Williams v. Seaboard Life Insurance

ELKINGTON, J. In an action on three medical and hospital cost reimbursement policies, defendant Seaboard Life Insurance Company of America (Seaboard) appeals from a judgment, after a court trial, in favor of plaintiff Virginia M. Williams. Seaboard had contended that plaintiff misrepresented and concealed material facts of her medical history, thus relieving the company from liability.

As our first inquiry is whether there is any substantial evidence in support of the trial court’s findings and judgment, we state the facts in a light most favorable to plaintiff who [97]prevailed in that court. We give her the benefit of every reasonable inference and resolve conflicts in her favor. (See Green Trees Enterprises, Inc. v. Palm Springs Alpine Estates, Inc., 66 Cal.2d 782, 784 [59 Cal.Rptr. 141, 427 P.2d 805].)

S. J. Posner was an authorized representative of Hospital Fund Agency which in turn represented Seaboard. On December 16, 1963, he called upon plaintiff's husband. They went upstairs and talked. Later, plaintiff was called upstairs where she answered questions asked by Mr. Posner. She was then told to sign some papers, which she did. The papers were two identical applications for insurance. Except for the signatures of plaintiff, the forms were filled out in the handwriting of Mr. Posner. On each application appeared the printed question: “Have any of the above named persons received medical or surgical treatment or advice within the last five years? If so explain fully.” Following were two blank lines, each about seven inches in length. In each application this space was completely occupied by Mr. Posner’s handwriting as follows: “7/63 Broken left wrist. Recovery complete (Dr. V. M. Dillon, 2166 Hayes Street) S.F. Benign intestinal tumorectomy—Dr. T. J. Whalen, 2020 Hayes, S.F.” Mr. Posner was described on the application forms as the “licensed representative” of Seaboard.

Around September 23, 1963, plaintiff’s personal physician Dr. Solomon had, at someone’s request, on an “insurance carrier” form, filled out a complete report on plaintiff’s medical history. His records showed that the original report was sent to plaintiff; he retained a copy.

Some time after the applications were signed,' plaintiff’s husband received the two insurance policies. With the policies was a “Hospital Fund Agency” advertising brochure on which the following was typewritten:

“Dear Roy: