TRAVELERS INSURANCE COMPANY, A CONNECTICUT CORPORATION, APPELLANT,
v.
ARTHUR E. ZIMMERMAN, APPELLEE

Fla. 3d DCA | 1975-03-25
No. 74-937
Before HENDRY, HAVERFIELD and NATHAN, JJ.
309 So. 2d 569 Florida District Court of Appeal, Third District (1975) Positive Treatment
Cited by 29 cases

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Synopsis

Travelers Insurance Company appeals a judgment for plaintiff Zimmerman in a disability insurance claim dispute. The court affirmed the jury verdict for the insured, holding that materiality of alleged misrepresentations and whether the insured reasonably could be held responsible are factual questions for the jury, not the court.


Holding

The court held that where evidence is not conclusive, questions regarding the extent of questions asked by the agent, accuracy of answers given, materiality of misrepresentations, and whether the applicant reasonably could be held responsible for incorrect statements are factual matters for jury determination, not for the court to decide on appeal.


Headnotes

[1] An innocent misrepresentation by an insured can bar recovery under an insurance policy if it is material to the acceptance of the risk or if the insurer would not have is…

[2] Where evidence of misrepresentation is not conclusive, the accuracy of an insured's answers and the materiality of alleged misrepresentations become disputed questions of…

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Key Quotes

“It is well established that under § 627.409, Fla.Stat. even an innocent misrepresentation by the insured can bar recovery if it is material to the acceptance of the risk or if the insurer in good faith would not have issued the policy under the same terms had it known the truth.”

Establishes the legal standard for misrepresentation in insurance cases under Florida law

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Facts & Procedural History

Zimmerman applied for disability insurance from Travelers on July 10, 1970, and answered affirmatively when asked about back problems, providing hospi…

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Opinion of the Court
PER CURIAM.

PER CURIAM.

Defendant-appellant seeks review of a final judgment for plaintiff entered pursuant to a jury verdict in an action to recover total permanent disability benefits under an insurance policy issued by the appellant. Plaintiff-appellee, Arthur E. Zimmerman, on July 10, 1970 met with one of the representatives of defendant-appellant, Travelers Insurance Company, for the purpose of applying for disability insurance. The representative asked the questions on the application and wrote down the responses thereto. Plaintiff answered in the affirmative the question if he ever had any back problems and gave to the representative the name of the hospital where he had his back operation and his doctor at the time of the surgery. Thereafter, the application was submitted to the home office of appellant, reviewed and approved. Thereupon, appellee was issued a disability policy and commenced paying the premiums. Subsequently, plaintiff became totally disabled as the result of an enlarged heart coronary artery disease and made a claim under his policy of insurance for disability income. Upon investigation thereof, appellant discovered from plaintiff’s hospital records that plaintiff had received treatment for polydipsia, diabetes, anxiety neurosis and chronic back problems. Defendant insurer refused to honor the claim for plaintiff’s failure to advise defendant of the above in his application for insurance. Thereupon, plaintiff filed a complaint to recover permanent disability benefits under the policy issued by defendant. Defendant Travelers answered and counterclaimed for rescission under § 627.409, Fla.Stat. on the grounds that there were material misrepresentations, omissions, incorrect statements or concealed facts in the application for the policy of insurance. The cause proceeded to a jury trial at the conclusion of which the jury returned a verdict in favor of the plaintiff. Judgment in the total amount of $10,176 was entered thereon. Defendant insurer appeals therefrom. We affirm.

It is well established that under § 627.409, Fla.Stat. even an innocent misrepresentation by the insured can bar recovery if it is material to the acceptance of the risk or if the insurer in good faith would not have issued the policy under the same terms had it known the truth. Life Insurance Company of Virginia v. Shifflet, Fla. 1967, 201 So. 2d 715. Nevertheless, where the evidence is not conclusive as in the case sub judice, then the extent of the questions asked by the insurance agent, the accuracy of the answers given by the insured and the insured’s alleged misrepresentation become disputed questions of fact to be resolved by the jury. Lamm v. Prudential Insurance Company of America, Fla.App.1965, 179 So. 2d 238; Hyman v. Life Insurance Company of North America, 481 F. 2d 444 (5th Cir. 1973). Furthermore, whether or not the insured falsely represented material facts that induced the insurer to issue policies solely on the strength of the insured’s statements, without regard to an independent investigation made by the insurer, is likewise a question of fact. Lamm, supra. Finally, each situation where an alleged misrepresentation or incorrect statement is advanced to vitiate a policy should be examined to determine whether under the particular circumstances the applicant reasonably could be held responsible for the incorrect statement and without fault on the part of the insurer. National Standard Life Insurance Company v. Permenter, Fla. 1967, 204 So. 2d 206 at 207.

There being competent substantial evidence contained in the record to support the jury’s determination, we will not disturb the verdict on appeal. Accordingly, the judgment herein appealed is affirmed.

Affirmed.


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Citator

Cited By (15 total)

  • Cont'l Assurance Co. v. Carroll, 485 So. 2d 406 (Fla. 1986)
    …cy. See Preferred Risk Life Insurance Co. v. Sande, 421 So. 2d 566 (Fla. 5th DCA 1982); Minnesota Mutual Life Insurance Co. v. Candelore, 416 So. 2d 1149 (Fla. 5th DCA), review denied, 424 So. 2d 760 (Fla.1982); Travelers Insurance Co. v. Zimmerman, 309 So. 2d 569 (Fla. 3d DCA 1975). See also Bishop v. Franklin Life Insurance Co., 412 F. 2d 949 (5th Cir.1969); Wissner v. Metropolitan Life Insurance Co., 395 F. 2d 204 (5th Cir. 1968). Less than seven months after this Court decided Shifflet, we decided Permen…
  • …ice Ervin’s concurring opinion to some extent by the appellate courts, for example in Garwood v. Equitable Life Assur. Soc. of U. S., 299 So. 2d 163 (Fla. 3rd DCA 1974), cert. den. 321 So. 2d 553 (Fla.1975); Travelers Insurance Company v. Zimmerman, 309 So. 2d 569 (Fla. 3rd DCA 1975); and Independent Fire Ins. Co. v. Horn, 343 So. 2d 862 (Fla. 1st DCA 1976). The Permenter view, accepted at least in part by the cited cases, holds that incorrect answers on an insurance application do not invalidate the policy…
  • Preferred Risk Life Ins. Co. v. Sande, 421 So. 2d 566 (Fla. 5th DCA 1982)
    …en there is a dispute as to what was asked by the agent when the policy was issued or the accuracy of the answers on the application itself. Beneby v. Midland Nat’l. Life Ins. Co., 402 So. 2d 1193 (Fla. 3d DCA 1981); Travelers Ins. Co. v. Zimmerman, 309 So. 2d 569 (Fla. 3d DCA 1975). Mr. Sande acknowledged at trial that the policy application accurately reflected what occurred at his meeting with the agent; therefore, no factual dispute is present. Furthermore, the insurer presented uncontroverted testimony t…

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