Van Dale v. Prudential Insurance Co. of America

274 N.W. 153, 225 Wis. 281, 1937 Wisc. LEXIS 211
CourtWisconsin Supreme Court
DecidedJune 21, 1937
StatusPublished
Cited by2 cases

This text of 274 N.W. 153 (Van Dale v. Prudential Insurance Co. of America) is published on Counsel Stack Legal Research, covering Wisconsin Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Van Dale v. Prudential Insurance Co. of America, 274 N.W. 153, 225 Wis. 281, 1937 Wisc. LEXIS 211 (Wis. 1937).

Opinion

Nelson, J.

The defendant contends, (1) that at the time the releases were obtained and the policies surrendered for cancellation and reissue it did not conceal any material information from the plaintiff; (2) that it made no affirmative misrepresentations; (3) that the plaintiff did not rely upon any alleged misrepresentations or concealment by the defendant; (4) that the plaintiff, by his conduct, ratified the releases and the settlement made; and (5) that the plaintiff did not establish that he is disabled within the meaning of the disability provision of the policies. The contentions of the defendant necessarily require a full statement of the relevant facts.

At the time of the trial the plaintiff was forty-nine years old. From January 18, 1926, up to June 4, 1932, he was employed by the defendant, first as a soliciting agent and later on as an assistant superintendent, having a crew of nine men under his supervision. While so employed he was apparently successful. His work was favorably commented upon in letters directed to him by his superiors in the home office. At the time he quit work on June 4, 1932, he had four life insurance policies issued by the defendant. The first policy, dated June 28, 1917, insured the plaintiff’s life 'for $2,000. It contained a deductible disability clause and waiver of premiums in the event of total and permanent disability. The second policy, dated July 2, 1928, insured the plaintiff’s life for $5,000. It provided for disability payments of $50 per month to the plaintiff in case of disability, without reduction of the face amount of the policy. The other two policies were group insurance policies-issued to him as an employee and evidenced by two certificates, each in the amount of $6,000. These two policies provided for the payment of disability income with reduction of the face amount of the cer[285]*285tificates and also for a waiver of premiums. Each of the four policies contained substantially the following disability provision:

“If the insured shall become totally and permanently disabled, either physically or mentally, from any cause whatsoever, to such an extent that he is rendered wholly, continuously and permanently unable to engage in any occupation or perform any work for any kind of compensation of financial value during the remainder of his lifetime . . . the company . . . will grant the following benefits : . . . ”

In November, 1931, the defendant informed its employees that after January 1, 1932, it would cease writing disability insurance. The plaintiff thereafter applied for a $5,000 policy with a disability provision, and was examined by a company doctor who sent in a confidential report to the company which was not shown to the plaintiff. The application was rejected, but the defendant offered the plaintiff a policy without disability benefits and rated at the highest rate which it wrote. The plaintiff refused the policy. Later on, Mr. Zimmer, the defendant’s superintendent in Milwaukee, advised the plaintiff to have a thorough medical examination. Accordingly on May 16, 1932, the plaintiff was examined by his family physician, Dr. Roberts, and by Dr. Bockhorst, a company doctor. Both doctors gave plaintiff and the company copies of their reports and findings and, on the instructions of his doctor, plaintiff quit work on June 4, 1932. The plaintiff testified that for months before he quit work he had constant pains across his chest every day, which sometimes were sharp, that he had pains in the back of his throat, the, side of his head, and down his left arm, and that his feet would swell, that he felt very tired, that rest would do him no good, that he slept very poorly, some nights not at all, that his voice changed and became hoarse, that he perspired a great deal nights for several hours at a time, his body seeming as if it were burning up, to such an extent that he could [286]*286not sleep and would have to get up, that he could walk only a few blocks without getting tired, short of breath, and feeling pain, that he lost considerable weight. The plaintiff’s wife corroborated him in substantially all respects. In the summer of 1932, the plaintiff applied for disability income pursuant to the terms of his policies. The application was accompanied by Dr. Roberts’ proof of disability, dated September 14, 1932. Dr. Roberts diagnosed the plaintiff’s trouble as aneurysm of the aorta. It was his opinion that the insured was incapable of performing all parts of his usual work; that the plaintiff was incapable of performing all other gainful work; that the plaintiff had been continuously wholly incapable of engaging in any gainful work from May 16, 1932; that the insured had not recovered sufficiently to engage in any gainful work; that the insured was so disabled that he would for all time be prevented from engaging in any gainful work of any kind. Upon receiving Dr. Roberts’ proof, the defendant sent the plaintiff to Dr. Stranberg, one of its own doctors, for an examination. Dr. Stranberg reported, as to the character of disability: “Aneurysm,” and as to his opinion as to when duties may be resumed: “No.” On the reverse side of the report used for further details, Dr. Stranberg, among other things, wrote “Of course, the prognosis is serious and I do not believe he should work at present. Perhaps a subsequent examination will change the prognosis. . . . The cough was the result of the aneurysm. I believe he is totally and permanently disabled. He has severe pain at most of the time.” On December 17, 1932, the defendant finally declared plaintiff totally disabled and paid him the monthly disability income under its four policies, commencing as of September, 1932. These payments continued until December, 1933. On August 18, 1933, plaintiff’s wife wrote defendant stating that they had a mortgage on their home, that due to plaintiff’s illness it was difficult to meet the pay-[287]*287merits, that the mortgagee was willing to take $5,000 in settlement, which would amount to quite a saying to' the plaintiff ; and asked defendant whether it would be possible to pay up in full one of plaintiff’s group insurance policies. At that time the balance left on each group policy was $5,357.60. The defendant replied that the matter was referred to a local representative. On September 28, 1933, the defendant wrote that it had requested Dr. Thompson, its medical referee in Milwaukee, to make an examination of plaintiff, and upon receipt of his report it would inform her more definitely. On November 1, 1933, defendant wrote that it had received Dr. Thompson’s report, and that it desired an examination to be made by a “noted cardiologist.” The defendant cautioned her not to infer from the investigation that it was obligating itself to grant the advancement, but was looking into the matter carefully so that no injustice would be done. On December 20, 1933, the defendant wrote to the plaintiff informing him of its “inability to comply with your wishesthat it had “hoped that an exception might be taken in your case if all of the factors seemed to warrant such a departure from our general practice. With this in mind we proceeded in good faith to ascertain the facts.” The letter referred to the original diagnosis of aneurysm by Dr. Roberts, and the subsequent examination by its doctor and an eminent cardiologist which revealed that the plaintiff was not suffering from aneurysm. The letter continued, “as it was on the basis of such a diagnosis that your claim was approved and as we now deem you capable of engaging in a gainful occupation, we must inform you that disability payments are being discontinued and your policies are being restored to a premium paying basis.”

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Cite This Page — Counsel Stack

Bluebook (online)
274 N.W. 153, 225 Wis. 281, 1937 Wisc. LEXIS 211, Counsel Stack Legal Research, https://law.counselstack.com/opinion/van-dale-v-prudential-insurance-co-of-america-wis-1937.