Berlan v. Metropolitan Life Insurance

24 S.W.2d 686, 224 Mo. App. 938, 1930 Mo. App. LEXIS 143
CourtMissouri Court of Appeals
DecidedFebruary 17, 1930
StatusPublished
Cited by6 cases

This text of 24 S.W.2d 686 (Berlan v. Metropolitan Life Insurance) is published on Counsel Stack Legal Research, covering Missouri Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Berlan v. Metropolitan Life Insurance, 24 S.W.2d 686, 224 Mo. App. 938, 1930 Mo. App. LEXIS 143 (Mo. Ct. App. 1930).

Opinion

ARNOLD, J.

This is a suit to recover on a policy of accident insurance.

Defendant is a corporation organized and existing under and by virtue of the laws of the State of New York, and authorized to write accident insurance in the State of Missouri, maintaining an office in Kansas City, Missouri, for that purpose. Plaintiff is a resident of Kansas City, Missouri, engaged in the business of general merchandising at 1412 East Eighteenth street in said city.

On October 6, 1922, in consideration of the payment of $19 premium, defendant issued its policy of that date insuring plaintiff for a term of twelve months ‘‘against the results of bodily injuries sustained while this policy is in force, and caused directly and independently of all other causes by violent and accidental means,” as provided in clause 1 of said policy. The policy is made an exhibit and attached to the petition herein.

At the expiration of the said twelve. months, the. policy was renewed and an additional premium paid for another twelve months. The policy provided for the payment of $5,000, in case of death under the terms thereof, and further provided plaintiff was to *941 receive the sum of. $25 per week' for total disability and-$12'. 50 per week for partial disability, and the further sum of, $100 for any surgical operation involving- cutting into the abdomen for .treatment of the organs therein. Further, the policy, provides in- clause 8 thereof:

“If any injury covered by this policy shall, within ninety days from the date of the accident, directly and independently of all other causes, necessitate any surgical operation named in the schedule of surgical operations endorsed hereon, the company will pay the insured the sum set opposite the said operation in the said schedule, provided always that if more than one such operation shall be necessitated as the result of any one accident, payment shall be made only for the operation first occurring. ”

Clause 9 provides, in part:

“Nor shall it cover accident, injury, disability', death or other loss caused wholly or partly by disease or bodily or mental infirmity or medical or surgical treatment therefor, or by ptomaines, or by bacterial infection (excepting only septic infection of and through a visible wound accidentally sustained).”

Further the policy provides:

“No agent has authority to change this policy or to waive any of its provisions. No change in this policy shall be valid unless approved by an executive officer of the company and such approval be endorsed thereon.”

“Written notice of injury on which claim may be based must be given to the company within twenty days after the date of the accident causing such injury.”

“Such notice given by or in behalf of the insured or beneficiary, as the ease may be, to the company at New York, or to any authorized agent of the company, with particulars sufficient to identify the insured, shall be deemed to be notice to the company. Failure to, give notice within the time provided in this policy shall not invalidate any claim if it shall be shown not to have been reasonably possible to give such notice and that notice was given as soon as was reasonably possible. ”

The schedule of operations referred to in clause 8, includes the following: “Abdomen — cutting into for treatment of organs therein.” The petition alleges that on or about the 1st day of November, 1923, and -while the said policy was in force, plaintiff; was injured violently and accidentally in his place of business at 1412 East Eighteenth - street in Kansas City,' Missouri, while engaged in an attempt to move a large -iron safe by use of á -crowbar, and- that plaintiff was “straining himself to move said safe;” that he slipped and fell against said crowbar, the end thereof striking -him in the *942 abdomen, thus causing plaintiff to sustain a hernia; that by reason of said injury plaintiff was rendered partially disabled from November 1, 1923, until the 21st day of January, 1924; that he underwent a surgical operation involving cutting into the abdomen for treatment of the organs therein on said 2'lst day of January, 1924, and that he was totally disabled and confined to a hospital from said date to February 20, 1924; that on said last named date, he was removed to his home and continued to be totally disabled, from said date until March 20, 1924; that plaintiff remained partially disabled from that date, until April 24, 1924, entitling him in all to the sum of $425 covering disability, and to the further sum of $100, covering the surgical operation; that plaintiff complied with all the terms and conditions of said policy and in due time after the injury and more than sixty days before the commencement of this action, plaintiff gave defendant due notice and proof of his loss, but that defendant failed and refused to pay thé amount claimed Under the terms of said policy; “that defendant without; reasonable grounds or just cause and in bad faith has vexatiously refused to pay plaintiff’s claim, to plaintiff’s further damage in the sum of $52.50 as damages for vexatious delay and in the further sum of $300 as damages for attorney’s fees for the prosecution of this action."

The prayer is for judgment for $525' actual damages, $52.50 for vexatious delay and the further sum of $300 as attorney’s fees, and for costs.

The answer admits the corporate status of defendant and that it transacts business in the State of Missouri; that the accident policy was issued to plaintiff as alleged in the petition; states that it was provided in the policy that said insurance should not cover accident, injury, disability, death or loss caused wholly or partly by disease or bodily or mental infirmity; that no agent should have authority to change said policy or waive any of its provisions, and that no change in said policy should be valid unless approved by an executive officer of said company, and be endorsed on the policy; that -it was provided in said policy that written notice of an injury upon which claim might be based must be given to said company within twenty days after the date of the accident causing the injury; that, with the consent of the company the policy might be periodically renewed upon successive expirations thereof, on payment of the specified premiums; that the policy herein was, in fact, renewed for a period of twelve months subsequent to' the original twelve months.

The answer avers that if plaintiff was injured as alleged in his petition, said injuries were caused by physical strain, or inherent physical weakness or defects or bodily infirmity, and were not caused directly and independently of all other causes by violent *943

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Montgomery v. Travelers Protective Ass'n of America
434 S.W.2d 17 (Missouri Court of Appeals, 1968)
Lesch v. Terminal RR Ass'n of St. Louis
258 S.W.2d 686 (Supreme Court of Missouri, 1953)
Kane v. Order of United Commercial Travelers of America
100 P.2d 1036 (Washington Supreme Court, 1940)
Pope v. Lincoln Nat. Life Ins.
103 F.2d 265 (Eighth Circuit, 1939)
State Bank of Seneca v. Saft.
75 S.W.2d 420 (Missouri Court of Appeals, 1934)
Prudential Ins. Co. of America v. Tidwell
1933 OK 102 (Supreme Court of Oklahoma, 1933)

Cite This Page — Counsel Stack

Bluebook (online)
24 S.W.2d 686, 224 Mo. App. 938, 1930 Mo. App. LEXIS 143, Counsel Stack Legal Research, https://law.counselstack.com/opinion/berlan-v-metropolitan-life-insurance-moctapp-1930.