Williams v. State Farm Insurance Co.

656 P.2d 966, 1982 Utah LEXIS 1042
CourtUtah Supreme Court
DecidedAugust 27, 1982
Docket17496
StatusPublished
Cited by48 cases

This text of 656 P.2d 966 (Williams v. State Farm Insurance Co.) is published on Counsel Stack Legal Research, covering Utah Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Williams v. State Farm Insurance Co., 656 P.2d 966, 1982 Utah LEXIS 1042 (Utah 1982).

Opinion

OAKS, Justice:

This is an action by the beneficiary of life insurance against the insurer for the face amount of the policy. After the jury gave its verdict on special interrogatories, the court entered judgment for the defendant, no cause of action. Plaintiff’s appeal presents a single issue having to do with an alleged misrepresentation the decedent-insured made on the “Medical History portion of Life Application” in applying for the policy. Plaintiff contends that this issue should not have been submitted to the jury (1) because under U.C.A., 1953, § 31-19-7(1), the Medical History form was not “part of the policy” and therefore was not “admissible in evidence in any action relative to such policy,” and (2) because, in any case, the defendant insurer waived its right to rely on the medical form because its answer did not plead misrepresentation as an affirmative defense. 1

The insurer issued a $38,000 policy of life insurance on plaintiff’s husband in 1977. In 1979, he was killed in a head-on automobile collision under circumstances indicating that his intoxication was a principal cause of his death. The insurer denied plaintiff’s claim on the basis “that there was a serious and material misrepresentation in obtaining the policy.... ” The insurer’s letter explained: “We relied upon the representations made in the application and had we been aware of Mr. Williams’ treatment for alcoholism with Dr. Jeppson and use of antabuse prior to our application, we would not have issued the policy.” This action followed.

There was ample evidence at trial from which the jury could conclude that the decedent had a serious drinking problem and had been treated for excessive use of alcohol. Dr. Jeppson, his family physician, testified that he had treated decedent for alcoholism from 1974 to 1976, including prescriptions for antabuse, a drug used for patients otherwise unable to control their drinking. Dr. Jeppson also recommended consultation with a psychiatrist, Dr. Nielsen. Dr. Nielsen saw the decedent almost weekly through most of 1976 and several times in 1977 for treatment of various problems including drinking. While Dr. Nielsen concluded that the decedent was not an alcoholic, he did diagnose his problem as alcohol abuse, and encouraged him to continue taking antabuse. Dr. Nielsen testified that the decedent was a “binge” drinker, who drank impulsively without regard for the consequences. The blood alcohol level reported at the time of his death (.088%) indicated the ingestion of about five drinks in one hour’s time.

In his signed “Life Application,” dated Sept. 14, 1977, the insured answered the following question as noted:

10. Have you ever received treatment or joined an organization for alcoholism or drug habit? yes no
_ _x_

In the “Medical Examiner’s Report-Adult, Medical History Portion of Life Application,” dated Sept. 29, 1977, which was also signed by the insured, he answered the following question as noted:

*968 2. Have you ever been treated for or ever had any known indication of:
1. Excessive use of alcohol, tobacco, or any habit-forming drugs? yes no
_ _x_

.So far as material to this appeal, the special verdicts of the jury found as follows:

1. That the decedent’s answer to question No. 10 on the Life Application was not an omission, an incorrect statement, or a misrepresentation;
2. That the decedent’s answer to question No. 2.1. on the Medical History was an omission, an incorrect statement, and a misrepresentation; and
3. That although the answer to question 2.1. was not fraudulent, it was material to the acceptance of the risk and material to the hazard assumed by the insurer; and
4. That the insurer would not have issued the policy and would not have issued the policy at the same premium rate or in as large an amount if the true facts had been made known as required in the application. 2

Consistent with these special verdicts, the district court entered judgment for the defendant insurer.

The jury’s special verdict that there was no omission, inaccuracy, or misrepresentation on the question having to do with “alcoholism” disposes of that basis for the insurer’s denial of plaintiff’s claim. This appeal must therefore turn upon whether the jury could properly hear evidence and rely upon the decedent’s false answer to question 2.1. of the Medical History that he had never been treated for excessive use of alcohol.

I.

WAS THE MEDICAL HISTORY PART OF THE POLICY?

Plaintiff first argues that the Medical History, which contained decedent’s false denial that he had ever been treated for excessive use of alcohol, is not part of the 1 policy and was therefore inadmissible in evidence under U.C.A., 1953, § 31-19-7(1), which reads as follows:

No application for the issuance of any life or disability insurance policy or annuity contract shall be admissible in evidence in any action relative to such policy or contract, unless a true copy of such application was attached to, or otherwise made a part of the policy or contract when issued.

Plaintiff challenges the district court’s specific finding “under our statute and the business practices of the carrier that this [Medical History] is a portion of the policy, it’s included in the policy.” As a result of this finding, the court permitted the Medical History to be introduced in evidence and later allowed the jury to consider the insured’s answer to question 2.1. in their deliberations. Plaintiff attacks the trial court’s ruling as contrary to plaintiff’s testimony that she did not remember finding a copy of the Medical History with the insurance policy in the family financial papers. In support of the court’s conclusion, the insurer refers to testimony that it was standard procedure for the insurer to attach a copy of the Medical History and Life Application to each policy when it was issued, that there was no evidence that this procedure varied in this case, and that the Medical History form that was introduced in evidence was in the insurer’s file. In addition, the insurer points to the following language that appears just above the insured’s signature on the Medical History: “this Medical History shall be a part of the application for life insurance on my life.”

On appeal, the record is reviewed in the light most favorable to the findings and action of the trial court, which are entitled to a presumption of validity and will not be disturbed if they are supported by substantial, competent evidence. Search v. Union Pacific Railroad Co.,

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Bluebook (online)
656 P.2d 966, 1982 Utah LEXIS 1042, Counsel Stack Legal Research, https://law.counselstack.com/opinion/williams-v-state-farm-insurance-co-utah-1982.