Majority
Headnote
1. Benefit Insurance—Health of Applicant—Misrepresentations.The action is brought to recover the sum of $2,000 upon a beneficiary certificate issued by the defendant on the nth day of November, 1895, to Charles Hopkins Jennings, who died on the 18th day of February, 1898, after having been admitted to membership in its Star Council No. 44 at Danbury, Conn. The plaintiff is the widow of the decedent, and in application for membership he designated her as his beneficiary, and, according to the terms of the beneficiary certificate, the beneficiary fund is payable to her. The defendant contested the claim on account of alleged breaches of warranty, misrepresentations, and fraudulent concealment of facts by Jennings in his application and in the medical examination. The other material facts were admitted upon the trial, and the only issues litigated were those arising on these affirmative defenses interposed by the defendant.
Before the close of the evidence the court ruled that the answers made by the decedent in the medical examination were warranties of the facts. At the close of all the evidence a motion was made for a dismissal of the complaint. The court reserved its decision, and submitted seven questions to the jury for special findings. Counsel for the defendant excepted to the refusal of the court to grant his motion, and to the submission of such questions. The court directed a verdict for the plaintiff upon the special findings of the jury. Neither party asked to go to the jury upon any other question; but the defendant excepted to such direction of a verdict. The questions which we deem important will be discussed separately.
First. The plaintiff interposed no reply, but upon the trial she gave evidence tending to show a waiver or estoppel on the part of the defendant from interposing this defense on account of an investigation instituted by the defendant’s supreme council in the month following Jennings’ admission to membership. If the defendant in the lifetime of Jennings became aware of all the facts upon which it is now contesting this claim, and acquiesced in his remaining in the order, and continued to receive dues and assessments from him down to the time of his death, undoubtedly it would be deemed to have waived such defense, and would be estopped from interposing the same. Phoenix Life Ins. Co. v. Raddin, 120 U. S. 183 , 7 Sup. Ct. 500 , 30 L. Ed. 644 ; Titus v. Glens Falls Ins. Co., 81 N. Y. 410 ; McClure v. Supreme Lodge, 41 App. Div. 131 , 59 N. Y. Supp. 764 ; Morrison v. Wisconsin Odd Fellows Co., 59 Wis. 162 , 18 N. W. 13 ; Bacon on Ben. Soc. §§ 104A, 427, 431, 841, 844. Upon the trial, however, the court ruled that the evidence offered by the plaintiff was insufficient to establish either a waiver or estoppel. The evidence being insufficient to establish a waiver or estoppel as matter of law, it does not avail to sustain the judgment; and whether it was sufficient to present a question for the jury may not properly be determined on the defendant’s appeal.
The second question submitted to the jury was as follows: “Second. When was the decedent last attended by a physician prior to the 20th day of January, 1895?” By question No. 14 in the medical examination decedent was asked, “When were you last attended by a physician?” and his answer was, “Last January.” The next ques
Third. The application on which the decedent was admitted to membership in the defendant was made on the 10th day of October, 1895, and the medical examination thereunder occurred on the 20th day of the same month. The third question specially, submitted to the jury was, “Had the deceased at any time prior to- the said 20th day of October, 1895, applied for membership in the Loyal Additional Benefit Association?” The jury answered this question in the negative. The applications for membership are made to the Loyal Additional Benefit Association. One of ,the questions put to the decedent in the medical examination was, “Have you ever before applied for membership in the Loyal Additional Benefit Association?” His answer was, “No.” In the month of May, 1895, there was no council of the defendant in Bridgeport, Conn. It appears that after some inquiries the decedent and 31 others signed a petition addressed, “To the Supreme Council, Officers and Members of the Supreme Council of the Loyal Additional Benefit Association,” in the form required by the constitution and by-laws of the defendant, and upon a blank furnished by it, for leave to establish a subordinate council at that place, to be known as “Phoenicia Council, No, 7, of the Loyal Additional Benefit Association.” Upon and pursuant to that petition a council was duly instituted, under the name suggested in the petition, at Bridgeport, on the 7th day of June, 1895. Upon the blank form of petition there was printed in small type, just above the signatures, information to members concerning the fees, dues, and assessments required to'be paid, and that a council could not be instituted with less than 15 members. It was therein stated, among other things, that each charter member must pay “two dollars for medical examination, fifty cents for supervising medical officer’s fee.” The inference is plain, although it does not distinctly appear, that formal applications for membership by each of the petitioners accompanied the petition. It does appear that the decedent signed an application for membership upon the form in use by the defendant, but whether this was signed at the time he signed the petition, or to whom it was delivered or forwarded, does not expressly appear. Dr. Banks was duly commissioned to examine these applicants for charter membership, and the application which decedent signed came into the hands of Dr. Banks, but it does not appear from whom he received it. The decedent subsequently presented himself to Dr. Banks for examination for admission to the defendant association. The application and printed questions for the medical examination were on the same sheet of paper, which, when folded, formed four pages. The doctor read the questions in the medical examination to decedent, and wrote his answer's thereto, and then decedent subscribed the same. Dr. Banks informed the decedent that he could 'not pass or recommend him for membership. Both the application and the medical examination were placed in a pigeonhole in the doctor’s desk, and there they remained until some
Fourth. Dr. Osborne, of Pasadena, Cal., was- examined as a witness for the defendant by commission. It appeared that he had attended Jennings’ father and mother professionally when Jennings resided with them at Southport, Conn., in the year 1895, and that, when making professional visits there in attending other inmates of the household, he noticed and observed the physical health and condition of Jennings, the decedent. He was asked to state fully the appearance of Jennings at those times and the knowledge he acquired concerning his health and physical condition, and to fully describe his health and physical condition, and to state what, if any, disease or diseases, ailment or ailments, he was then afflicted with. This was objected to upon the ground that it appeared that Dr. Osborne was the family physician of the decedent, and the objection was sustained,
Fifth. Dr. Oley, who examined and passed the decedent at the time he was admitted to membership in the defendant, was called as a witness for the plaintiff. On his direct examination he was asked concerning an interview between him and some of the officers of the defendant after the death of Jennings at a time when the alleged first application and medical examination, had before Dr. Banks in May, 1895, were exhibited to him. He testified that Mr. Apgar, the legal adviser and examiner of claims of the defendant, at that time asked him if, in view of the variance between the answers in the two sets of medical examination, he thought Mr. Apgar could approve, or he (Oley) could approve, of the plaintiff’s claim; to which he replied, in substance, that he did not see how Mr. Apgar could, and, “I certainly could not, in face of comparison of those two sets of answers.” He was permitted to explain that these answers were based upon the supposition that the first medical examination was a genuine document, and not false or fictitious. Not content with this, however, counsel for the plaintiff, on redirect examination, persisted in showing, and was permitted to show, that the witness had since changed his mind about the advisability of paying this claim, and the reasons for his change of mind on the subject; one of which was that he had since learned that there had been an investigation by the supreme officers of the defendant into the question during Jennings’ lifetime, which was dropped, as being of no importance. This evidence was all received under defendant’s objections and exceptions to its competency, relevancy, materiality, and that it was usurping the province of the jury.
We are of opinion that this evidence was incompetent, and that its reception constituted prejudicial error. The plaintiff’s counsel, after himself drawing out the declarations of the doctor, adverse to his client, made at that interview, was permitted to show that they were made on the assumption that the first medical examination was a genuine document, which counsel for the plaintiff contested upon’ the trial. It was not competent for him then to place before the jury the weight and influence of the opinion of Dr. Oley in favor "of the payment of this claim, and his reasons for such opinion. Sufficient
Sixth. We are of opinion that the case was tried upon an erroneous theory, and we deem it our duty, for the guidance of the trial court, to give expression to our views upon that subject, although upon the trial the defendant had the benefit of the erroneous rulings, and the question is not, therefore, directly presented by the appeal. Ordinarily, statements of material facts which are within the personal knowledge of an applicant for life insurance are warranties, and their falsity will defeat a recovery on the policy. Clemans v. S. A. R. S. of G. F., 131 N. Y. 485 , 30 N. E. 496 , 16 L. R. A. 33 . But here we think that the statements contained in the application and in the answers to the questions in the medical examination were not warranties as to the facts, but were only representations that such statements were true to the best of the knowledge and belief of the applicant; or, in other words, there was no strict warranty, but merely a warranty that these statements were made honestly, without any fraudulent representation or concealment of fact. Both the application and the medical examination were on printed forms prepared by the defendant, and the rule is that they should be construed most strictly against it, and any ambiguity therein should be resolved in favor of the deceased member. Fitch v. Am. Pop. L. Ins. Co., 59 N. Y. 557 , 17 Am. Rep. 372 ; Moulor v. Am. Life Ins. Co., 111 U. S. 335 , 4 Sup. Ct. 466 , 28 L. Ed. 447 . In the printed application which Jennings was required to sign, he stated, on his honor as a man, “that the statements by me subscribed herein are each and every one of them true to the best of my knowledge and belief.” Then follows the statement, among other things, that he had not within six months been rejected, was not under suspension, and had never been expelled from any council of the defendant; that he was then in good health, and had no injury or disease which would tend to shorten his life; and, “I do hereby warrant the truthfulness of the statements in this application, and consent and agree that any untrue or fraudulent statements, or any concealment of facts therein, or to or from the medical examiner,” should forfeit his rights and those of his beneficiary. The only provision of the medical examination material on this question is at the close, and just preceding Jennings’ signature, where the following appears: “I hereby warrant the truthfulness of all answers given to the above questions.” The beneficiary certificate upon which the action is based declares, that both the application and medical examination form a part of the contract. In the medical examination innumerable questions are asked as to whether the applicant or certain of his relatives ever had ailments or diseases particularly specified. As to many of these it ' is manifest that the applicant could have no personal knowledge, and'that his information would be family tradition or hearsay. The clause quoted from the medical examination, which it is claimed is a warranty of the facts, literally relates to all answers contained in the medical examination. Another rule applicable to the decision
We are also of opinion that the application and medical examination should be construed together and alike. As has been seen, in the medical examination there is no express reference to the application, but in the application there is an express reference to the medical
The case of Foley v. Royal Arcanum, 78 Hun, 222 , 28 N. Y. Supp. 952 , 151 N. Y. 196 , 45 N. E. 456 , 56 Am. St. Rep. 621 , is distinguishable in that there an express warranty of the truthfulness of the statements was not qualified, as here, by a clause showing that the warranty was intended to be that they were true to the best of the knowledge and belief of the applicant. Moreover, as shown by the opinion at General Term, it was immaterial whether they were warranties or representations, for the applicant knew he had the diseases and had been treated therefor.
For the reasons stated, the judgment and order should be reversed, and a new trial granted, with costs to appellant to abide the event.
VAN BRUNT, P. J., and PATTERSON, J., concur. HATCH, J., concurs in the first, fourth, and sixth propositions discussed in this opinion. INGRAHAM, J., concurs in result.
Footnotes
- V V 3. See Insurance, vol. 28, .Cent. Dig. § 568.
Cases cited
- Phænix Life Insurance v. Raddin 120 U. S. 183 p. 91, p. 99
- Titus v. Glens Falls Insurance 81 N. Y. 410 p. 91
- McClure v. Supreme Lodge, Knights of Honor 41 App. Div. 131 p. 91
- Dilleber v. Home Life Insurance 69 N. Y. 256 p. 94
- People v. Koerner 154 N. Y. 355 p. 96
- Griffiths v. Metropolitan Street Railway Co. 171 N. Y. 106 p. 96
- Green v. Metropolitan Street Railway Co. 171 N. Y. 201 p. 96
- Patten v. United Life & Accident Insurance 133 N. Y. 450 p. 96
- Clemans v. Supreme Assembly Royal Society of Good Fellows 131 N. Y. 485 p. 98
- Fitch v. American Popular Life Insurance 59 N. Y. 557 p. 98
- Moulor v. American Life Insurance 111 U. S. 335 p. 98
- Butler v. Supreme Council Catholic Benevolent Legion 43 App. Div. 531 p. 99
- Van Nostrand v. Marvin 161 N. Y. 650 p. 99
- Louis v. Connecticut Mutual Life Insurance 58 App. Div. 137 p. 99
- Ames v. Manhattan Life Insurance 40 App. Div. 465 p. 99
- Fitzgerald v. Supreme Council of Catholic Mutual Benefit Ass'n 167 N. Y. 568 p. 100
- Sternaman v. Metropolitan Life Insurance 170 N. Y. 13 at 62 p. 100
- Foley v. Royal Arcanum 151 N. Y. 196 p. 101