Opinion ID: 2161364
Heading Depth: 1
Heading Rank: 1

Heading: Effect of the Medical Examiner's Report.

Text: In order to qualify as a certificate of health or a declaration of fitness, the report of the medical examiner need not be couched in those precise terms. That this is true is demonstrated by Gibson v. Prudential Ins. Co. (1956), 274 Wis. 277, 80 N. W. (2d) 233, and the Frozena Case, supra . In the Gibson Case, at page 287, the court made this amply clear in stating the following: In the case at bar we are obliged to conclude that the statements of the medical examiner that the applicant's condition of hydrocele `should not affect insurable risk' and that `in his opinion the risk was not questionable because of any factor, such as the presence or history of . . . physical defect, etc.,' amounted to a declaration that the applicant was a fit subject for insurance. We are unable to perceive substantial distinction in the purpose and effect of the question here compared to one which may have inquired: `In your opinion is the applicant a fit subject for insurance because of the presence or history of a physical defect, etc.?' This same point was brought out in the Frozena Case, as discussed in Jespersen v. Metropolitan Life Ins. Co. (1947), 251 Wis. 1, 4, 27 N. W. (2d) 775, where the court said: In the Frozena Case, supra , the medical examiner was asked to characterize the risk as `first class, average, doubtful or poor' and he characterized it as `first class.' This amounted to a declaration that the applicant was a fit subject for insurance and brought sec. 209.07 into operation. Based on the foregoing, it becomes clear that no special verbiage is required to constitute the certificate or declaration contemplated in sec. 209.07, Stats., and we must determine whether the medical report, consisting of the two pages of Exhibit 3, is such a certificate or declaration under the statute. The trial court made the following determination with reference to question 20 appearing in the medical examiner's report: This question was phrased so that the insurance company, when reading the medical examiner's answer, would know the medical examiner, in effect, declared the applicant a fit subject for insurance. The appellant, on the other hand, relies upon the Jespersen Case, supra . In that case, at page 4, the court observed that . . . sec. 209.07 does not apply where a medical examiner merely enters his findings with respect to the physical examination and forwards them to the company without comment. The court went on to note the following (p. 4): The medical examiner simply certified height, weight, measurements, pulse, and blood pressure and that he had found no evidence of impairment of the heart, brain, stomach, lungs, etc. These answers were all in response to specific questions required to be answered by the medical examiner and there is nowhere in the record, so far as we can discover, a certification of health or declaration that the applicant is a fit subject for insurance. Our examination of the second page of Exhibit 3, considered in its entirety, persuades us that the trial court was correct in deciding that the report constituted a declaration of fitness for insurance. The medical report consists of two pages. On the first page, the physician records the applicant's answers to numerous questions, most of which relate to the applicant's medical history. On the second page of the report, however, the doctor is asked questions which are significantly different from those on the first page. Unlike the first page, the second page of the report is not to be signed by the applicant. While a few of the questions contained on the second page call merely for the recitation of measurements, the answers to other questions thereon must necessarily involve the doctor's professional appraisal. For example, in question 14, the doctor is asked to evaluate the applicant's general appearance and apparent age. Question 16 reads as follows: Do you find evidence of past or present disease or abnormality of the following? (a) Eyes, Ears, Nose, Throat. Measure markedly impaired vision, corrected and uncorrected. State if hearing aid used. (b) Skin: Thyroid or other Endocrine Glands. (c) Lungs or Pleurae. (d) Abdominal Organs (including Hernia). (e) Musculoskeletal System. (Any deformity?) (f) Vascular System. (Any Varicose Veins?) (g) Nervous System. (Any tremor or abnormal reflexes?) Question 20 reads as follows: In your opinion is there anything detrimental in the habits, surroundings or occupation of the proposed insured? The responses to the foregoing questions appearing on page 2 of the medical report reflect the doctor's evaluation as to the applicant's health. For the purposes of sec. 209.07, Stats., the medical examiner, in effect, gave an opinion as to the applicant's fitness for insurance. The foregoing conclusion is directed by the statement of this court in Ludwig v. John Hancock Mut. Life Ins. Co. (1956), 271 Wis. 549, 74 N. W. (2d) 201. In that case, two of the questions which were asked of the examining physician were as follows: In your opinion, is there anything detrimental to the risk in the habits, occupation or surroundings of the proposed insured? Do you have any other information which might affect the company's decision? It is apparent that the first question recited above from the Ludwig Case is substantially the same as question 20 in the case at bar; the court in that case said, at page 554: The record indicates that the insured was examined by a medical examiner of the defendant on July 24, 1953, and that the examiner in effect declared the applicant a fit subject for insurance. The appellant seeks to avoid the impact of the Ludwig Case on the ground that the portion quoted immediately above was only obiter dicta. The applicability of sec. 209.07, Stats., in relation to the questions contained on the medical report was raised in the respondent's brief in the Ludwig Case and was pertinent to the court's decision. In our opinion, the trial court was correct in regarding the Ludwig Case as controlling in the case at bar.