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DONG SHENG LU, ETC., respondent, v. EQUITABLE COMPANY, INC., ET AL., defendants, MICHAEL HO, appellant.

DECISION ORDER

ORDERED that the order is reversed insofar as appealed from, on the law, with costs, the motion is granted, and the complaint is dismissed insofar as asserted against the appellant.

In September 1996 the plaintiff's decedent applied to defendant The Equitable Life Assurance Society (hereinafter Equitable) for a life insurance policy. However, she failed to inform Equitable that she had undergone dual valve replacement heart surgery in 1991. The decedent died about one year after the policy was issued, and Equitable refused to pay the policy benefits. As a result, the plaintiff, as administrator of the decedent's estate, brought the instant action against, among others, Equitable and the defendant Michael Ho, who sold the policy to the decedent, to recover the proceeds of the policy. The plaintiff alleged that Ho had told the decedent to omit from her application her medical history as it related to her heart. Equitable and Ho separately moved for summary judgment dismissing the complaint insofar as asserted against them. Although the Supreme Court granted Equitable's motion, it denied Ho's motion. Ho appeals from so much of the order as denied his motion for summary judgment. We reverse the order insofar as appealed from, and grant Ho's motion for summary judgment.

On appeal, the plaintiff correctly "concedes that he does not possess a valid cause of action for breach of contract against defendant Ho as agent of [Equitable], his disclosed principal." Therefore, the first cause of action insofar as asserted against Ho to recover damages for breach of contract should have been dismissed.

Ho was also entitled to summary judgment dismissing the second cause of action insofar as asserted against him, which alleges fraud. The elements of a cause of action alleging fraud are "a representation of fact, which is either untrue and known to be untrue or recklessly made, and which is offered to deceive the other party and to induce them to act upon it, causing injury" ( Jo Ann Homes at Bellmore v. Dworetz, 25 N.Y.2d 112, 119; see Avecia, Inc. v. Kerner, 299 A.D.2d 380; Cohen v. Houseconnect Realty Corp., 289 A.D.2d 277, 278). Additionally, the plaintiff's reliance on the misrepresentation must be justifiable ( see Cohen v. Houseconnect Realty Corp., supra).

In the context of insurance, "[a]n insured cannot remain silent while cognizant that his insurance application contains misleading or incorrect information. In particular, he or she must notify his or her insurance company of nonapparent medical conditions which the company probably would consider relevant when deciding whether to issue a policy" ( North Atl. Life Ins. Co. of Am. v. Katz, 163 A.D.2d 283, 284-285 [citations omitted]; see Minsker v. John Hancock Mut. Life Ins. Co., 254 N.Y. 333, 338; Boyd v. Allstate Life Ins. Co. of N.Y., 267 A.D.2d 1038; Equitable Life Assur. Soc. of U.S. v. O'Neil, 67 A.D.2d 883, 884). Thus, in the instant case, the decedent's reliance on Ho's alleged representations that she did not have to include her history of heart surgery on her insurance application was unjustifiable as a matter of law ( see Wageman v. Metropolitan Life Ins. Co., 24 A.D.2d 67, 70-71, affd 18 N.Y.2d 777).

Finally, the plaintiff's claim for punitive damages also should have been dismissed ( see Rocanova v. Equitable Life Assur. Socy. of U.S., 83 N.Y.2d 603, 613).

SMITH, J.P., GOLDSTEIN, ADAMS and TOWNES, JJ., concur.

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LU v. EQUITABLE CO., INC
(Apr 26, 2004)