Stein v. New York Life Insurance

179 A. 589, 319 Pa. 225, 1935 Pa. LEXIS 666
CourtSupreme Court of Pennsylvania
DecidedMay 15, 1935
DocketAppeal, 296
StatusPublished
Cited by18 cases

This text of 179 A. 589 (Stein v. New York Life Insurance) is published on Counsel Stack Legal Research, covering Supreme Court of Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Stein v. New York Life Insurance, 179 A. 589, 319 Pa. 225, 1935 Pa. LEXIS 666 (Pa. 1935).

Opinion

Opinion by

Mr. Justice Drew,

Plaintiff, Jennie. Stein, brought this action as beneficiary of a policy of insurance issued by defendant upon the life of her daughter, Kate Stein. The defense pleaded was that insured had made false and fraudulent answers to questions in her “answers to the medical examiner,” which formed a part of the application, a copy of which was attached to the policy. The jury returned a verdict for plaintiff, upon which the tidal court entered judgment. After the affirmance of that judgment by the Superior Court (116 Pa. Superior Ct. 109), we allowed an appeal.

*227 The answers alleged to have been falsely and fraudulently made stated that insured had never undergone any surgical operation, had never been under observation or treatment in any hospital, and had never consulted a physician for or suffered any ailment or disease of the middle ear. Defendant produced evidence that at the time the application was made insured had chronic ear trouble and sinusitis and that she had previously suffered from, and had undergone operations for, nasal and mastoid trouble. Plaintiff made no serious effort to contradict this evidence, but sought to escape its effect by showing that the questions with regard to the health of insured were not asked of her by the examining physician nor answered by her, and that the answers were not filled in when insured signed the paper containing these questions. Over defendant’s objection, two brothers of insured, whose presence at the medical examination was shown both by their own testimony and by that of the agent who solicited the policy,- were permitted to testify to this effect. The admissibility of this testimony is the chief question raised on this appeal.

We are of opinion that the testimony Avas admissible. The policy provides that “all statements made by the insured shall, in the absence of fraud, be deemed representations and not warranties.” Where the policy contains such a clause, the insurer, to avoid the policy, must prove fraud on the part of insured in the making of the statements (Livingood v. N. Y. Life Ins. Co., 287 Pa. 128; Kuhns v. N. Y. Life Ins. Co., 297 Pa. 418; Lilly v. Metropolitan Life Ins. Co., 318 Pa. 248) ; the insurer must show not only that the answers were false in fact but also that insured knew they were false when he made them: Lilly v. Metropolitan Life Ins. Co., supra. This could not possibly be true if the ansAvers were not made by insured at all but were supplied later by someone else. The purport of the testimony objected to was that insured Avas totally unaware of the statements on which defendant now relies. Plainly she could not have been aware *228 of the falsity of the statements if she was unaware of their very existence. The testimony was therefore clearly relevant for the purpose of negativing fraudulent misstatement (see Suravitz v. Prudential Ins. Co., 244 Pa. 582; Skruch v. Metropolitan Life Ins. Co., 284 Pa. 299; Campdon v. Continental Assurance Co., 305 Pa. 253), and its admission was proper.

Defendant relies upon Rinker v. Ætna Life Ins. Co., 214 Pa. 608; Koppleman v. Commercial Cas. Co., 302 Pa. 106, and Applebaum v. Empire State Life Assurance Society, 311 Pa. 221, in which evidence that insured made truthful answers but that untruthful answers were inserted by the agent or examining physician before insured signed was held to be inadmissible. Under the terms of the contracts there involved, however, the answers were warranties; such being the case, the mere falsity of the statements avoided the policies, and knowledge of their falsity on the part of insured was immaterial: Dinan v. Supreme Council, 201 Pa. 363; see Suravitz v. Prudential Ins. Co., supra. The answers in the instant case were not warranties, but statements which would avoid the policy only if they were made with knowledge of their falsity. If, as the testimony indicated, they were not even made by insured, who was hence not aware of their existence, she could not have known that they were false.

Benzinger v. Prudential Ins. Co., 317 Pa. 561, is urged upon us by defendant as controlling the instant case. There the application, a copy of which was attached to the policy as part of the contract, contained the following provision: “I further agree that . . . unless the full first premium is paid by me at the time of making this application, the policy shall not take effect until issued by the company and received by me and the full first premium thereon is paid, while my health, habits and occupation are the same as described in this application.” The jury, while it returned a general verdict for plaintiff, made a special finding that at the time the first premium was paid and the policy issued by the company the appli *229 cant’s health was substantially worse than as described in the application. It was contended that the lower court erred in entering judgment for defendant in this state of the case, in view of the fact that plaintiff had produced testimony that insured signed the application in blank and that the questions in it were not asked of insured by the examining physician nor answered by him. In rejecting this contention and holding that the testimony was irrelevant, we said: “The provision that the policy should not take effect unless the health of the insured at the date of the issuance of the policy and payment of the first premium was as described in the application was neither a warranty nor a representation but a condition precedent; the inquiry is not whether the insured knew the state of his health at that time and fraudulently concealed it from the insurer, but simply whether, in fact, he was then in the same state of health as described in the application. So far as concerns this clause, the portions of the application describing his health are integral parts of it, and in this character, as distinguished from their character as representations, they are terms of the contract. When the insured signed in blank the paper headed ‘declarations made to the medical examiner,’ he was, to say the least, put on notice that negative answers to the questions here involved would have to be filled in, as they were. . . . Having accepted the policy as written, he was bound by its terms, and since the finding of the jury establishes that there was a violation of the express and fundamental condition that the policy should not take effect unless his health at the date of its issuance was as described in the application, there can be no recovery upon it.” Since the statements appearing in the application as attached to the policy were used not as representations but as part of the contract itself, no intent to defraud was there involved. It is obvious, therefore, that the case is not controlling here. As we have previously pointed out, fraud was an essential element of the insurer’s defense in the instant case,.and the evidence that *230 the questions in the application were not asked of or answered by insured was relevant to that issue and accordingly admissible. In Swan v. Watertown Fire Ins. Co., 96 Pa. 37, relied upon by defendant, the policy was likewise avoided by a breach of its own terms, not by fraudulent representations or breach of warranty.

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Bluebook (online)
179 A. 589, 319 Pa. 225, 1935 Pa. LEXIS 666, Counsel Stack Legal Research, https://law.counselstack.com/opinion/stein-v-new-york-life-insurance-pa-1935.