Citations
- 36 F. Supp. 3d 761
Full opinion text
MEMORANDUM OPINION & ORDER
WILLIAM H. BAUGHMAN, JR., United States Magistrate Judge.
Introduction
This is a diversity case arising out of defendant Penn Mutual Life Insurance Company’s refusal to pay death benefits to plaintiff Barbara Ramsey on the death of her husband John Ramsey, the insured. Before me are cross-motions for summary judgment. In addition to briefing their respective motions, responding in opposition, and replying to such responses, the parties have participated in an oral argument on these motion's and submitted joint stipulations of fact before and after the oral argument.
For the reasons that follow, Ramsey’s motion will be denied and Penn Mutual’s motion will be granted.
Facts
A. Background facts
Although the parties have raised and argued many facts, the relevant facts underlying the present action are contained in the supplemental joint stipulation of fact.
In February 2010, John Ramsey completed and signed an application for a life insurance policy with Penn Mutual. Part of that application was a “medical examiner’s report” that was prepared by an LPN working for Penn Mutual based on answers given by Ramsey, with the completed application signed by Ramsey. In that section Ramsey stated that he had been hospitalized for colitis in 1984 but that he had made a “full recovery” and had last been seen for this condition in 2006, which examination yielded “normal findings.”
Also included in the application was a so-called “good health” representation whereby Ramsey agreed that insurance would not be issued unless the first premium was paid in full, the policy was delivered, and his “health, habits, occupation and other facts” are “the same as described” in the application, the medical examiner’s report attached, and in any subsequent amendments or supplements.
Based on the disclosure of colitis, Penn Mutual determined that additional information was needed before a policy could issue. In that regard, Penn Mutual, with Ramsey’s approval, obtained various medical records and, after reviewing those records, offered to insure Ramsey at a higher than usual premium.
Virtually contemporaneous with this event, Ramsey was examined by Ian Lav-ery, M.D., the physician who had treated him for colitis in 1984, because Ramsey was experiencing “diarrhea/blood in stool” and “having frequent bloody bms and feels bad.” A follow-up examination by Dr. Lavery a month later, in May 2010, revealed that medication had produced “some improvement” in Ramsey’s symptoms but that he was “still having 15 + loose stools a day.”
Subsequent to these visits to Dr. Lav-ery, which were then unknown to Penn Mutual, Penn Mutual drafted amendments to Ramsey’s application for coverage. The amendments asked if Ramsey had “ever been treated for, or had any indication of: ... intestinal bleeding, ulcer, hernia, colitis, ... or other disorder of the stomach, intestines, liver or gall bladder?” In both cases, Ramsey, on June 1, 2010, answered,