Aetna Life Insurance Co. v. Daniel

65 S.W.2d 1025, 251 Ky. 760, 1933 Ky. LEXIS 955
Court of Appeals of Kentucky (pre-1976)·Decided December 12, 1933·Published·Cited by 7 cases

Opinion

Opinion op the Court by

Judge Richardson

Affirming.

This action involves a group policy of insurance, issued September 17, 1923, to the North-East Coal Company by the -¿Etna Life Insurance Company of Hartford, Conn. The annual premiums without any cost whatsoever to its employees were paid by the NorthEast Coal Company. The policy insured, as per its terms, the lives of the employees who were under 60 years of age, against total and permanent disability so long as they continued in the employ of the coal company. It divided them into two groups, office employees and ordinary laborers. The maximum insurance on the lives of the first group was $2,000 each, and *762 on the latter, $1,500. They were -not eligible to the benefits of the policy until they had worked for the coal company for a period of six consecutive months. If the employee ceased to work for the coal company, his certificates were canceled on the cessation of his employment. There ' was issued and delivered contemporaneously with the group policy, to Warren Daniel, an employee of the coal company, a certificate of $500, and thereafter a certificate of $100 for the years 1924, 1925, 1926, 1927, 1928, 1929, and 1930, aggregating $1,200 was delivered. The annual premiums on the group policy were paid by the coal company to the insurance Company from the date of its issuance, 1923, during all of the intervening years up to and until January 1, noon, 1932, when it was canceled. A rider was attached to the group policy, which contained a statement that the policy was automatically to expire, without privilege of further renewal, on January 1, 1932.

Daniel was laid off by the coal company from August, 1931, to November, 1931, and again on February 29, 1932. He claims that he was excused by the coal company from continuing in the work for it on account of bad health. The .¿Etna Life Insurance Company contends that Daniel’s employment with the coal company ceased on the 31st day of July, 1931, and later, November 2, 1931, he went back in the service of the coal company. At the time he left its employment, in July, his name was dropped from the pay-roll, and the group policy, as to him, was canceled as of July 31, 1931. It claims that when he resumed work in November, 1931, he was taken back by the coal company as a new employee and that thereafter he had to continue in the service of the coal company for a period of six months before he would be eligible for insurance. For this reason it insists that he was not reported by the coal company as an employee under the group policy. The policy carried a provision that when the employee insured thereunder leaves' the employ of the coal company it is automatically canceled.as to him. It canceled Daniel’s certificates before November 2,- 1931; but the policy, itself, was not canceled until January, 1932. Also, the insurance company claims that Daniel again left the employment of the coal company in February, 1932; that at that time he was laid off on account of the reduction of the number of employees by the coal com *763 pany. After the policy was canceled in July, 1931, the coal company paid to the insurance company no premiums on the group policy for Daniel.

The insurance company refused, to recognize and pay the certificates issued to Daniel under the group policy; hence this action.

Daniel’s cause of action is based on the certificates. The answer of the insurance company contains four separate paragraphs. The first is a traverse. The second presents as a defense a clause in the policy, which reads:

“If you are sick or absent on account of other excusable causes, you are requested to report same immediately to this office. If ten days of absence is unexplained it will be understood that you left our employ and your insurance will be - canceled. ’ ’

The third paragraph relies upon a provision in the policy respecting total and permanent disability, and charges such disability did not exist for a period of at least six months before the commencement of the action and that this provision is a bar to Daniel’s recovery. The fourth relies upon the cancellation of the policy, as to Daniel, on the 31st day of July, 1931.

The issues were formed by appropriate pleadings, and on a trial before a jury, a verdict was returned in favor of Daniel of $1,200.

The insurance company urges it was entitled to .a directed verdict at the close of all the evidence, that incompetent testimony was admitted, and the instructions are erroneous.

The basis of the argument that the verdict should have been directed for it is: (a) The insurance was canceled and terminated July 31, 1931; (b) Daniel had not been employed by the coal company for six months as provided in the group policy; (c) the evidence failed to establish that his disability was permanent and total, or originated either prior to July 1, 1931, or January 1, 1932, and the pay-roll records of the coal company together with the testimony of its officials are conclusive of this question; (d) and that even if his disability be regarded as permanent and total, it did not originate until after the cancellation of the group pol *764 icy and after Daniel had left the employment of the coal company.

If the testimony of Daniel be utterly disregarded and only the pay-.roll record of the coal company and the testimony of its officials are considered, the insurance company is correct in its presentment of the issues.

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Aetna Life Insurance Co. v. Daniel, 65 S.W.2d 1025, 251 Ky. 760, 1933 Ky. LEXIS 955 (Ky. 1933).

65 S.W.2d 1025 (Aetna Life Insurance Co. v. Daniel) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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