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Wernle v. Country Life Insurance Co.

OPINION FILED MARCH 17, 1986.

BRENDA WERNLE, INDIV. AND AS SPECIAL ADM'R OF THE ESTATE OF MICHAEL WERNLE, DECEASED, PLAINTIFF-APPELLANT,

v.

COUNTRY LIFE INSURANCE COMPANY, DEFENDANT-APPELLEE.



Appeal from the Circuit Court of Madison County; the Hon. Horace L. Calvo, Judge, presiding.

PRESIDING JUSTICE KASSERMAN DELIVERED THE OPINION OF THE COURT:

Rehearing denied April 23, 1986.

Plaintiff, Brenda Wernle, has perfected this appeal from an order of the circuit court of Madison County which dismissed her complaint against defendant, Country Life Insurance Company, Inc.

The record indicates that on December 22, 1980, plaintiff's deceased husband, Michael Wernle, applied to defendant for a medical insurance policy. At this time, he paid defendant $372.70 for insurance coverage for six months and received from defendant a receipt which provided in pertinent part as follows:

"CONDITIONAL RECEIPT

12-20-80

READ THIS RECEIPT CAREFULLY. UNLESS EACH AND EVERY CONDITION SPECIFIED IS FULFILLED, NO INSURANCE WILL BECOME EFFECTIVE PRIOR TO POLICY DELIVERY. NEITHER THE AGENT WHOSE SIGNATURE APPEARS ON THE REVERSE SIDE NOR ANY OTHER AGENT OF THE COMPANY IS AUTHORIZED TO ALTER, WAIVE OR OTHERWISE CHANGE THE CONDITIONS OF THIS RECEIPT.

Received from MICHAEL D. WERNLE, applicant, the sum of $372.70 dollars, which is given as a payment on the first premium of a Health Insurance Policy or Policies applied for in Country Life Insurance Company. It is agreed that this payment is made and accepted subject to the following conditions:

1. If this application shall be approved by the Company without any further information being required of the applicant or any family member, or without the requirement of any medical examination of the applicant or any family member, the policy or policies issued by the Company shall take effect as of the date of this application, or the date requested by the applicant, whichever is later.

2A. If the Company requires further information, or a medical examination or any statement of the attending physician of the applicant or any family member, then any policy or policies (subject to section 2C, below) issued by the Company without modification by endorsement or extra premium shall be deemed to take effect as of the date of this application, or the date requested by the applicant, whichever is later.

2B. If the Company requires further information, or a medical examination or any statement of the attending physician of the applicant or any family member, and thereafter the Company is not willing to issue a policy or policies unless modified by endorsement or extra premium, the Company may tender to the applicant a policy or policies so modified which, when accepted by the applicant and the additional premium (if any) paid to the Company, shall be deemed to take effect as of the date the Company determined the policy modification or extra premium, or the date requested by the applicant, whichever is later.

3. If this application, as to any one or more policies, is not approved and accepted by the home office of the Company within sixty (60) days from the date of this receipt, then the policy or policies concerned will not be issued and the insurance as to any such policy not issued shall be null and void from the beginning, and the Company will promptly return that portion of the payment evidenced by this receipt for any such policy not issued.

4. If the Company without requiring further information or medical examination is willing to issue a policy or policies on a modified basis or extra premium, it may tender to the applicant a policy or policies modified by endorsement or extra premium which policy or policies if accepted by the applicant will take effect as of the date of application, or the date requested by the applicant, whichever is later. If such modification results in a reduced premium, any excess premium paid shall be returned to the applicant.

5. There is no coverage for injury, sickness or pregnancy unless a policy is issued, and then coverage will take effect for any injury sustained, sickness first manifested or pregnancy commenced on or after the ...


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