Case Name: Allen GREEN, as Personal Representative of the Estate of Harold Green, Individually, Appellant, v. LIFE & HEALTH OF AMERICA, a foreign corporation authorized to do business in the State of Florida, Appellee
Court: Florida District Court of Appeal
Jurisdiction: Florida
Decision Date: 1997-04-09
Citations: 692 So. 2d 220
Docket Number: No. 96-1418
Parties: Allen GREEN, as Personal Representative of the Estate of Harold Green, Individually, Appellant, v. LIFE & HEALTH OF AMERICA, a foreign corporation authorized to do business in the State of Florida, Appellee.
Judges: POLEN, J., concurs.
Reporter: Southern Reporter, Second Series
Volume: 692
Pages: 220–224

Head Matter:
Allen GREEN, as Personal Representative of the Estate of Harold Green, Individually, Appellant, v. LIFE & HEALTH OF AMERICA, a foreign corporation authorized to do business in the State of Florida, Appellee.
No. 96-1418.
District Court of Appeal of Florida, Fourth District.
April 9, 1997.
Rehearing Denied May 16, 1997.
Shelley H. Leinicke of Wicker, Smith, Tu-tan, O’Hara, McCoy, Graham & Ford, P.A, Fort Lauderdale, for appellant.
Nancy W. Gregoire of Bunnell, Woulfe, Kirschbaum, Keller & McIntyre, P.A, Fort Lauderdale, for appellee.

Opinion:
SHAHOOD, Judge.
In March 1991, Harold Green ("Green") applied for a home health care benefits policy with appellee, Life & Health Insurance Company of America, ("Life & Health"). The application contained a section which listed nine medical conditions and asked "Have you or your spouse within the past 5 years had or been told you have the following conditions." Next to each condition, including "kidney failure" and "chronic obstructive lung disease," Green checked the box for "no". The application also contained the following language to which Green signed his name: "The answers given by me are full, true and complete to the best of my knowledge and belief. All statements made herein are deemed representations and not warranties." Life & Health issued the policy.
One year later, Green made a claim against the policy. At that time, Life & Health reviewed Green's medical records and discovered that he suffered from chronic renal failure. As a result, Life & Health rescinded the policy and returned all of the previously paid premiums. Green filed suit against Life & Health seeking reimbursement pursuant to the insurance policy for the cost of his hospitalization and post-hospitalization care. Life & Health answered the complaint asserting that the insurance policy had been rescinded due to a material misrepresentation made in the application. Green died shortly after the initiation of the lawsuit and his personal representative, Allen Green ("appellant"), was substituted as a party.
Life & Health moved for summary judgment asserting that it had issued a home health care benefits policy to Green based on his representations in the application that he did not suffer from kidney failure or chronic obstructive lung disease. In support of its motion for summary judgment, Life & Health submitted the deposition of Dr. Ross Nochimson, a doctor of internal medicine who had treated Green since approximately December 1988. Dr. Nochimson referred to Green's medical chart from 1991 wherein he had written that Green suffered from chronic obstructive pulmonary disease ("COPD"). Dr. Nochimson testified, however, that he probably told Green that he had "a little asthma" or "a little bronchitis." In addition to COPD, Green had also been diagnosed as having diabetes mellitus, gout, and chronic renal failure. With regard to the renal failure, Dr. Nochimson testified that he told Green that he had "some sluggish kidneys." The doctor stated that it is his practice to use layman's terms instead of medical terms when informing patients of their conditions.
Green's son testified by way of affidavit that he accompanied his father to his doctors' appointments and that at no time in 1991 did any doctor either state that Green had kidney failure or suggest kidney dialysis. According to his son, Green's various physicians told him only that he had slow kidneys or small kidneys.
The trial court entered summary final judgment in favor of Life & Health finding that, under section 627.409, Florida Statutes (1993), an insurance company has the right to deny coverage "based upon any misrepresentation materially affecting risk, even if such misrepresentation was made in good faith." The relevant portions of section 627.409, Florida Statutes (1993), are as follows:
Representations in applications; warranties -
(1) Any statement or description made by or on behalf of an insured or annuitant in an application for an insurance policy or annuity contract, or in negotiations for a policy or contract, is a representation and is not a warranty. A misrepresentation, omission, concealment of fact, or incorrect statement may prevent recovery under the contract or policy only if any of the following apply:
(a) The misrepresentation, omission, concealment, or statement is fraudulent or is material either to the acceptance of the risk or to the hazard assumed by the insurer.
(b) If the true facts had been known to the insurer pursuant to a policy requirement or other requirement, the insurer in good faith would not have issued the policy or contract, would not have issued it at the same premium rate, would not have issued a policy or contract in as large an amount, or would not have provided coverage with respect to the hazard resulting in the loss.
The issue according to the statute, then, is not whether the applicant intentionally gives misinformation, but whether said information materially affects the risk.
In Continental Assurance Co. v. Carroll, 485 So.2d 406, 409 (Fla.1986), the supreme court considered section 627.409 and held that "[t]he plain meaning of the statute indicates that, where either an insurer would have altered the policy's terms had it known the true facts or the misstatement materially affects risk, an unintentional misstatement in an application will prevent recovery under an insurance policy." See also Morrone v. State Farm Fire and Cas. Ins. Co., 664 So.2d 972 (Fla. 4th DCA 1995)(misrepresentations in application for insurance need not be knowingly made in order to void policy.) In so holding, the court emphasized that Life Insurance Co. v. Shifflet, 201 So.2d 715 (Fla.1967), which stands for the proposition that misrepresentations need not be knowingly made in order to void the policy, is still good law.
The supreme court's holding in Carroll compels us to affirm the trial court's grant of summary judgment in the instant case despite the undisputed evidence that Green had no knowledge of his condition and any misrepresentation was therefore unintentional. Nevertheless, we acknowledge the line of cases from the Eleventh Circuit which hold that "knowledge and belief' language in a contract drafted by the insurer imposes a different standard of accuracy than that provided in section 627.409(1). Hauser v. Life Gen. Sec. Ins. Co., 56 F.3d 1330 (11th Cir.1995); National Union Fire Ins. Co. v. Sahlen, 999 F.2d 1532 (11th Cir.1993); William Penn Life Ins. Co. v. Sands, 912 F.2d 1359 (11th Cir.1990). Under these cases, innocent misstatements or omissions do not justify the insurance company's reeision of a policy where the contract requires only that the applicant answer to the best of his knowledge and belief. Contrary to the standard enunciated by the statute, the relevant inquiry under this authority is what did the applicant believe to be true, and not whether the misstatement was material to the risk. Hauser, 56 F.3d at 1335; Sands, 912 F.2d at 1365.
We note that in a situation factually similar to that in the instant ease, the First District Court of Appeal recently applied Sands and its progeny in reversing the trial court's grant of summary judgment in favor of an insurance company. Carter v. United of Omaha Life Ins., 685 So.2d 2 (Fla. 1st DCA 1996)(summary judgment in favor of insurer reversed because material fact issues existed as to whether insured's answers on application were material misstatements under "knowledge and belief' standard). Therefore, while we affirm the trial court's grant of summary judgment in favor of Life & Health based upon section 627.409, Florida Statutes (1993), we certify conflict with the First District's holding in Carter.
POLEN, J., concurs.
PARIENTE, J., dissents with opinion.