Brinkoetter v. Pyramid Life Ins. Co.
| Decision Date | 06 April 1964 |
| Docket Number | No. 23999,23999 |
| Citation | 377 S.W.2d 560 |
| Parties | Pearl BRINKOETTER, Appellant, v. PYRAMID LIFE INSURANCE CO., Respondent. |
| Court | Missouri Court of Appeals |
Rogers, Field & Gentry, Robert L. Shirkey, Kansas City, for appellant.
Caldwell, Blackwell, Sanders & Matheny, Kansas City, for respondent.
This is a suit brought in the Circuit Court of Jackson County by Pearl Brinkoetter, plaintiff-appellant, against Pyramid Life Insurance Company, defendant-respondent, for certain hospital and medical expenses claimed to be covered by a 'Health and Accident' insurance policy. Plaintiff obtained a jury verdict and judgment in the sum of $560.00. The trial court set this judgment aside and entered judgment for defendant. Plaintiff has appealed.
The decisive question before us is whether the trial court erred in holding that plaintiff had not made a submissible jury case and in entering judgment for defendant. It is our general duty to review the pertinent evidence in the light most favorable to plaintiff and to give her the benefit of every inference reasonably deductible therefrom. Plaintiff is, of course, bound by her own testimony. Tomlin v. Alford, Mo.Sup., 351 S.W.2d 705(3).
Plaintiff previously had a 'Health and Accident' insurance policy with the defendant which she had allowed to lapse. Shortly after this policy had lapsed plaintiff became ill and was hospitalized on July 10, 1960 for approximately ten days. We quote her testimony concerning her hospitalization: '* * * they took x-rays, they told me I had ulcers * * * gave me medication and some more, a series of x-rays.' She was then released thinking she was all right, but did go back a month later for more tests which she stated reassured her she was all right.
On October 7, 1960, after an agent of defendant had solicited her, she made an application for a new policy with defendant. The application form for the policy contained, among others, these questions and her answers: '6. Are you * * * now in good health and free from any physical or mental defect? Yes. 8. Have you * * * ever had any disease of the heart, lungs, kidneys, stomach, or bladder * * *? No. 9. Have you, or any member of the Family Group to be insured, received medical or surgical advice or treatment within the past three years? Yes. If answer is After talking with plaintiff, the insurance agent had filled in these answers based on what she told him. The portion, 'Check files on H-14 lapse & # FR-158580' was later added to the application by defendant's agent. Nothing in that file in any way referred to ulcers or to any stomach illness or disease.
Plaintiff's version of the occurrence is: ? .
Plaintiff explained by saying that although her ulcers were located in her stomach she did not understand that having ulcers was a disease. Thereafter, on October 7, 1960, the policy which is the subject of this suit was issued to plaintiff.
Plaintiff acknowledged that between July of 1960 and January of 1961 she had 'a slight pain in the stomach' and was taking x-rays to see if she had a recurrence. In January, 1961, she reentered the hospital for a stomach operation for stomach ulcers that she had, and approximately two-thirds of her stomach was removed for that cause. Her resultant hospital and medical expenses totaled at least $560.00.
Defendant refused to pay her hospital and medical bill on the ground the mentioned answers in the application for insurance were deliberately a false misrepresentation of a material matter upon which defendant had relied in issuing its policy.
In accordance with the view we have taken of the case it is unnecessary to state defendant's evidence which, in the main, was to the same general effect as that given above by plaintiff. Defendant did adduce evidence that it relied on plaintiff's quoted answers to its detriment, and would not have issued the policy without an exception of this disease if plaintiff had given true answers to the questions.
The health of an applicant for insurance upon his health is of vital importance to the insurer, and questions to elicit pertinent information on the subject in regard to what disease the applicant has or has had are proper to be asked and should be truthfully answered. Good faith on the part of both the insurer and the applicant is called for.
The pertinent general rule is that an intentional material...
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