Haman v. Pyramid Life Ins. Co.
| Decision Date | 05 June 1961 |
| Docket Number | No. 7912,7912 |
| Parties | Fannie L. HAMAN, Plaintiff-Respondent, v. PYRAMID LIFE INSURANCE COMPANY, a corporation, Defendant-Appellant. |
| Court | Missouri Court of Appeals |
Oliver & Oliver, Richard D. Jones, Cape Girardeau, for appellant.
Dwight Crader, Sikeston, for respondent.
This is an action to collect benefits on a hospital, surgical, medical and special services expense policy. Plaintiff recovered a verdict and judgment against defendant for $735. Defendant appealed.
The petition alleged, inter alia, that on July 21, 1958, defendant executed and delivered to plaintiff its policy of insurance by which it agreed to pay the benefits provided therein for expenses of hospital confinement, medical treatment and other specified expenses incurred while the policy is in force; that while said policy was in force plaintiff became ill and entered the Missouri Delta Community Hospital at Sikeston, Missouri, on March 9, 1959, remaining there until March 18, 1959; re-entered said hospital on March 26, 1959, remaining therein until April 2, 1959, and re-entered April 28, 1959, remaining until May 22, 1959; that because of such sickness defendant became liable for benefits as provided in said policy for hospital confinement, medicines, drugs, dressings and supplies, x-ray examinations, room service for forty days, including doctor bills in the sum of $735.
The defense of appellant was based upon certain false answers in the application for the purported policy, which appellant maintains were misrepresentations and fraudulent concealments of true answers to these questions contained in the application, and further that the policy was rescinded and cancelled, and all premiums tendered back to the respondent, which she refused to accept. The policy sued on contained the following:
'Part 10 Time Limit on Certain Defenses
'(a) After three years from the date of issue of this policy no misstatements, except fraudulent misstatements, made by the applicant in the application for such policy shall be used to void the policy or to deny a claim for loss incurred after the expiration of such three-year period; (b) No claim for loss incurred after three years from the date of issue of this policy shall be reduced or denied on the ground that a disease or physical condition not excluded from coverage by name or specific description effective on the date of loss had existed prior to the effective date of coverage of this policy.
'Part 12 Limitations and Exclusions Standard Provisions
'Additional Provisions
* * *'
The application for the policy contained, in part, the following questions and answers:
It is appellant's contention that respondent admitted in the trial that the answers to questions numbered 6, 8, and 9 of the application were false; that the policy was issued in consideration thereof so that respondent's misrepresentations as to such false answers induced appellant to rely thereon to its detriment and that because of such false answers respondent is barred from recovery under the policy.
It is respondent's contention that at the time of applying for the policy she truthfully stated to the agent the facts involved in the risk and the agent, without knowledge or collusion of the insured, inserted false statements in the application, therefore appellant cannot set up such misstatements in avoidance of the policy.
Appellant admits that on July 21, 1958, it issued and delivered to respondent the insurance policy sued on; that as a part thereof it contained the application, signed by respondent. Respondent admits she signed the application.
Respondent testified that appellant's agent, a Mr. MacDonald, first talked to her about the insurance July 15, 1958, and, at that time, asked about the condition of her health; that she explained to him she was in good health, all except arthritis in her knees; that he said that made no difference. She stated she asked him to return the next day as she wanted to consult her banker about taking out the policy; that the agent returned and at that time she told him she would take the policy. She testified that when the agent returned she invited him into the house and they sat down in the living room, she on the divan and the agent in a chair a little beyond her; that she and the agent were the only ones present at the time the application was made. She stated the agent asked all the questions and wrote the answers down; that he only asked her four questions--her name, residence, occupation and post office box; that he never asked her questions contained in the application numbered 6, 8, 9, 10, and 11, and that she did not give the answers contained therein. Respondent testified:
She testified she did not read the application before signing it. She stated:
Respondent stated she paid the agent $24.85, the premium on the policy for three months and had paid all premiums on said policy since receiving it.
Respondent testified that the agent sat down and wrote in the answers to the questions on the application, which was on his lap; that she could see him writing. She gave this evidence:
'Q. Did he have to get up to hand you the application? A. No, we were close enough that he handed me the application and I signed it, because I had answered all the questions that he asked me.
'Q. You have no difficulty reading the application I assume, from what you say? A. Oh, no, I can read it. You mean now?
'Q. Yes. A. I can read it.
Q. You could have read it on that day, too? A. Oh, yes, I could have, but I didn't read the whole thing, no. I just----
'
'
Respondent testified that in 1956, while visiting her son in Arkansas, she had an attack and was treated by Dr. Hyber, who thought she had some gall bladder trouble and advised her upon returning home to see her family doctor; that in 1956, approximately two years prior to the date of the application for insurance, she went to the Missouri Delta Community Hospital in Sikeston for a checkup; that she was treated by Dr. McClure, who diagnosed her case as diverticulitis; that she did not know whether this trouble she had back in 1956 continued up until her treatment in 1959. She admitted that at the time she signed the application for insurance she knew she had been in the hospital and had been treated for diverticulitis but stated that appellant's agent had not asked her if she had been in the hospital. She gave this evidence:
Respondent admitted, in her deposition, that...
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