Court Opinion

ID: 9674136
Source: CourtListenerOpinion
Date Created: 2023-08-24 04:23:45.063147+00
Date Added: 2024-06-11T18:16:25.764347
License: Public Domain

On Rehearing.
On rehearing appellant calls our attention to the wording of art. 21.16 Insurance Code, which provides that misrepresentations in an insurance application shall not be a defense in a suit on the policy unless “the matter or thing misrepresented was material to the risk or actually contributed to the contingency or event on which said policy became due and payable * * (Emphasis supplied.)
Appellant contends that the use of the disjunctive word “or” shows that it was intended that the insurer might obtain cancellation of the policy by proving either (1) that the misrepresentations were material to the risk, or (2) that the misrepresentations actually contributed to the contingency upon which the policy became payable, but that it was not intended that the insurer must prove both.
Appellant says that the phrase “material to the risk” refers to such a representation as would induce the insurance company to decline the insurance altogether or demand the payment of a higher premium; and that the thing represented, to be material to the risk, need not have any causal connection with the contingency or event upon which the policy became due and payable.
Appellant’s view finds support in some of the authorities: Gorman v. Jefferson Standard Life Ins. Co., Tex.Civ. App., 275 S.W. 248; Stipcich v. Metropolitan Life Ins. Co., 277 U.S. 311, 48 S. Ct. 512, 72 L.Ed. 895; New York Life Ins. Co. v. Kuhlenschmidt, 218 Ind. 404, 33 N.E.2d 340, 135 A.L.R. 397. However there are cases to the contrary: National Life & Accident Co. v. Dickinson, Tex. Civ.App., 115 S.W.2d 1180; Southern Surety Co. v. Butler, Tex.Civ.App., 247 S.W. 611; Pacific Mutual Life Ins. Co. v. Johnson, 5 Cir., 74 F.2d 367. We think also that the concluding provision of the statute is unfavorable to appellant’s view: “ * * * and whether it was material and so contributed in any case shall be a question of fact * * It will be observed that in the above quoted concluding provision of the statute the conjunctive word “and” is used, and that the fact issue to be determined is referred to in the singular number, not in the plural number. We find ourselves unable to accept appellant’s contention, but we shall not belabor the question further for the reason that as we see it, even if the law is as appellant con*350tends, it cannot be applied under the facts disclosed by the record before us.
In this case the jury found in substance that appellee did not make the misrepresentations in question, and in our opinion the evidence amply sustains such findings. Appellee was a woman 75 years of age. Appellant’s agent who sold ap-pellee the policy filled out the application for her. Appellee told her of earlier visits to doctors, but appellant’s agent brushed these answers aside as immaterial. She, the agent, considered only appellee’s last visit to a doctor as important. Moreover months later, after appellee had suffered her collision injuries and after appellant had obtained full knowledge of appellee’s prior illnesses, appellant wrote a letter to appellee asking her to pay up the premiums on her policy so that it might be reinstated. Under the circumstances we think appellant is in no position to complain that its own agent did not correctly and completely write down appellee’s answers to the questions propounded to her. Texas Prudential Ins. Co. v. Beach, Tex.Civ.App., 98 S.W.2d 1057; Inter-Ocean Casualty Co. v. Brown, Tex.Civ.App., 31 S.W.2d 333; 24 Tex.Jur. 923.
Appellant cites us to the case of San Angelo Life & Accident Ass’n v. Haynes, Tex.Civ.App., 106 S.W.2d 363, wherein it is held that when there is a collusion between the company’s agent and the insured, the company is not bound by the agent’s failure to fill in the application correctly. The facts in the cited case are not analogous to the facts here. There is no jury finding of collusion in this case, and in our opinion there is not sufficient evidence to support such a finding if it had been made. An insurer seeking to avoid a policy because of misrepresentation must plead and prove not only that the insured’s answers were false, but that insured knew or should have known their falsity and made them willfully and with the intention of inducing the insurer to issue the policy. Clark v. National Life & Accident Ins. Co., 145 Tex. 575, 200 S.W. 2d 820; Great Southern Life Ins. Co. v. Doyle, 136 Tex. 377, 151 S.W.2d 197. We think that under the record before us appellant has failed to meet the above test or to show collusion.
Appellant’s motion for rehearing is overruled.