Barker v. Federated Life Ins. Co., 41127
| Decision Date | 09 February 1965 |
| Docket Number | No. 41127,No. 3,41127,3 |
| Citation | 141 S.E.2d 206,111 Ga.App. 171 |
| Parties | C. H. BARKER v. FEDERATED LIFE INSURANCE COMPANY |
| Court | Georgia Court of Appeals |
Syllabus by the Court
An insurer cannot recover the payment of a claim made by mistake without showing a valid reason for failing to ascertain the truth.
The plaintiff sued on a group life insurance policy covering his deceased wife, for the face amount of the policy, penalty and attorney's fees for bad faith. By answer and cross action the defendant (Federated Life) alleged that it held an assignment of a claim of Federated Mutual Implement and Hardware Insurance Company (which owned Federated Life) against the plaintiff for an alleged payment by mistake to the plaintiff of a claim for hospitalization insurance benefits under a group policy of Federated Mutual, and that it had tendered to plaintiff $6,200--the amount of the life insurance policy, $7,500 less the amount of its assigned claim, $880. After the parties presented evidence the court directed a verdict for the plaintiff for $6,200. The plaintiff assigns error on the judgment overruling his motion for new trial on the ground that the evidence on the defendant's assigned claim for reimbursement of hospitalization insurance benefits paid to plaintiff by Federated Mutual did not authorize the verdict directed.
Guy B. Scott, Jr., Athens, for plaintiff in error.
Erwin, Birchmore & Epting, Nickolas P. Chilivis, Athens, for defendant in error.
The evidence showed that the plaintiff's wife was hospitalized in 1961 from January 3 to March 15, and the plaintiff filed a claim with Federated Mutual, including a physician's certificate dated April 27, 1961, stating that the plaintiff's wife was treated for 'metastatic carcinoma with pathological fracture of right femur,' and that she had been treated in 1958 by 'radical mastectomy, right.' This claim was filed on May 26, and paid on September 26, 1961, after Federated Mutual checked to determine whether there was a relation between the condition for which she had been treated in 1958 and the condition for which she was hospitalized in 1961. The patient was again admitted to the hospital on March 18, 1961, and remained there until November 23, 1961. The plaintiff filed a claim with Federated Mutual for this hospitalization including the physician's statement dated November 16, 1961, that the 'nature of sickness or injury' was 'metastatic carcinoma.' This claim was filed on January 19 and paid ($880) on January 25, 1962.
A physician's testimony was that the plaintiff's wife's disease was cancer that had spread to the bones of the body from an origin in another organ of the body; that he first noticed bone fractures by X-ray examination on March 18, 1961; that bone fractures are normally expected in this disease; and that the fractures he observed in this patient were in his opinion due to the disease, whether or not the patient might have had a fall or trauma; and that all her treatment during both hospitalizations was for cancer.
The defendant contends that Federated Mutual's payment of the second claim was made in error because the policy provides that hospitalization benefits are payable for a maximum of 70 days during any one period of confinement, and 'Successive periods of confinement shall be considered one period of confinement unless: 1. the subsequent confinement commences after return to active full-time work and after complete recovery from the injury or sickness causing the previous confinement, or 2. the subsequent confinement is due to causes entirely unrelated to the causes of the previous confinement.'
The general authorities conclude from decided c...
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Gulf Life Ins. Co. v. Folsom
...a valid reason for failing to ascertain the truth. See e.g., Atlanta Coach Co. v. Simmons, 184 Ga. 1 (1937); Barker v. Federated Life Ins. Co., 111 Ga.App. 171 (1965). See also Bohannon v. Manhattan Life Ins. Co., 555 F2d 1205, 1212 (5th Cir.1977). 1 In addition, Georgia courts have placed ......
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Gulf Life Ins. Co. v. Folsom
...a valid reason for failing to ascertain the truth. See e.g., Atlanta Coach Co. v. Simmons, 184 Ga. 1 (1937); Barker v. Federated Life Ins. Co., 111 Ga.App. 171 (1965). See also Bohannon v. Manhattan Life Ins. Co., 555 F2d 1205, 1212 (5th Cir.1977). 1 In addition, Georgia courts have placed ......
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...version of the voluntary payment statute addressed itself to "[p]ayments of taxes or other claims" (see Barker v. Federated Life Ins. Co., 111 Ga.App. 171, 173, 141 S.E.2d 206 (1965), quoting Civil Code 1933, § 20-1007), the modern version speaks only of "payment of claims," an acknowledgme......
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...subject to a number of limitations, such as where the insurer is grossly negligent in making payment, e.g., Barker v. Federated Life Ins. Co., 111 Ga.App. 171, 141 S.E.2d 206 (1965), or where the payee is an innocent third party and such payee is a creditor of the insured and had no notice ......