A-7350, FEBRUARY 27, 1925, 4 COMP. GEN. 723

A-7350: Feb 27, 1925

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A SHOWING AS TO THE GOOD HEALTH OF THE APPLICANT MADE BY THE WIDOW SUBSEQUENT TO THE DEATH OF THE APPLICANT IS NOT SUFFICIENT ON WHICH TO REINSTATE THE LAPSED POLICY AS TO AUTHORIZE PAYMENTS OF INSURANCE THEREUNDER. 1925: I HAVE YOUR LETTER OF JANUARY 8. ALLEN WAS COMMISSIONED AS FIRST LIEUTENANT. WAS DISCHARGED FROM THE SERVICE ON DECEMBER 6. WILL BE NOTED THAT HIS INSURANCE LAPSED AT MIDNIGHT. THAT THIS PREMIUM WAS TENDERED DURING THE MONTH FOLLOWING THE MONTH OF LAPSE. HIS CERTIFICATE OF DEATH STATES THAT DEATH WAS CAUSED BY LOBAR PNEUMONIA OF TWO DAYS' DURATION. THAT INFLUENZA OF FIVE DAYS' DURATION WAS A CONTRIBUTORY CAUSE OF DEATH. WHICH WAS RETURNED. WAS ISSUED RELATIVE TO THE APPLICATION OF DELAYED PREMIUMS TO YEARLY RENEWABLE TERM AND CONVERTED INSURANCE ACCOUNTS: "1.

A-7350, FEBRUARY 27, 1925, 4 COMP. GEN. 723

WAR RISK INSURANCE - REINSTATEMENT WHERE AN APPLICANT FOR REINSTATEMENT OF A LAPSED POLICY OF WAR RISK INSURANCE TENDERED PREMIUMS WITHIN THE TIME FIXED BY REGULATION BUT FAILED TO FURNISH DURING HIS LIFETIME A STATEMENT OF GOOD HEALTH AS REQUIRED BY REGULATION AND THE CONTROLLING STATUTE, A SHOWING AS TO THE GOOD HEALTH OF THE APPLICANT MADE BY THE WIDOW SUBSEQUENT TO THE DEATH OF THE APPLICANT IS NOT SUFFICIENT ON WHICH TO REINSTATE THE LAPSED POLICY AS TO AUTHORIZE PAYMENTS OF INSURANCE THEREUNDER.

COMPTROLLER GENERAL MCCARL TO THE DIRECTOR, UNITED STATES VETERANS' BUREAU, FEBRUARY 27, 1925:

I HAVE YOUR LETTER OF JANUARY 8, 1925, REQUESTING DECISION WHETHER THE INSURANCE POLICY OF CHARLES B. ALLEN MAY BE CONSIDERED AS HAVING BEEN REINSTATED SO AS TO AUTHORIZE PAYMENTS OF INSURANCE THEREUNDER UPON THE FOLLOWING STATEMENT OF FACTS:

CHARLES B. ALLEN WAS COMMISSIONED AS FIRST LIEUTENANT, MEDICAL CORPS, ON OCTOBER 21, 1918, AND ON OCTOBER 24, 1918, MADE APPLICATION FOR $10,000.00 WAR RISK INSURANCE, NAMING HIS WIFE, GRACE MARY ALLEN, AS BENEFICIARY. WAS DISCHARGED FROM THE SERVICE ON DECEMBER 6, 1918, AND REGULARLY PAID PREMIUMS ON HIS INSURANCE TO INCLUDE APRIL, 1924. ON JUNE 3, 1924, ALLEN REMITTED TO THIS BUREAU $10.80, THE AMOUNT OF ONE MONTH'S PREMIUM. WILL BE NOTED THAT HIS INSURANCE LAPSED AT MIDNIGHT, MAY 31, 1924, THE EXPIRATION OF THE GRACE PERIOD ALLOWED FOR PAYMENT OF THE PREMIUM DUE MAY 1, 1924, AND THAT THIS PREMIUM WAS TENDERED DURING THE MONTH FOLLOWING THE MONTH OF LAPSE.

ALLEN DIED JUNE 21, 1924. HIS CERTIFICATE OF DEATH STATES THAT DEATH WAS CAUSED BY LOBAR PNEUMONIA OF TWO DAYS' DURATION, THAT INFLUENZA OF FIVE DAYS' DURATION WAS A CONTRIBUTORY CAUSE OF DEATH. AFTER ALLEN'S DEATH HIS WIDOW TENDERED ANOTHER PREMIUM IN THE SUM OF $10.80, WHICH WAS RETURNED.

UNDER DATE OF JANUARY 26, 1921, THE FOLLOWING REGULATIONS, KNOWN AS REGULATION NO. 48-D, WAS ISSUED RELATIVE TO THE APPLICATION OF DELAYED PREMIUMS TO YEARLY RENEWABLE TERM AND CONVERTED INSURANCE ACCOUNTS:

"1. IN ALL CASES WHERE A PREMIUM IS NOT PAID ON OR BEFORE THE LAST DAY OF THE GRACE PERIOD, SAID PREMIUM MAY BE PAID AT ANY TIME DURING THE CALENDAR MONTH FOLLOWING THE MONTH FOR WHICH THE PREMIUM WAS DUE AND SAID PREMIUM MAY BE REGULARLY APPLIED AS PREMIUM PAYMENT TO THE UNPAID MONTH: PROVIDED, THAT THE INSURED AT THE TIME OF TENDERING OF THE DELAYED PREMIUM, IS IN AS GOOD HEALTH AS AT THE EXPIRATION OF THE GRACE PERIOD AND FURNISHED A STATEMENT TO THAT EFFECT; NOR LATER THAN THE LAST DAY OF THE CALENDAR MONTH IMMEDIATELY FOLLOWING THE MONTH IN WHICH THE DELAYED PREMIUM IS TENDERED.'

SECTION 408 OF THE WAR RISK INSURANCE ACT, AS AMENDED BY THE ACT OF MARCH 4, 1923, 42 STAT. 1525, IN FORCE DURING THE PERIOD IN QUESTION, PROVIDED IN PART AS FOLLOWS:

IN THE EVENT THAT ALL PROVISIONS OF THE RULES AND REGULATIONS OTHER THAN THE REQUIREMENTS AS TO THE PHYSICAL CONDITION OF THE APPLICANT FOR INSURANCE HAVE BEEN COMPLIED WITH, AN APPLICATION FOR REINSTATEMENT OF LAPSED OR CANCELED YEARLY RENEWABLE TERM INSURANCE OR APPLICATION FOR UNITED STATES GOVERNMENT LIFE INSURANCE (CONVERTED INSURANCE) HEREAFTER MADE MAY BE APPROVED: PROVIDED, THAT THE APPLICANT'S DISABILITY IS THE RESULT OF AN INJURY OR DISEASE, OR OF AN AGGRAVATION THEREOF, SUFFERED OR CONTRACTED IN THE ACTIVE MILITARY OR NAVAL SERVICE DURING THE WORLD WAR: PROVIDED FURTHER, THAT THE APPLICANT DURING HIS LIFETIME SUBMITS PROOF SATISFACTORY TO THE DIRECTOR SHOWING THE SERVICE ORIGIN OF THE DISABILITY OR AGGRAVATION THEREOF AND THAT THE APPLICANT IS NOT TOTALLY AND PERMANENTLY DISABLED. * * *

THE FACTS FAIL TO SHOW, AS REQUIRED BY THIS STATUTE, A COMPLIANCE WITH THE PROVISIONS OF THE REGULATIONS THAT THE INSURED FURNISHED A STATEMENT OF GOOD HEALTH AT THE TIME HE TENDERED THE DELAYED PREMIUMS. THE MATTER MAY BE BRIEFLY SUMMARIZED THAT THE INSURED, ALLEN, TENDERED HIS PREMIUM WITHIN THE TIME ALLOWED AFTER IT WAS DUE AND INSURANCE HAD LAPSED, BUT HE FAILED TO SEND WITH IT AS REQUIRED BY THE REGULATIONS RELATING THERETO A STATEMENT THAT HE WAS THEN IN AS GOOD HEALTH AS WHEN THE GRACE PERIOD EXPIRED. THE QUESTION THUS BECOMES WHETHER, THERE BEING NO STATEMENT OF THE HEALTH CONDITION AT THE TIME IT SHOULD HAVE BEEN MADE, THE TENDER OF THE PREMIUM ONLY WAS INEFFECTIVE. THE PURPOSE OF A STATEMENT AS TO HEALTH CONDITION IS SO THAT THERE BE NO INCREASE OF THE INSURANCE RISK. THIS CAN ONLY BE DETERMINED FROM THE INSURANCE SUBJECT HIMSELF AT THE TIME. STATEMENTS OF OTHERS AFTER A FATALITY HAS OCCURRED ARE ON A DIFFERENT BASIS AND ARE GENERALLY OPINIONS BASED PROBABLY ON CLOSE PERSONAL CONTACT AND OBSERVATION, BUT NEVERTHELESS NOT THE SAME AS THE LIVING SUBJECT STATEMENT AND IN CONNECTION WITH WHICH THERE MAY BE A DISCLOSURE OF LATENT DISABILITY. IT MAY BE ADDED THAT THE PRESENT SUBMISSION DOES NOT DISCLOSE WHAT ACTION WAS TAKEN BY THE BUREAU ON THE FAILURE TO SEND THE HEALTH STATEMENT WITH THE TENDER OF PREMIUM. IF THE TENDER WAS OTHERWISE ACCEPTABLE, IT WOULD HAVE BEEN PROPER FOR THE BUREAU TO REQUEST THE HEALTH STATEMENT, AND THERE WOULD HAVE BEEN NO REINSTATEMENT IN THE MEANTIME, AND IN ALL EVENTS THERE COULD HAVE BEEN NO WAIVER OF SUBMITTING THE HEALTH STATEMENT. IT FOLLOWS THAT THE TENDER OF THE PREMIUM COULD NOT HAVE BEEN ACCEPTED WITHOUT THE HEALTH STATEMENT, AND THE SITUATION MUST BE DETERMINED AS BEING ONE OF AN INCOMPLETE TENDER, NOT AUTHORIZED TO BE NOR IN FACT ACCEPTED, AND THEREFORE THERE WAS NO EFFECTIVE INSURANCE AND NONE IS PAYABLE. ACCORDINGLY, NEITHER THE REGULATIONS NOR THE STATUTE WAS COMPLIED WITH BY THE APPLICANT FOR REINSTATEMENT DURING HIS LIFETIME. THERE IS NO AUTHORITY FOR THE ACCEPTANCE OF A STATEMENT OF GOOD HEALTH MADE BY THE WIDOW OF AN APPLICANT WHO FAILS TO COMPLY WITH THE STATUTE DURING HIS LIFETIME. YOU ARE ADVISED, THEREFORE, THAT UPON THE FACTS SUBMITTED THERE MAY NOT BE CONSIDERED TO HAVE BEEN A REINSTATEMENT OF THE POLICY SUCH AS TO AUTHORIZE PAYMENT OF INSURANCE THEREUNDER.