Metropolitan Life Ins. Co. v. Bates
| Decision Date | 04 August 1948 |
| Docket Number | 16117. |
| Citation | 49 S.E.2d 201,213 S.C. 269 |
| Parties | METROPOLITAN LIFE INS. CO. v. BATES. |
| Court | South Carolina Supreme Court |
Hubert E. Nolin and Benjamin A. Bolt, both of Greenville, for appellant.
Haynsworth & Haynsworth, of Greenville, for respondent.
Already holding three life insurance policies aggregating over $8000 in respondent Company, for the oldest of which ($5000) he had been medically examined by a physician of the Company's choosing on March 9, 1945, applicant was repeatedly solicited by the agents of respondent to purchase an accident and health policy. This he applied for on April 15, 1946, and the application form was filled and witnessed by an agent, and applicant signed. Negative answers to two of the questions in the application are now concerned. One was whether applicant ever had, or been treated for numerous diseases and symptoms including any disease of the stomach, vertigo and dizziness. The other relevant question was whether applicant had within the last five years medical or surgical advice or treatment or other departure from good health. The application was handled in the usual manner and forwarded to the Company with a satisfactory report of inspection which was vouched and signed by the Assistant District Manager and the District Manager. There was no additional medical examination and no advance collection of premium. Policy was issued in due course by the Company at its home office and forwarded to the Greenville branch office for delivery. When such was attempted appellant objected to the annual payment of premium and an agent for the Company prepared another application providing for a semi-annual instead of annual premium. This was dated May 24, 1946, and was identical with the first and likewise contained negative answers to the stated questions which were inserted by one of the soliciting agents, and was signed by appellant. On the same date the Company's agent procured appellant's signature to another form which was entitled 'Request for change in mode of premium payment' and provided semi-annual instead of annual payments.
Policy in accord with the request was thereafter issued and delivered to appellant, dated May 24, 1946, and to it was attached copy of the application of the same date. Sec. 7987-1, Code of 1942.
Appellant became ill about August 11, 1946, and called a physician who testified that he found appellant suffering from a nervous breakdown which he thought was caused by overwork. He sent appellant to the General Hospital in Greenville whence he was moved on the next day to a hospital in Aiken where he was a patient for over a month. This physician had only casually seen appellant working in his drug store since his return from the Aiken Hospital. He made a physical examination when called to appellant about Aug. 11 and the latter gave a history of an attack of dizziness while driving his automobile; he was found to have a hypertension.
Appellant made claim on account of his illness for the policy benefits which respondent refused. The latter gave notice on November 18, 1946, of cancellation of the policy on November 24, 1946 in accord with its right under its terms and thereafter commenced this action June 19, 1947 in the Court of Common Pleas for rescission of the policy contract upon the grounds that the negative answers to the questions constituted a warranty by the insured that the facts were as indicated by his answers; that the latter were false; that the respondent relied upon the answers and issued the policy but on November 18, 1946, had advised the insured that the policy would not be renewed, and upon discovering erroneous answers in the application tendered back the premium which had been paid together with interest, but the tender was refused. The prayer of the complaint was for cancellation of the policy ab initio.
Appellant's answer denied any false or erroneous statements in the application and alleged that his answers in reference to the condition of his health were true. The answer contained a counterclaim upon the alleged liability of the Company under the policy for appellant's illness, including weekly indemnity of $50 for nine weeks' disability, hospital expenses, etc., all aggregating $1555, for which judgment was demanded against respondent. There was a reply to the answer which admitted the refused claim, denied liability under the policy, again alleged the erroneous answers to questions in the application upon which respondent relied and without them would not have issued the policy; further that appellant's disability resulted from sickness contracted prior to the date of the policy, liability for which was excluded under the terms of the latter.
Trial of the issues was commenced before a jury but at the close of the evidence the Court directed verdict in favor of respondent, that is, for appellant in the amount of the premiums paid. The grounds of respondent's motion are here copied from the transcript:
'We would like to move for a directed verdict on the grounds that this policy of insurance was void in its inception on the grounds that the application--and that the amount has been tendered back--that is admitted in the answer--on the grounds that the application contains misstatements, which the testimony conclusively shows, at least the only conclusion from the testimony is that these were misstatements, and that said misstatements were warranties.
'Now, if they be construed not as warranties, then we submit that we are still entitled to a directed verdict on the grounds that they are either a condition precedent or that they were statements material, representation material to the risk, and we are entitled as a matter of law that since they are misstatements and they are material to the risk to a directed verdict.'
In the course of the ruling the court held that the questioned answers were representations rather than warranties, which matter is not necessarily before us in the absence of appeal or sustaining ground but it will be later noticed. Our problem then is to determine whether the evidence was reasonably susceptible only of the inference that there were false representations, material to the risk and knowingly made with the intention to mislead the company into issuance of the policy, which they did. Kizer v. Woodmen of the World, 177 S.C. 70, 180 S.E. 804. Nix v. Sovereign Camp, W.O.W., 180 S.C. 153, 185 S.E. 175.
Respondent's medical witness, Dr. Lipscomb, testified that he was called to appellant's home to see him on November 29, 1945, and found him with a respiratory infection and cold, gave him something for his stomachache and recommended that he go to his office for a check-up. This appellant did next day and the witness examined him, including a metabolism test. The doctor said that appellant gave him a history of gall bladder trouble and said that he had had an X-ray a year or so before, but he did not produce the picture and the doctor never saw it. The occasion of the consultation was appellant's complaints of dizziness, discomfort and pain in his chest and upper abdomen. Examination disclosed a mild anemia and slight hypo-thyroid. The doctor gave him something for his stomachache, advised him as to diet and also administered a small dose of thyroid. The thyroid condition was all that the examiner found although he was of the opinion, from the patient's history, that there was a chronic gall bladder disease.
Also offered as a witness by respondent was another doctor who was a specialist in X-ray. His records disclosed an X-ray of the gall bladder of William J. Bates, which is appellant's name, made on June 3, 1942. Other evidence indicated that Bates' father sometimes went by the same initials and they were associated together in the operation of drug stores. The X-ray expert witness had no recollection of appellant's call for an X-ray examination, and did not know him or his father. He testified solely from his records. The picture showed a disease of the gall bladder and the opinion of the witness was that the possessor of it would be a sick man and would have needed the services of a physician before 1945. He said that the patient of whom the X-ray was made was referred to him by Dr. C. O. Bates.
The last named physician testified for the appellant that he had never had appellant as a patient and therefore had not referred him to the X-ray expert. However, he had practiced for appellant's father, whom he knew as Dr. John Bates and the son (the appellant) as Bill Bates. He operated on Dr. John Bates for removal of his gall bladder in 1934. The X-ray expert was in practice in Greenville at that time.
Only the items of this medical testimony which are considered most important have been recounted. With respect to it appellant testified that his wife's call of the physician to him at his home on November 29, 1945, was because he was sick at his stomach and the doctor advised him to come to the office next day for a metabolism test, which he did, and if the doctor got any information from him with respect to gall bladder trouble, it was in reference to his father's history of that. He denied that he had any X-ray examination in 1942 or at any other time for gall bladder or any other trouble. He recalled going with his father for the latter's X-ray examination; and he had never told anyone that he had had any gall bladder ailment.
It is impossible to conclude upon this conflicting evidence that there is only one reasonable inference as to the accuracy of it. It made an issue for the jury and should have been so submitted for solution.
The leading case of Rogers v. Atlantic Life Insurance Co., 135 S.C. 89, 133 S.E. 215, 45 A.L.R. 1172, involved negative answers to questions in...
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