Bakkensen v. John Hancock Mutual Life Insurance

353 P.2d 558, 222 Or. 484, 1960 Ore. LEXIS 526
CourtOregon Supreme Court
DecidedJune 22, 1960
StatusPublished
Cited by14 cases

This text of 353 P.2d 558 (Bakkensen v. John Hancock Mutual Life Insurance) is published on Counsel Stack Legal Research, covering Oregon Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Bakkensen v. John Hancock Mutual Life Insurance, 353 P.2d 558, 222 Or. 484, 1960 Ore. LEXIS 526 (Or. 1960).

Opinion

MILLARD, J.

(Pro Tempore)

The defendant insurance company appeals from a judgment of the circuit court of Linn county in the sum of $1,040, plus attorney’s fees and costs, rendered *488 in favor of the plaintiff in an action wherein he is claiming disability benefits as a workman under the terms of a policy of group insurance issued by defendant upon the application of plaintiff’s union and wherein full-time employees are eligible if covered by an agreement between the employer and the union under its health and welfare program. In connection with this it appears that it is without question that plaintiff was an employee of an employer who entered into such an agreement with his union and that a policy of group insurance was issued.

Upon the completion of plaintiff’s case in chief, defendant moved for an involuntary nonsuit, which was denied. Upon conclusion of the trial both parties moved for a directed verdict, and thereupon a verdict was directed in favor of plaintiff. Defendant first assigns as error the denial of each of its motions. Both, in effect, were based upon the grounds that there was insufficient evidence to establish that plaintiff was a full-time employee under the terms of the policy by showing that he worked a regularly scheduled working week equal to or in excess of 20 hours a week.

It, therefore, becomes necessary that we review the evidence in the light most favorable to plaintiff. The policy provided that as a part of its “Basic Insurance” benefits, plaintiff, if he were eligible, would be entitled to certain “nonoccupational weekly benefits” for a period of about 26 weeks if while insured for accident and sickness under the policy, he became wholly and continuously disabled by disease for which he was not entitled to any benefit under a Workmen’s Compensation Law or Act, and was prevented from performing any and every duty of his occupation. There was no contention made that plaintiff could have made claim under the Workmen’s Compensation Law as it then *489 existed, nor eonld such have been done. The policy further provided that “Basic insurance” was available to “Eligible Class of Employees” defined as “each full time employee, if the work of such employee is covered by a Collective Bargaining Agreement of an Employer with a local of the IWA-CIO — Northwest Region providing Health and Welfare Benefits under the IWA — Health and Welfare program * *

The benefits claimed are covered by provisions of the policy relating to nonoccupational weekly benefits which provided that “If disability commences while actively at work as a full time employee: 70% of basic weekly wage but in no event to exceed $40 per week.” The policy defined “Basic weekly wage” as “the normal number of hours per week in the employee’s work schedule, not to exceed forty hours, multiplied by the employee’s hourly wage rate,” exclusive of bonus or overtime.

The policy also defined a full-time employee as “an employee whose regular working schedule with one Employer equals or exceeds twenty hours per week.” At this point we digress to point out that this does not expressly require the employee to work 20 hours per week, but only that a regular working schedule be contemplated for such period. The term “regular working schedule” is not separately defined therein. The union contract, however, which was admitted into evidence over defendant’s objection does contain provisions with reference to hours of work as follows:

“The regular hours of labor shall consist of five (5) consecutive eight (8) hour days. All time worked in excess of eight (8) hours in any one day shall be paid for at one and one-half times the employee’s job rate of pay. All work performed on the sixth and seventh day of the regularly scheduled work week shall be paid for at one and one-half *490 times the employee’s job rate of pay. The regularly scheduled work week shall at all times commence on Monday.
"* * * * *
“An employee called to his job but not put to work, through no fault of his own, shall receive two (2) hours’ pay unless notified prior to reporting that his services are not required. * *

Plaintiff was not an emergency fire fighter but was hired as a fire watcher at logging operations and seasonally had worked for his employer in that capacity more than one year. It appears that watchers were required because after the start of the fire season on April 1, forestry regulations required the employer engaged in logging to keep a watcher present at the point of operations while the loggers were off work and while there was a danger of fire. He started to work for the company on May 13, 1956, at the rate of a few cents over $2 per hour. He worked four days in May, four days in June, and ten days in July prior to his disability on July 26. His insurance premiums were deducted from his pay check and remitted to defendant, who accepted them and then attempted to return them after plaintiff made a claim for disability, claiming that the company was unaware of the hours plaintiff actually worked. On July 26, 1956, while on the job, plaintiff suffered a heart attack, disabling him for at least 26 weeks. Plaintiff testified in effect that under the terms of his employment he was required to be available for work every morning, although he was not reqxdred to work if it rained or if in the discretion of the employer there was no danger of fire and that if he had not been available he would have been fired. In any event, whether in fact he did work on any particular day depended on whether or not in the discretion of his employer there was a danger of fire so *491 that in fact his actual hours of work were erratic. Witness Stratman, called by defendant and who was the fire warden for the employer and who had charge of this phase of the work, testified in reference to the fire watchers that “They were supposed to come. It might be sunshining where they live and it might be raining in the mountains.” In response to the question: “So sometimes it was your job to keep them from work or vice versa?, the witness answered “No. They were to find from the office if they were to go to work.” The witness answered “yes” when asked “So from April 1 to November 1 the men know they have a job as fire watchers.” He further testified they were paid for an eight-hour day, the same as the fallers and buckers. Defendant’s witness Todd, personnel manager for the employer, testified that Stratman told them whether to come to work and that in that respect their position was different from that of the loggers who reported unless told otherwise.

Since only full-time employees were eligible for insurance if covered by a union agreement and since plaintiff was subject to such an agreement, we now consider the question of whether or not plaintiff was a full-time employee. It appears that plaintiff was at all times required to be available for work even though his services might not be required. In the case of Harlan v. Washington Nat. Ins. Co., 388 Pa 88, 130 A2d 140, wherein the question was whether or not a seasonal or transitory employee was a full-time employee within the meaning of that term as contained in a group policy of life insurance, it was stated:

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Bluebook (online)
353 P.2d 558, 222 Or. 484, 1960 Ore. LEXIS 526, Counsel Stack Legal Research, https://law.counselstack.com/opinion/bakkensen-v-john-hancock-mutual-life-insurance-or-1960.