Albert v. Cuna Mutual Insurance Society

255 So. 2d 170, 1971 La. App. LEXIS 5242
CourtLouisiana Court of Appeal
DecidedDecember 2, 1971
Docket3599
StatusPublished
Cited by26 cases

This text of 255 So. 2d 170 (Albert v. Cuna Mutual Insurance Society) is published on Counsel Stack Legal Research, covering Louisiana Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Albert v. Cuna Mutual Insurance Society, 255 So. 2d 170, 1971 La. App. LEXIS 5242 (La. Ct. App. 1971).

Opinion

255 So.2d 170 (1971)

Leroy ALBERT, Plaintiff-Appellee,
v.
CUNA MUTUAL INSURANCE SOCIETY, Defendant-Appellant.

No. 3599.

Court of Appeal of Louisiana, Third Circuit.

December 2, 1971.

*171 Stafford, Pitts & Bolen by Grove Stafford, Sr., Alexandria, for defendant-appellant.

Garrett, Ryland & Downs, by Donald M. Garrett, Alexandria, for plaintiff-appellee.

Before FRUGE, HOOD and DOMENGEAUX, JJ.

HOOD, Judge.

Leroy Albert instituted this action against Cuna Mutual Insurance Society to recover benefits alleged to be due on a group life, health and accident insurance policy issued by Cuna to Valex Federal Credit Union. Plaintiff, alleging that he is totally and permanently disabled, seeks a judgment condemning defendant to pay to him or to Valex the balance of Albert's indebtedness to that credit union and condemning Cuna to pay to plaintiff penalties and attorney's fees.

The trial court rendered judgment in favor of plaintiff, ordering defendant to pay $2,770.00 to Valex, in discharge of plaintiff's obligation to that payee, and condemning Cuna to pay to plaintiff the additional sum of $1,000.00 as attorney's fees. Defendant appealed, and plaintiff has answered the appeal.

The issues are: (1) Does Albert have a right of action against Cuna? (2) Is plaintiff totally and permanently disabled? (3) Should penalties and attorney's fees be awarded?

Plaintiff worked as a housekeeping aide for Veterans Administration Hospital in Alexandria, Louisiana, from January, 1962, until October 17, 1967. He has suffered from plantar warts and callouses on his feet for several years, beginning prior to his employment by the hospital, and he has been under almost constant medical treatment for his feet since 1962. His condition grew progressively worse while he was working for the Veterans Hospital, and in August, 1967, he submitted to surgery for the removal of a plantar wart from his right foot. Additional warts developed shortly after that surgery was performed, and since that time plaintiff has continued to suffer from numerous plantar warts and callouses on his feet. He also has suffered from low back pain and weakness of the knees.

Because of his physical condition, Albert was granted a disability retirement from the Veterans Administration Hospital on October 17, 1967, and he has performed no work since that time. He contends that he became totally and permanently disabled on that date.

While employed by the hospital, Albert became a member of Valex Federal Credit Union, a financial institution operated for the employees of the hospital, and he borrowed money from that institution in December, *172 1966, and in June, 1967. At the time of his disability retirement, on October 17, 1967, he owed $2,770.00 to Valex on the loans which had been made to him by that credit union.

Valex had procured a group life, health and accident insurance policy from defendant Cuna, and that policy was in effect when the above mentioned loans were made to plaintiff and when plaintiff was granted his disability retirement. That policy provides:

"Cuna Mutual Insurance Society * * * will pay to the Valex Federal Credit Union, Alexandria, Louisiana, * * * the amount remaining unpaid at the time of death or total and permanent disability of the Member on any insurable loan balance up to a maximum of $10,000.00, plus interest as herein provided, promptly upon receipt of satisfactory proof (a) of the amount of the Member's unpaid loan balance, and (b) of the Member's death prior to his 70th birthday, or of the Member's total and permanent disability as hereinafter defined prior to his 60th birthday. Cuna Mutual further agrees to waive the right of subrogation." (Emphasis added).

The term "total and permanent disability" is defined in the policy as meaning that the member, prior to his 60th birthday, "is totally and permanently unable to engage in any occupation for remuneration or profit." Plaintiff was 33 years of age when he was granted his disability retirement.

On October 18, 1967, Albert, through the credit union, submitted a formal claim to Cuna for payment of plaintiff's outstanding loan balance of $2,770.00. The basis for that claim, as shown on the claim statement, was "total and permanent disability" on the part of plaintiff Albert. Cuna refused to pay the claim on the ground that plaintiff "is not totally and permanently disabled from all gainful employment." Albert then instituted this suit.

Albert initially sought judgment in his favor, with penalties and attorney's fees. Defendant filed an exception of no right of action, based on the contention that no contractual relationship existed between plaintiff and defendant, and that Cuna thus was not obligated to pay anything to plaintiff. The exception was sustained by the trial court, but thereafter, with the court's permission, Albert amended his petition to demand, alternatively, that judgment be rendered condemning defendant to pay the amount of the loan indebtedness directly to Valex. Cuna answered, denying liability and reserving its rights under the exception. Judgment on the merits was rendered condemning Cuna to pay directly to Valex the amount of the loan indebtedness, and to pay to plaintiff $1,000.00 as attorney's fees.

Exception of No Right of Action

Defendant contends that Albert lacks the requisite interest to maintain an action against Cuna, because there is no contractual relationship between those parties and plaintiff is seeking merely to assert the rights of Valex.

Article 681 of the Louisiana Code of Civil Procedure provides that, "Except as otherwise provided by law, an action can be brought only by a person having a real and actual interest which he asserts."

Insurance policies, such as the one which is at issue here, are regulated by statutory law, found principally in Title 22 of our Revised Statutes. LSA-R.S. 22:175 (B) (4) defines the term "group life insurance," as including "Life insurance covering only the lives of all members of a group of persons * * * who become borrowers from one financial institution." In LSA-R.S. 22:215 (A) (3) (e) the term "blanket health and accident insurance" is defined as including "Under a policy or contract issued to a creditor who shall be deemed the policy holder to insure debtors of the creditors." The policy which was issued by Cuna to Valex, the creditor, *173 covers the lives of all members who become borrowers, and it was issued "to insure debtors of the creditors." Plaintiff was a member of Valex, and he was a borrower from and a debtor of that credit union. The policy thus covered his life and his health, and it was issued to insure him against loss in the event of death or disability. We construe the policy, as well as the cited statutes, to mean that Albert was an insured under the policy issued by Cuna. As the insured, we think he has a real and actual interest sufficient to entitle him to maintain this action.

We have been referred to no Louisiana cases in which this question has been finally determined. In other jurisdictions, however, courts have held that an individual who is insured under a group credit life or health and accident insurance policy may judicially enforce his rights under that policy. See Betts v. Brown, 219 Ga. 782, 136 S.E.2d 365 (1964); Pioneer Homeowners Life Insurance Company v. Hogan, 110 Ga.App. 887, 140 S.E.2d 212 (1965); McDaniel v.

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Bluebook (online)
255 So. 2d 170, 1971 La. App. LEXIS 5242, Counsel Stack Legal Research, https://law.counselstack.com/opinion/albert-v-cuna-mutual-insurance-society-lactapp-1971.