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Tesluk v. Metropolitan Ins.

SEPTEMBER 21, 1970.

TONY TESLUK, AS ASSIGNEE OF DONNA PIEGARE, PLAINTIFF-APPELLEE,

v.

METROPOLITAN LIFE INSURANCE COMPANY, A CORPORATION, DEFENDANT-APPELLANT.



Appeal from the Circuit Court of Cook County; the Hon. JOSEPH C. MOONEY, Judge, presiding. Reversed.

MR. PRESIDING JUSTICE BURMAN DELIVERED THE OPINION OF THE COURT.

This is an action to recover life insurance and accidental death benefits under a plan of group insurance covering Robert A. Tesluk, who died of accidental causes on November 25, 1967. The plaintiff, Tony Tesluk, as assignee of Donna Piegare, the named beneficiary of the policy, filed suit against the insurer, Metropolitan Life Insurance Company. The jury rendered a verdict for the plaintiff upon which the court entered judgment and from which this appeal is taken.

In July, 1967, Tony Tesluk operated a paint and wallpaper store and employed his son, Robert A. Tesluk, who was 21 years of age, and one Joseph Vogenthaler. After a solicitation by a Metropolitan agent, applications for the insurance were executed by the three, and a group insurance policy was issued.

Part C of Robert A. Tesluk's signed application contained the following pertinent information:

6. Have you (or any other said family member) received treatment, attention, or advice from any physician or other practitioner for, or been told by any physician or other practitioner that you (or said family member) had:

Yes No (d) Epilepsy, paralysis, dizziness or any mental or nervous disorder?

[x]

7. During the past 5 years, have you (or any other said family member) had any other diseases, ailments, or injuries not revealed elsewhere on this application for which there was treatment, examination, or advice by or under the direction of a physician or other practitioner, or at a clinic, hospital, dispensary or sanitorium?

[x]

8. If any of questions 3-7 is answered Yes, give full details, including (if applicable)

Question Name Dates Ailment Duration Name of Physician or Treatment or other practitioner or name of Clinic or Hospital, etc.

7. Robert 11-66 Hemorrhoids 4 wks. Ireland Army Hospital, Fort Knox, Ky.

Prior to this application, Robert A. Tesluk had a six-year history of mental disorder. On June 19, 1961, he was admitted to the Cook County Hospital Mental Health Clinic on a doctor's diagnosis that he had acute psychotic reaction. Plaintiff, Tony Tesluk, then signed a petition for his son's commitment as a person in need of mental treatment. The subsequent order recited that he was a mentally ill person incapable of managing his own estate, and he was committed to his father's custody. On March 14, 1962, he was restored to the legal status of a sane person. In April, 1962, he was admitted to a hospital for mental treatment and then again admitted in September of that year. In February, 1963, a doctor diagnosed him as a mentally ill person with need of immediate restraint, and he was admitted to a mental health clinic upon his father's petition for commitment. Upon examination under court order, two doctors found him to be a mentally ill person, and he was committed to a research hospital. On June 2, 1964, his father again petitioned for commitment. The physicians appointed by the court found he was suffering from schizophrenic reaction of the chronic undifferential type, and he was committed to the Elgin State Hospital. This same procedure was followed in April, 1966, when Robert Tesluk was again admitted to the Elgin State Hospital. He was released on a conditional discharge on June 29, 1966. On July 1, 1967, he executed the application to Metropolitan under the group plan being applied for by Tony Tesluk. Elgin State Hospital granted him an absolute discharge on July 11, 1967.

Hunter A. Jopes testified that as an insurance consultant for Metropolitan, he visited Tony Tesluk's shop and solicited a group insurance policy. He returned there on two occasions, and nothing was ever said to him about the ill health of any of the three employees. He said he asked Robert Tesluk the questions appearing on Part C, sections 6, 7 and 8 of the application and put down Robert's answers before Robert signed the application. Robert told him that he had been recently discharged from the army, where they told him he was ...


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