or mental reservation by insured in so stating. It was held by the Wisconsin Supreme Court that there could be no recovery on the policy.1 In another instance an applicant, who warranted his answers, stated to the medical examiner that he had five sisters, aged respectively fiftytwo, fifty, forty-seven, forty-five, and thirty-six years; their ages were, in fact, respectively, forty-nine, forty-six, forty-four, thirty-six, and thirty-three years. The Texas Supreme Court held that the provisions of the policy constituted a warranty of the truth of the statements in the application, and that the discrepancies forfeited the contract. This impresses one as a very rigid construction of the law of warranty, because the man had five sisters, and there was in each instance such immaterial difference between the actual and the stated age that it would have made no difference to the medical director in arriving at an opinion. WOMEN AS RISKS. 2 It has been only within recent years that the life insurance companies in general have adopted a more liberal policy as regards the acceptance of women as risks. The published mortuary experience of the Mutual Life Insurance Company of New York reported that from 1843 to 1874 the female risks constituted about 3 per cent. of the whole number of persons insured and of the 101,967 insured lives, 5385 males and 161 females died during the period specified. Later investigations by this company showed that in 46,525 deaths there were 1540 females, 3.31 per cent. for the entire period, although the rate during the last four years of the period was 4.65 per cent. The experience with females reversed that with males, the former giving the greater number of deaths under forty-five and the fewest over sixty years. Deaths from diseases of the respiratory and the genito-urinary organs were more numerous among female than male risks. Likewise in the Washington Life Insurance Company, Dr. Brannan wrote: "The deaths of males only are considered, those of females, 68 in number, being too few for profitable analysis." 6 Also in the Australian Mutual Provident Association there were 110,299 lives exposed, of whom 104,326 were men and 5973 were women, during the forty years from 1849 to 1888, of these 5325 men and 221 women died during the time specified. The annual mortalityrate was 0.82 per cent. among the men and 0.84 among the women.7 The objection to the acceptance of women as risks has been as much from the actuarial as from the medical side of life insurance. Hopf McGowan vs. Supreme Court of I. O. F. of Toronto, Canada, 83 N. W., 775, 1900. Medical Statistics, p. 5. 5 Report on the Mortality Records of the Mutual Life Insurance Company of New York from 1843 to 1898, New York, 1900. The Washington Life Ins. Co., Historical, Actuarial, and Medical Statistics, N. Y., 1889, p. 96. Report on the Mortality Experience of the Australian Mutual Provident Assoc., Sydney, 1891. VOL. I.-31 maintained that there was no doubt that a greater proportion of females who assured their lives at the younger ages died early. "The deviation is too significant and too constant to be considered accidental. We are not able to explain it by any other supposition than by the circumstance that women feel internal hidden infirmities and defects in a higher degree than men, and have a presentiment of approaching danger in consequence of that, which impels them to insure their lives; or that they understand better and more skilfully than men to hide the true state of their health and to deceive by it even their medical men."1 It is not probable that women are more keen to recognize existing disorders than men, but it is a fact that it is rare that an examiner is able to make as thorough an examination of a woman as of a man. How otherwise is it possible to reconcile the disparity between the status of a woman as a risk and as an annuitant? Mr. R. W. Weeks wrote: "It is a singular fact that the three annuity experiences here compared agree in showing a very low mortality-rate among females under the age of fifty, the ratios to the mortality among males under that age being as follows: This low mortality among the younger female annuitants cannot be attributed to chance, since the exposure under age of fifty in the three experiences aggregate over 36,000 lives for one year. This result is in startling contrast with the experience of the companies on insured female lives, such lives under the age of fifty showing a mortality much in excess of the male." When the applicant is a woman she is questioned in regard to the present or past existence of menstrual disorder, uterine or ovarian disease, and affection or tumor of the breast. She is asked whether she has borne children, whether she has had an abortion or trouble in labor, whether she is pregnant, or whether she has passed the climacteric. A woman within a short period of her confinement was examined for insurance, and the concealment of a fact material to the risk was urged in opposition to the payment of the claim. The Court held that the insurer did not allege that the lives of married women were not insured by them, or that the perils of childbirth were not covered by the policy. No warranty against it was in the policy, and none of the questions required to be answered seemed intended to reach it. The certificate of the physician selected by the company was given in evidence, and aware, as he ought to have been, if he performed his duty, of the situation of the woman, he repeated to the company that the life was a good one. She was a young woman, and it did not appear but that she was a vigorous woman. She had already borne one child in 1 Jour. Inst. Act., vi., p. 5. 2 Monetary Mortality Experience on Annuities in American Life Ins. Companies," Trans. Act. Soc. of America, 1892. safety, so that there was no constitutional impediment. In insuring the life of a young married woman for the whole term of her natural life the company must be presumed to know that, in the ordinary course of things, it is a peril she must expect frequently to encounter. Was this then a fact material to the risk? This is a question which the jury are to decide. If material, was it concealed?i In the absence of any specific question in reference to the existence of pregnancy, there was not the slightest ground for the insurer to contest the payment of the claim on the ground that there had been concealment of a material fact. 1 Lefavour vs. Insurance Company, 2 Bigelow, 158. THE MEDICAL JURISPRUDENCE OF ACCIDENT INSURANCE. THE Supreme Court of Pennsylvania has defined an accident as "an event that takes place without one's foresight or expectation; an event which proceeds from an unknown cause or is an unusual effect of a known cause, and therefore not expected." A policy of accident insurance has been defined as an agreement to indemnify the insured for disability or death caused by external, accidental, and violent means; and some have maintained that each and all of these factors much be shown to exist to enable the insured to recover. James Briggs Porter, Esq., takes a very logical view of the idea of indemnification : "An agreement to compensate a man for injuries by accident might seem to be a contract of indemnity; but it must be remembered that in this case, as in that of an insurance on a man's own life, the value of the peril insured against cannot be appraised in money, and therefore the insured cannot really be indemnified; for although the evil results of bodily injury can often be alleviated by what money will procure, mere money cannot allay or remove the suffering, and therefore cannot really constitute an indemnity.2 risks. Dr. Elias J. Marsh, in a monograph entitled Mortality from Casualties, reviews the mortality experience of the Mutual Life Insurance Company and states that "the proportion of deaths from casualties compared with the total mortality is far less now than formerly, but this difference is chiefly due to the difference in the ages of the company's In the earlier records the proportion of elderly persons was very small; the business was new business, and consequently there was little accumulation of old lives. Among old lives other natural causes of death preponderate and the casualties are reduced to a small proportion, although they may be as numerous when compared with the lives at risk as they were at an earlier age." Dr. Marsh's investigations showed that in order of frequency fatal casualties were caused by: (1) Railroad accidents; (2) falls and falling bodies; (3) drowning; (4) injuries due to horse and wagon; (5) homicide; (6) firearms; (7) poisons; (8) heat, cold, etc.; (9) burns, scalds, etc.; (10) machinery tools, elevators. Accident insurance policies have been defined as including "horse or vehicle policies," which insure an employer against liability for accidental injuries to others than employés, and which are caused by horses 1 North American Life and Accident Co. vs. Burroughs, 69 Pa., 43. 2 The Laws of Insurance, London, 1884. or vehicles of the insured; "elevator policies," which insure against accidental personal injuries caused by elevators or their appurtenances; "general liability policies," which insured against liability for accidental personal injuries to any persons other than employés or persons injured by elevators, for which the insured may be liable as landlord or tenant; and "outside liability policies," which insure builders and contractors against liability for accidental personal injuries to workmen employed by other contractors and to the public, which may be caused by the insured or by his workmen.' While this decision indicates the wide range of accident insurance, the present paper is intended to deal only with that phase of the subject that pertains to suits at law in which some medical feature is concerned. It may be said that the fundamental grounds for contest of an accident insurance policy are that the accident was the consequence of the reckless or intentional act of the person insured, or it was in part or wholly due to existing disease afflicting that person, or the injury was due to the intentional act of a third person. Provisions of an accident insurance policy should be applied strictly against the insurer, in order that the indemnity purchased should not be defeated.2 Occasionally contests have arisen on the ground that death was the ultimate result of an accident, as in a case in which the policy provided that the company would be liable only for injuries through external, violent, and accidental means which should immediately and wholly disable the insured from transacting business. The insured sustained a fall, but for two months was able to attend partly to business, when at the end of that time he was incapacitated by a stroke of paralysis which was the direct result of the accident. The Court held that the company was not liable under the conditions of the policy. It is evident that the paralysis was not an immediate and complete disability, so recovery on the policy could not be expected. It has been decided that the loss of one's fingers or hand does not ordinarily constitute total disability. The Application.-The application for accident insurance gives the individual's name, age, residence, and occupation; the height and weight; the amount of insurance to be paid in the event of death; the amount of weekly indemnity; the name, residence, and relationship of the beneficiary; the amount of accident insurance in force and the names of the companies or associations in which it is placed; there is a statement in regard to rejection for such insurance or cancellation of a policy or payment of indemnity. The applicant warrants the truth of the answers to these questions, and also that he never had fits or disorders of the brain, that his habits of life are correct and temperate, and that he has no physical or mental infirmity. Warranty and Representation.-The questions of warranty 1 Employers' Liability Assoc. vs. Merrill (Mass.), 29 N. Eng. Rptr., 529. 2 McElfresh vs. Odd Fellows' Acc. Co. of Boston, 52 N. E., 819 (Ind. App., 1899). 3 Merrill vs. Travelers' Insurance Co., Wisconsin Supreme Court, 1895. Hutchins vs. The Supreme Tent of the Knights of the Maccabees of the World, 68 Hun, 355. |