&198tna Life Ins. Co. v. Roberts

164 So. 311, 174 Miss. 278, 1935 Miss. LEXIS 30
CourtMississippi Supreme Court
DecidedNovember 25, 1935
DocketNo. 31898.
StatusPublished
Cited by5 cases

This text of 164 So. 311 (&198tna Life Ins. Co. v. Roberts) is published on Counsel Stack Legal Research, covering Mississippi Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
&198tna Life Ins. Co. v. Roberts, 164 So. 311, 174 Miss. 278, 1935 Miss. LEXIS 30 (Mich. 1935).

Opinion

Ethridge, P. J.,

delivered the opinion of the court.

The appellee was plaintiff in the court below and filed suit upon a policy of life insurance issued by the appellant to recover disability benefits provided for under said policy which contained what is commonly called a “total and permanent disability” clause, reading as follows:

*286 “Permanent Total Disability Provision. If before default in payment of premium, the insured becomes totally and permanently disabled by bodily injuries or disease and is thereby prevented from performing any work or conducting any business for compensation or profit, the following benefits will be available;
“When such disability occurs before age Sixty; A waiver of the payment of premiums falling due during such disability, and an income of ten dollars a month for each one thousand dollars of the sum insured payable to the life owner each month in advance during such disability.
“If before attaining the age of sixty years, the insured becomes totally disabled by bodily injuries or disease and is thereby prevented from performing any work or conducting any business for compensation or profit for a period of ninety consecutive days, then, if satisfactory evidence has not been previously furnished that such disability is permanent, such disability shall be presumed to be permanent. In such a case, benefits shall accrue from the expiration of the said ninety days, but not from a date more than six months prior to the date that evidence of such disability, satisfactory to the Company, is received at its Home Office. No benefit shall accrue prior to the expiration of said ninety days, unless during that period, evidence satisfactory to the Company is received at its Home Office while the insured is living that the total disability will be permanent, in which event benefits will accrue from the commencement of disability.”

The appellant filed a plea of the general issue giving notice thereunder that if the appellee was disabled, such disability arose after the default in the payment of premiums, and that notice of such disability was received by the appellant within the ninety-day period and after the alleged commencement of the disability. It was also alleged that evidence of such disability was never, at any tipie, received by the appellant, and had not beep received *287 at the time the suit was filed, and for these reasons the policy was null and void.

The notice given by the plaintiff to the insurance company was by two letters, the first one dated February 29, 1932, at a time when the plaintiff was at Outwood, Kentucky, in a hospital being treated for tuberculosis, and reads as follows:

“Ætna Life Ins. Co.
“Age-Herald Bldg.,
“Birmingham, Ala.
‘ ‘ Gentlemen:
“November 31, 1931, paid up extension on a $5,000.00 policy issued to John M. Roberts, Brookhaven, Missississippi, expired. I have not the number available, as it is at home. This policy has the disability clause. In view of the above expiration, have I any claim for disability due to the following facts set forth briefly: During the latter part of July, 1931,1 became unable to work. Filed claim for examination with the U. S. Veterans Bureau in November, 1931. Diagnosed active T. BL after X-ray and Exam. Jan. 24th, 1932. Confirmed as active far advanced by board of examiners U. S. Veterans Hospital, Outwood, Ky., Feb. 23,1932, and am now receiving treatment at the above mentioned hospital. Your advices in the matter will be very much appreciated. ’ ’

The second letter was dated March 15, 1932, and addressed to the .¿Etna Life Insurance Company, at Memphis, Tennessee, and reads as follows:

“In view of the following facts has the undersigned any claim on the above numbered policy which' expired November 13, 1931. I have been totally disabled and unable to work since July, 1931. During the early part of November, 1931, I made application on the United States Veterans Bureau for Hospitalization, and was examined on such application at the regional office at Jackson, Miss., January 24, 1932, at which time I was diagnosed as an active tubercular. I entered the Veterans Bureau Hospital at Outwood, Ky., February 12th, *288 and pronounced by the medical board as a far advanced case. Tbe above policy carried a disability clause. This iniformaition was furnished your office under date of February 24th, but through error was addressed to the Age-Herald Building, Birmingham, Ala. Tour advices in the above will be appreciated.”

The appellant replied to these letters under date of March 29', 1932, as follows:

“Mr.' John M. Boberts,
“c/o H. S. Veterans Hospital
“Outwood, Ky.
“Dear Sir:
“In regard to your recent letter, inquiring if you are covered under the disability clause in Policy N-531,712, will advise that your letter addressed to our general agent at Birmingham, on March 11th, was forwarded to the Home Office, and on March 21st, they wrote to him stating that your policy lapsed for non-payment of the quarterly premium falling due August 25, 1929, and that the extended insurance feature was operative until November 13, 1931. The disability clause states that an insured must be permanently and totally disabled before default in payment of premium. Hnder this interpretation the Company is not considering your application for disability.”

The plaintiff remained in the hospital at Outwood, Kentucky, until the fall of 1932, when he returned to Brookhaven, Mississippi, and attended to certain legal business in which he had been engaged, and in December, 1932, he had a hemorrhage and was sent to the Veterans’ Hospital at Alexandria, Louisiana, where he stayed until May, 1932. He then returned to Brookhaven, had another hemorrhage, and was returned to the hospital at Outwood, Kentucky.

The policy involved had lapsed once for nonpayment of premiums, and was reinstated in February, 1928. The last premium paid on the policy, which had the thirty *289 days of grace provision, was on May 25,1929, and another premium became due on August 25, 1929.

There was considerable testimony as to the condition of the plaintiff on and before August 25', 1929, and as to whether or not his condition of health on the date when the last premium was or should have been paid was such as to show that he was totally and permanently disabled.

In 1928, he had a casual examination by a physician attending one of his family at which time the appellee had a severe cold, and this physician testified that the appellee then had blood in his sputum, which indicated tuberculosis.

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Bluebook (online)
164 So. 311, 174 Miss. 278, 1935 Miss. LEXIS 30, Counsel Stack Legal Research, https://law.counselstack.com/opinion/198tna-life-ins-co-v-roberts-miss-1935.