Sterling Insurance v. Dansey

81 S.E.2d 446, 195 Va. 933, 1954 Va. LEXIS 171
CourtSupreme Court of Virginia
DecidedMay 3, 1954
DocketRecord 4181
StatusPublished
Cited by23 cases

This text of 81 S.E.2d 446 (Sterling Insurance v. Dansey) is published on Counsel Stack Legal Research, covering Supreme Court of Virginia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Sterling Insurance v. Dansey, 81 S.E.2d 446, 195 Va. 933, 1954 Va. LEXIS 171 (Va. 1954).

Opinion

Smith, J.,

delivered the opinion of the court.

This action was instituted on September 8, 1952, by Willie Roy Dansey against the Sterling Insurance Company on a policy of accident and health insurance to recover for total disability. Sterling denied liability and defended on the grounds that Dansey had, in his application for insurance, made two material misrepresentations of fact, namely: (1) by denying he had ever had diabetes when in fact he had suffered from such disease, (2) by failing to disclose previous medical treatment.

The trial resulted in a verdict and judgment in favor of the insured for $1,535.00, the amount .agreed to be due if Dansey was entitled to recover under the terms of the policy. To review that judgment, this writ of error was awarded the insurance company.

No medical examination was required but the policy was issued on a written application, which was signed by the insured on November 26, 1948, and made a part of the policy. An agent of the insurance company wrote the answers to the questions in the application. The following questions and answers are relevant here:

Question No. 15: “Have you ever had any of the following: '* * * (B) Cancer, diabetes, epilepsy, * * *? No.”

Question No. 16: “Have you received medical or surgical advice or treatment or had any local or constitutional disease, not mentioned above, within the last five years?” Dansey answered “yes”; gave the date as April or May 1947; the nature of the treatment as a “check up”; and gave additional information not called for in the application by inserting the name and address of the attending physician as “Dr. William Jordan, M. D., Richmond, Va.”

*935 Question No. 17: “Do you understand and agree that no insurance will be effected until a policy is issued to you? Yes.”

Question No. 18: “Do you hereby apply to STERLING INSURANCE COMPANY for this policy to be issued solely and entirely in reliance upon the written answers to the foregoing questions, which you agree are true and correct to the best of your knowledge and belief, and do you agree that the company is not bound by any statement made by or to any agent unless written herein; and do you hereby authorize any physician or other person who has attended or may attend you to disclose any information thus acquired? Yes.”

The insured, Dansey, also executed and delivered to the company’s agent an “Authorization Form and Attending Physician’s Report,” directed to Dr. William Jordan and reciting that the insurance company would like more explicit information than Dansey was able to give concerning the illness or illnesses for which Dr. Jordan had treated him. It contained this specific request:

“To facilitate consideration of my case by the Medical Department of the Company, will you please make below a brief and general statement, giving the desired information with any other facts which would assist in the proper valuation?

“Please mail your reply in the enclosed addressed envelope. I shall greatly appreciate this courtesy on your part.”

This special authorization and the application were delivered by the agent to his superior and a policy, dated November 30, 1948, was issued by the home office of the company in Chicago, Illinois, forwarded to the agent and delivered by him to Dansey upon payment of the initial premium. Thereafter, on June 8, 1951, Dansey had a brain hemorrhage and he has since been totally disabled.

Upon receipt of Dansey’s claim, the company denied liability and tendered to him the sum of $251.20, the amount *936 of the premiums paid. The tender was refused and the present action followed.

The company promptly filed its special plea and grounds of defense, both of which were included in the same paper. In its special plea the company asserted that it was not liable because Dansey had in his application: (1) “knowingly made false statements relating to his health and physical condition, said false statements materially affecting the acceptance of the risk by the defendant,” (2) “knowingly suffered from diabetes for some time prior to the time of the application, November 26, 1948, and had received medical treatment within the five years prior to November 26, 1948, other than that which he disclosed.” The grounds of defense asserted that the company was not liable “because of false statements made by the plaintiff in the application for the policy, said false statements being untrue when made and being material to the risk assumed by the defendant under the policy.”

The issue of whether Dansey had diabetes at or prior to the date of his application was submitted to the jury under Instruction No. 3, 1 to which there was no objection. This was a purely medical question on which the doctors gave conflicting testimony; however, they agreed that diabetes cannot be cured and can only be controlled by the use of insulin.

To support its allegations, the insurance company called Dr. William Jordan who testified that Dansey had diabetes prior to and after November 26, 1948, the date of his application for insurance. His conclusion was based primarily on several examinations made in December of 1946, which indicated that Dansey had an excess of sugar in his blood and urine. Most of these examinations were made at the Medical College of Virginia Hospital. In his next examination of Dansey, on March 14, 1947, Dr. Jordan found the urine and *937 blood sugar normal. Then after a further examination on July 28, 1947, Dr. Jordan wrote Dansey that his blood sugar was “a slightly, tiny bit above normal—but I think is pretty satisfactory * * * certainly, the sugar is not causing you to feel badly.” Dr. Jordan recommended that Dansey take insulin which is the usual treatment for diabetes, suggested a diet, and gave him a manual on the care of diabetes, but he never told Dansey prior to November 26, 1948 that he was suffering from diabetes. Subsequent to the brain hemorrhage in June of 1951, Dansey was examined by Dr. Jordan on two occasions.

Dr. Douglas G. Chapman, who gave Dansey a physical examination and electrocardiogram on May 29, 1951, in a written statement read by agreement as a part of the evidence, said he found Dansey had diabetes in May of 1951, and that he was told by Dansey that Dr. Jordan had treated him three years for diabetes.

On the other hand, Dr. W. H. Hosfield, Dansey’s family physician, testified that Dansey did not have diabetes. His conclusion was based on five urinalyses, one of which was made in the summer of 1948, prior to the date of the application, and the other four of which were made after his hemorrhage in 1951.

Dansey himself testified that if he ever had diabetes, he never knew it; that he was never told prior to the date of his application that he had diabetes; and that he did not tell Dr. Chapman that he had been treated by Dr. Jordan for diabetes. Also, his wife testified that for more than a year she had tested her husband’s urine every day in accordance with Dr.

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Bluebook (online)
81 S.E.2d 446, 195 Va. 933, 1954 Va. LEXIS 171, Counsel Stack Legal Research, https://law.counselstack.com/opinion/sterling-insurance-v-dansey-va-1954.