Under § 307 of the World War Veterans Act, as amended July 3,
1930, a claim for total permanent disability on a reinstated and
converted War Risk policy cannot be contested upon the bare ground
that the total and permanent disability existed before the
insurance was reinstated. P.
303 U. S.
342.
Section 307 provides that policies of insurance
"issued, reinstated, or converted shall be incontestable from
the date of issuance, reinstatement, or conversion, except for
fraud, nonpayment of premiums, or on the ground that the applicant
was not a member of the military or naval forces of the United
States."
The converted policy sued on promised to pay in the event of
total permanent disability, upon due proof of such disability
"while this policy is in force." Unlike original policies issued
under the War Risk Act, it contained no clause expressly excluding
liability for total permanent disability incurred before the policy
was applied for.
90 F.2d 715 affirmed.
Certiorari, 302 U.S. 676, to review the affirmance of a judgment
recovered against the Government on a Veteran's policy of
insurance.
Page 303 U. S. 342
MR. JUSTICE BLACK delivered the opinion of the Court.
January 31, 1918, Stanley J. Patryas (respondent), then a
soldier, purchased from the government a $10,000 yearly renewable
war risk insurance contract which he permitted to lapse after his
honorable discharge from the Army July 29, 1919. June 28, 1927,
while a patient at a Veterans' Government Hospital, he obtained
reinstatement of his war risk policy and immediately converted it
into a five-year renewable term policy upon which he paid premiums
to June, 1932. Claiming total permanent disability, the veteran
obtained, in the District Court, a verdict and judgment on his
reinstated policy. Finding the issues for the veteran, the jury
fixed the date of permanent total disability at 1924 -- a date
three years before his policy was reinstated.
The Circuit Court of Appeals affirmed. [
Footnote 1]
The government's right to contest this policy is limited by the
following statutory provision: [
Footnote 2]
". . . policies of insurance . . . issued, reinstated, or
converted shall be incontestable from the date of issuance,
reinstatement, or conversion, except for fraud, nonpayment of
premiums, or on the ground that the applicant was not a member of
the military or naval forces of the United States."
The question here is:
Can the government, in the absence of fraud or bad faith,
"contest" and defeat payment of total permanent disability
insurance, sold to a World War veteran, on the ground that the
veteran was totally and permanently disabled before the policy was
reinstated and converted?
First. The government contends that
"Congress has
Page 303 U. S. 343
not, . . . authorized . . . insurance benefits for total,
permanent disability existing prior to any contract of insurance on
which the claim is made."
The original War Risk Insurance Act of October 6, 1917,
[
Footnote 3] provided:
"That, in order to give to every commissioned
officer and
enlisted man and to every member of the Army Nurse Corps
(female) and of the Navy Nurse Corps (female) when employed in
active service under the War Department or Navy Department greater
protection for themselves and their dependents, . . . the United
States, upon application to the bureau and
without medical
examination, shall grant insurance against the death or total
permanent disability of any such person."
The War Risk Insurance Act must be considered in the light of
its passage during war, while men and women were being called into
war service. This requires recognition of its generous and liberal
purpose to provide "greater protection for [soldiers, sailors and
nurses] and their dependents." [
Footnote 4] Its passage indicated Congress conclusively
presumed that every person, who had successfully undergone mental
and physical examination for war service, was, when inducted into
such service, insurable against death and total permanent
disability. [
Footnote 5] The
act commanded that insurance against death and total permanent
disability be granted, without medical examination, to every
applicant who had previously been examined and accepted for war
service. Congress manifestly intended by these sweeping provisions
that policies should be granted without regard to the health of
applicants and should be enforceable obligations against the
government. Any other construction of this broad, war-time
Page 303 U. S. 344
legislative grant to soldiers, sailors, and nurses would take
away the benefits Congress intended them to receive. The provisions
of the War Risk Insurance Act are sufficiently comprehensive and
inclusive to authorize its administrators to grant insurance
covering past or future total permanent disability, if such action
is found necessary to carry out its far-reaching national plan and
purposes.
Second. It is contended that the government can contest
liability on the ground that the veteran was totally and
permanently disabled prior to the reinstatement, despite the
provision that such policy
"shall be incontestable . . . except for fraud, nonpayment of
premiums, or on the ground that the applicant was not a member of
the military or naval forces of the United States."
It is urged that this provision
"has no application where, as here, the validity of the policy
is not questioned and liability under it is denied solely on the
ground that a loss has not occurred during the period of insurance
protection."
However, it is admitted that this policy did not "expressly
exclude total permanent disability occurring prior to insurance
protection as did the language of the original term contract."
This converted policy of insurance provided protection against
loss from two causes -- namely, death and total permanent
disability. A provision making a policy "incontestable" except for
certain clearly designated reasons is wholly meaningless and
ineffective if, after proof of the loss insured against, the policy
can be contested upon grounds wholly different from those set out
in the exception. The object of the provision is to assure the
insured that payment on his policy will not be delayed by contests
and lawsuits on grounds not saved by the exceptions. [
Footnote 6] Here, it has been established
that the veteran is
Page 303 U. S. 345
totally and permanently disabled. Yet his policy is contested on
the ground that it does not insure against this disability, because
it existed before the policy was issued. If this defense can be
interposed, his policy has never actually protected him against
total permanent disability. Since permanent total disability is one
of the two risks insured against in the policy, any contest (not
based on the exceptions) which may prevent the policyholder's
recovery for such admitted total permanent disability, existing
while the policy is in force, is a "contest" forbidden by the
"incontestable" provision.
No legal obstacle prevents parties, if they so desire, from
entering into contracts of insurance to protect against loss that
may possibly have already occurred. Marine insurance and antedated
fire insurance policies frequently afford protection against risks
which, unknown to the parties, have already attached. [
Footnote 7]
Even with the benefit of scrupulous good faith, it is not always
easy to determine with complete certainty whether or not total
permanent disability exists. This uncertainty may lead an insurer,
after his own investigation, and for adequate compensation, to
treat unknown past and uncertain prospective disability, upon the
same basis. This case is an illustration. Here, the government has
never admitted that the veteran is totally and permanently
disabled. It not only issued him a policy against such disability,
with complete knowledge of his then condition, but, in this
continued contest, has denied that the policyholder was totally and
permanently disabled
Page 303 U. S. 346
at any time -- before, when, or after the policy was issued.
There was also a sharp conflict of evidence on this disputed
fact.
When a policy of disability insurance is issued after complete
examination by the insurer and full and fair disclosure by both
parties, there is no legal reason why the insurer cannot contract
to afford full protection against loss resulting from past as well
as prospective disability. This veteran's policy did not expressly
limit liability to
prospective total permanent disability.
The provisions of the policy in this regard contain a promise to
pay the veteran "in . . . event of the total, permanent disability
. . . [and] Upon due proof of the total permanent disability while
this policy is in force. . . ." Original policies issued under the
War Risk Act expressly excluded liability for total permanent
disability incurred before the policy "was applied for." The
deliberate omission, in the converted policies, of this previous
exclusion, the language and purport of the original act and its
amendments, the administrative interpretations and legislative
history, all throw a flood of light on the intention to include
liability for disabilities existing prior to the issuance of the
policies.
For more than a decade prior to 1934 (during which period this
veteran's policy was purchased), the Bureau, unvaryingly observing
the statutory mandate, announced and applied the practice that
"insurance was incontestable except for the grounds specifically
enumerated" in the incontestable provision. A "
subsequent
rating of permanent total disability
effective as of a
date prior to the date of reinstatement," under this
consistent administrative interpretation and practice, did "not
affect the validity of such reinstatement." Because of court
decisions and rulings by the Comptroller General tending to nullify
and defeat this administrative practice, [
Footnote 8] the Veterans'
Page 303 U. S. 347
Administration urged the amendment of July 3, 1930, to confirm
its practice and to strengthen and clarify the incontestable
provision. For this purpose, the Administrator of Veterans' Affairs
testified before the Senate Committee as to the necessity for this
amendment: [
Footnote 9]
"This is a very sweeping amendment, and will place beyond
contest many contracts and policies of insurance which otherwise
would be contestable. It is a well recognized principle of
commercial insurance companies, however, and
in reality is only
a clarification of the existing law which was practically nullified
by a recent decision of the Comptroller General."
The Solicitor of Veterans' Affairs also testified:
". . . the present World War Veterans' Act of 1924 as amended,
contains a provision to the effect that, where a policy is
maintained in force for a period of six months, it should be
incontestable, except for fraud or nonpayment of premiums.
We
have followed that, and, in all cases where the policy has remained
in force for six months, we have paid the claim, irrespective
of the merits of it, unless there was fraud or failure to pay
premiums. . . . However, under date of January 16, 1930,
notwithstanding the long practice of the bureau, the
Comptroller General, in the case of
Mabry W. Woodall, held
that, if a man was
permanently and totally disabled at the
time he applied for a reinstatement of insurance, or conversion of
insurance, . . .
the policy was not incontestable, the statute
did not protect it. . . ."
In the
Woodall case referred to, the Comptroller
General had held:
". . . if the insured was in fact dead
or permanently and
totally disabled at the date of application, reinstatement or
conversion, . . . the insurance was subject to subsequent
contest. . . ."
"
* * * *
Page 303 U. S.
348
"
"Accordingly, the rule may be stated that,
where the
Veterans' Bureau has heretofore established or may hereafter
establish the condition of permanent total disability at or prior
to date of original application for insurance, or application for
reinstatement and/or conversion of insurance, . . . the insurance
should be considered as invalid. . . ."
The Senate Report on this amendment [
Footnote 10] stated:
"
The purpose is to make all contracts or policies of
insurance incontestable from date of issuance, reinstatement, or
conversion, for all reasons except fraud, nonpayment of premiums,
or that the applicant was not a member of the military or naval
forces of the United States. This incontestability would protect
contracts . . . where the applicant was not in the required state
of health, or was permanently and totally disabled prior to the
date of application, . . . It is appreciated that this is a
broad provision, but it was felt that
it was necessary in
order to do justice to the veterans . . . and
to overcome
decisions of the Comptroller General which practically nullified
the section as it now exists."
The conclusion is inescapable that Congress enacted the 1930
amendment in order to overcome the effect of the above rulings of
the courts and the Comptroller General, and with the intention to
sustain the Bureau's previous administrative interpretation and
practice under the incontestable provision.
To resist payment of this veteran's insurance policy on the
ground that he was totally and permanently disabled prior to the
issue of the policy is to "contest" payment within the generally
accepted meaning of the word, and violates the "incontestable"
provision. The purchaser of a policy contract containing a
provision that
Page 303 U. S. 349
the insurer waives its right to contest except for fraud,
nonpayment of premiums, and lack of military or naval service is
entitled to rely on the plain terms and inducements of the
provision which limits the grounds for contest of liability to
those specifically reserved. [
Footnote 11] The incontestable provision here means that
a claim of a veteran whose death or total permanent disability is
established shall not be contested except for fraud, nonpayment of
premiums, or on the ground that the insured had not really been a
member of the war forces of the nation or because he was included
in Title 38, U.S.C. § 447. [
Footnote 12] Congress evidently believed these exceptions
afforded the government ample protection against impositions or
unjust claims, and intended to limit the right to contest these
policies to the specific grounds reserved in the exceptions. The
judgment of the Circuit Court of Appeals is
Affirmed.
MR. JUSTICE CARDOZO and MR. JUSTICE REED took no part in the
consideration or decision of this case.
[
Footnote 1]
90 F.2d 715.
[
Footnote 2]
Sec. 307, World War Veterans' Act 1924, as amended July 3, 1930,
c. 849, § 24, 46 Stat. 1001.
[
Footnote 3]
Section 400, War Risk Insurance Act of Oct. 6, 1917, c. 105, 40
Stat. 409.
[
Footnote 4]
See United States v. Arzner, 287 U.
S. 470,
287 U. S.
472.
[
Footnote 5]
See United States v. Domangue, 79 F.2d 647, 648.
[
Footnote 6]
Northwestern Life Ins. Co. v. Johnson, 254 U. S.
96,
254 U. S.
101-102.
[
Footnote 7]
General Interest Ins. Co. v.
Ruggles, 12 Wheat. 408;
see Hooper v.
Robinson, 98 U. S. 528,
98 U. S. 537;
Pendergast v. Globe, etc., Ins. Co., 246 N.Y. 396, 159
N.E. 183;
Hallock v. Ins. Co., 26 N.J.L. 268, 2 Dutch.
268;
see Springfield Fire & Marine Ins. Co. v. Nat. Fire
Ins. Co., 51 F.2d 714, 718, 719. A valid aleatory contract may
be based on an unknown past event. 3 Williston, On Contracts (Rev.
Ed.), § 888.
[
Footnote 8]
9 Compt.Gen. 291;
Jordan v. United States, 36 F.2d 43;
United States v. Golden, 34 F.2d 367.
[
Footnote 9]
H.R. 10381, 71st Cong., 2d Sess., Hearings Senate Committee on
Finance, pages 90-91.
[
Footnote 10]
Senate Report No. 1128, 71st Cong., Sess., on H.R. 13174.
[
Footnote 11]
See Northwestern Life Ins. Co. v. Johnson, supra, at
254 U. S.
102.
[
Footnote 12]
38 U.S.C. § 518, and § 447. This reference to § 447 excluded
from the benefits of this incontestable provision any person who
had been discharged or dismissed from the service on the ground
that he was
"guilty of mutiny, treason, spying, or any offense involving
moral turpitude, or willful and persistent misconduct, of which he
was found guilty by a court martial, or that he was an alien,
conscientious objector who refused to perform military duty or
refused to wear the uniform, or a deserter. . . ."