thus, appellee asserted that, by requesting renewal premiums subsequent to appellee’s alleged misrepresentations, appellant acted inconsistently with and thereby waived its defense that the policy was void as the result of those misrepresentations. (T-307-33, 342-343) The trial court directed a verdict against appellant and for appellee as to the “void” policy defense. Appellant asserts this ruling as error.

Provisions such as that involved in the instant case which declare the entire insurance policy void upon misrepresentation or concealment of any material fact, fraud, or false swearing by the insured have been held to be applicable to proofs of loss and other statements made under oath by the insured. “[Such a provision] would cover cases of fraudulent misrepresentation of material facts or circumstances, made by [the insured] to the company or its agents *6 that might affect the action of the insurer in respect to settling or adjusting the claim of the insured ...” Goldberg v. Provident Washington Ins. Co., 144 Ga. 783, 790 (87 SE 1077) (1942). See also American Alliance Ins. Co. v. Pyle, 62 Ga. App. 156 (4) (8 SE2d 154) (1940); Couch on Insurance 2d § 49A:60. The question for resolution is whether the trial court correctly held that, under the evidence in the instant case, appellant waived any right it might otherwise have had under the policy provision to declare the policy void.

Appellant claims that the “voiding” of the policy occurred upon the fraudulent misrepresentations by appellee in the statements contained in his proof of loss and subsequent amended proofs of loss. Appellant admits it received those statements which, prior to March 10.1980, put it on notice of such misrepresentations. On April 8,1980, appellant nevertheless mailed to appellee a premium notice. Further, when appellant submitted its written notification to appellee on June 17.1980, it merely stated that it was denying the claim based upon the misrepresentations, and made no mention that it considered the entire policy void. Finally, even subsequent to this letter of June 17, appellant mailed to appellee a cancellation notice providing that if appellant received payment before or on the cancellation date, appellee’s policy would be renewed and he would be afforded uninterrupted and continuous coverage. At no time did appellant indicate that it considered the entire policy void or forfeited, but instead gave every indication to appellee that the policy remained in full force and effect.

‘A forfeiture occurs, if it results at all, immediately upon a breach of the condition of the contract on which it is based; and, forfeitures not being favored in law, a waiver of the forfeiture, once made, can not be recalled. The demand for payment in full of a future premium subsequently to the breach of a condition which would have entitled the insurer to insist upon a forfeiture of the contract will be held to be a waiver of the forfeiture, and be treated as an acknowledgement that the delinquent policy-holder is still entitled to the benefits conferred by his contract.’ [Cit.]” Farmers Mut. Co-op. Fire Ins. Co. v. Kilgore, 39 Ga. App. 528 (2) (147 SE 725) (1929). Also see Couch on Insurance 2d, § 32:289. Appellant’s actions in the instant case acted as a waiver of the defense that the entire policy was void as of the date of appellee’s alleged misrepresentation and fraud. Loeb v. Nationwide Mut. Fire Ins.

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Bluebook (online)
305 S.E.2d 801, 167 Ga. App. 4, 1983 Ga. App. LEXIS 2373, Counsel Stack Legal Research, https://law.counselstack.com/opinion/state-farm-fire-casualty-co-v-jenkins-gactapp-1983.