White v. American Family Life Assurance Co.

The trial court did not erroneously charge the jury that they could find in favor of an insurer in a breach of contract action to recover health insurance proceeds, if they determined that the insureds made material misstatements in their health insurance application, even if such misstatements were made innocently.

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Following a jury trial in this breach-of-contract action to recover health insurance proceeds, plaintiffs Gary and Sheila White appeal the defense verdict and resulting judgment, arguing that the court erroneously charged the jury that they could find in favor of the defendant American Family Life Assurance Company AFLAC if they determined that the Whites made material misstatements in their insurance application, even if such misstatements were made innocently. Holding that the jury instructions were accurate and applicable statements of the law, we affirm. The record reveals that in February 2001, Sheila and Gary White completed an AFLAC insurance application to insure their health against certain specified health events such as irreversible kidney failure or organ transplant. In response to the question on the application “Has anyone to be covered ever been diagnosed with or received treatment for impaired kidney function or other listed maladies by a member of the medical profession,” the Whites marked “No.” Had they responded “Yes” to this question on the application, the application provided that the policy would not cover the person who had been so diagnosed or treated.

The Whites further answered “No” to the question as to whether either of them had been diagnosed with, received treatment for, or been prescribed medication for kidney disease within the last five years. If they had answered “Yes” to this question, they would have been required to give more specific information. Sheila signed the application, agreeing that she had read the completed application, that she realized policy issuance was based upon statements and answers provided therein, and that the statements and answers were “complete and true to the best of my knowledge and belief.” Relying on these statements, AFLAC issued a policy effective February 13, 2001, which attached and incorporated the completed application form.

White v. American Family Life Assurance Co.

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