Wabash Life Insurance Co. v. Maguire

461 S.W.2d 916, 1970 Ky. LEXIS 644
CourtCourt of Appeals of Kentucky
DecidedNovember 20, 1970
StatusPublished

This text of 461 S.W.2d 916 (Wabash Life Insurance Co. v. Maguire) is published on Counsel Stack Legal Research, covering Court of Appeals of Kentucky primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Wabash Life Insurance Co. v. Maguire, 461 S.W.2d 916, 1970 Ky. LEXIS 644 (Ky. Ct. App. 1970).

Opinion

PALMORE, Judge.

Wabash Life Insurance Company appeals from a verdict and judgment awarding Frances R. Maguire $30,000, the aggregate face amount of two life insurance policies issued on the life of her late husband, John T. Maguire, in the fall of 1966, and in which she was the named beneficiary.

Both policies were issued on the basis of the same application and medical report. The ground on which the company denied liability and defended against the beneficiary’s claim is that these two preliminary instruments, which are incorporated in the contracts, contained material misrepresentations, and that a report furnished by Maguire’s family physician concealed material information.

The application was filled out by the company’s agent and signed by Maguire on September 1, 1966. Dr. Don Pruitt, a physician selected by the company, conducted a medical examination on September 6, 1966, and filled out the medical report according to the information furnished him [917]*917by Maguire. Both Maguire and Dr. Pruitt signed the report. The application for insurance disclosed that Maguire’s records concerning a heart attack in 1963 were in possession of Dr. Lee Heine and contained a general authorization for any physician or medical institution to provide to the insurance company complete details of any information gained through observation or attendance of the applicant.

At the time the policies were issued Maguire was 49 years old. Five years earlier, in 1961, he had been treated by Dr. Gerald Greenfield for what his widow described as chest pains. In 1963 he had been hospitalized for three weeks and confined in bed for another three weeks under diagnosis of arteriosclerotic heart disease, acute coronary insufficiency, and possible myocardial infarction. In the summer of 1966 he had applied to other companies for life insurance but had been rejected. The policies issued by the appellant company in the fall of 1966 were rated substandard, which meant that Maguire was charged a higher premium than would have been the case had he not experienced any coronary symptoms. He died on December 22, 1967, as the result of acute myocardial infarction.

Among other items, the application signed by Maguire on July 1, 1966, contained a series of eight specific questions with a requirement that as to any of them answered in the affirmative the applicant should “give details below such as: condition, date of treatment or confinement, physician attending.” The following questions were answered in the affirmative:

“2. Has application for or reinstatement of Life or A. & H. Insurance been declined, postponed or rated?”
“3. Have you been a patient in any Hospital or Sanitarium during the past five years?”
“4. Have you consulted or had treatment from any Physician or Practitioner for any cause not mentioned above within the past five years? List Family Doctor.”
“8. Do You Have Or Have You Had: (a) Heart or Circulatory Trouble?”

In a space provided below the questions the following details were given:

“# 3 6-64 Stomach Ulcer (no surgery) Completely healed.
“# 4 Ins. Exam 6-66 Dr. Lee Hiene [sic] 6506 Strawberry Ln.
“# 2 Provident Life & Accident declined 6-66
“# 8 Myocardic infraction [sic] 6-61 Dr. Lee Hiene [sic] 6506 Strawberry Ln.”

Among the inquiries and answers on the medical report were the following:

“8. Have you EVER had any symptoms of or been affected with: (If ‘Yes’ to any, give full details under Remarks below.)
******
“b. Disease or Disorder of Heart, Intestine, Kidney, Liver, Lung, Stomach or other vital Organ? Yes.” [Answer “Yes” inserted and “Heart” underscored]
“9. Have you consulted a physician or received hospital or sanitarium observation or care during past five years?-(Yes or No)
Examiner should develop history carefully and state details below.
[918]*918“13. Are you in sound health, as far as you know and believe? Yes”
“REMARKS — Use for details of any special comment.
“8. Dr. Lee Heine 273 Evangeline Louisville Ky. has this man’s records. Applicant was hosp. for 3 weeks and was on bed rest for 3 weeks. Complete recovery after 6 weeks. No recurrence. Has ECG with every check up every 6 months.”

This report showed also that both of Maguire’s parents had died of coronary ailments at the age of 69. It should be noted that although the application of July 1, 1966, did not mention the 1963 coronary episode and hospitalization, they were explicitly reported to and recorded by the medical examiner. The company’s brief makes a considerable point of this omission in the application, and treats it as a misrepresentation to the effect that Maguire had experienced but one heart attack rather than two. Apparently it takes the further position that the omission of a material fact in either of the two instruments would constitute a fatal misrepresentation. It seems to us, however, that common sense requires the two forms to be considered together. If the fact which is for some reason omitted from one is reported in the other, it simply has not been concealed, either by the applicant or from the company.

But to go on with a recitation of the facts, the company sent Dr. Lee Heine its printed form requesting him to provide information as therein indicated relative to Maguire, which he did. It appears, however, that he gave only the data contained in his own file on Maguire, which included treatment in 1965 for a gastric ulcer but did not cover the period of time during which he had been treated by Dr. Greenfield, who before his death in 1965 had been associated with Dr. Heine. Hence the information provided by Dr. Heine did not provide the details about Maguire’s coronary history that would have been disclosed by Dr. Greenfield’s records, particularly those which were made out incident to Maguire’s admission to the hospital in 1963.

Aside from the aforementioned contention that Maguire falsely stated that he had suffered only one heart attack instead of two, the company’s argument finally centers on the circumstance that Maguire had suffered anginal pains and customarily carried nitroglycerin tablets, which facts were not reported in the application or the medical report. In view of his apparent or alleged reliance on this medication, the argument is that (1) it was a material misrepresentation for Maguire to report to the medical examiner that he was in sound health (question 13, medical report), and (2) this was a substantial detail fairly required to be stated in the application and medical report in connection with the mention of his coronary history.

Before going on to an analysis of this basic argument, which concerns the misrepresentations and concealment alleged to have been made by the insured himself in the application and medical report, we shall digress for a moment to discuss the contention that the claimed omissions from Dr. Heine’s report also constituted a ground for avoidance of the policy.

In support of this latter contention the company cites one case, Reserve Loan Life Ins. Co. v. McCoy, 15 F.Supp. 933 (E.D.

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Related

The MacCabees v. Covert
194 S.W.2d 498 (Court of Appeals of Kentucky (pre-1976), 1946)
Reserve Loan Life Ins. v. McCoy
15 F. Supp. 933 (E.D. Kentucky, 1936)

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Bluebook (online)
461 S.W.2d 916, 1970 Ky. LEXIS 644, Counsel Stack Legal Research, https://law.counselstack.com/opinion/wabash-life-insurance-co-v-maguire-kyctapp-1970.