Carnelious v. Louisiana Industrial Life Ins.

138 So. 533, 18 La. App. 739, 1931 La. App. LEXIS 385
Louisiana Court of Appeal·Decided December 14, 1931·No. No. 13797·Published·Cited by 16 cases

Opinion

WESTERFIELD, J.

This is a suit on an industrial life and accident insurance policy. The plaintiff, Hesi-kiah Carnelious, a longshoreman, suffered an accidental injury to his right leg on February 2, 1930. His leg was amputated on June 1, 1930. The amputation of the leg is alleged to have totally disabled plaintiff, and it is claimed that he is entitled to twenty [534] times the amount of the weekly premium of $.25, or $5 a week, for 100 weeks; that, at the time of the filing of the suit, 35 weeks were due, totaling $175, upon which a credit of $105 was acknowledged, leaving a balance of $70, for which amount judgment is asked, plus $5 a week from September 30, 1930, the date of the filing of the suit, until the rendition of judgment, together with reservation of his right to sue' for additional weekly benefits, as the same may become due. As originally filed, a penalty of double the amount due, plus attorney’s fees, was prayed for, because of the delayed payment, under the policy, in accordance with Act No. 310 of 1910.

There was judgment below in plaintiff’s favor, as prayed for, with the exception of the penalties. Prom this judgment defendant has appealed. No modification of the judgment with reference to penalties is asked for by plaintiff’s counsel, for the reason that, since the institution of the suit, plaintiff has died, and it is admitted that his succession representative is not entitled to claim the penalties.

Defendant admits the issuance of the policy, the injury, and amputation of plaintiff’s leg, but denies that he was permanently and totally disabled within the meaning of the policy. It avers that plaintiff was paid more than he was entitled to at the time this suit was brought.

Plaintiff relies upon the following provisions of the policy: “If through accident the insured sustains an injury which directly, and independently of all other causes, results in entire and continuous disablement of the insured within sixty, days from the date of such accident and which shall wholly and permanently disable the insured from performing any and .every kind of duty pertaining to his trade or occupation, then and in that event, the Company will, in lieu of all other benefits, pay to the insured for a period not exceeding one hundred weeks a weekly indemnity equalling twenty times the amount of the premium payable hereunder totalling the amount stated in the schedule belów.”

The position of plaintiff with regard to the totality of the disability is that his occupation, that of longshoreman, was such as to preclude his further pursuit of it with only one leg; that a longshoreman needs two legs in order to carry on. Sizemore v. Kirkland Timber Co., 15 La. App. 229, 131 So. 501, 502; Jennings v. Brotherhood Accident Co., 44 Colo. 68, 96 P. 982, 18 L. R. A. (N. S.) 109, 130 Am. St. Rep. 109; Taylor v. Southern States Life Ins. Co., 106 S. C. 356, 91 S. E. 326, L. R. A. 1917C, 910. In the latter case it was held that “total disability,” as used in accident policies, means “generally such disability as prevents the insured from following his usual vocation in which he was engaged when he was injured.” We conclude on this point that a longshoreman who-loses one leg is totally disabled within the meaning of the policy.

But defendant says that plaintiff cannot claim under the quoted paragraph, because he has not alleged, nor proved, that the loss-of the leg on Ju»e 1st was due to the accident which he suffered on February 2d, and that certainly the disability was not “immediate or continuous after the injury” and not the direct cause “independent of all other causes” of his disablement. He contends-that, if anything is due plaintiff, it is due him under another clause of the policy, where ten times the amount of the premium, or $2.50 a week in this case, would be due, which clause reads as follows: “Should such accident result in the loss of one hand above the wrist or of one foot above the ankle, then and in that event the company will consider such loss as constituting partial disability in the sense of this clause and will pay to the insured, in lieu of all other benefits under this policy, for a period not exceeding one hundred (100) weeks, a weekly indemnity equaling ten (10) times the amount of the premium payable hereunder totaling the amount stated in the schedule below.”

Defendant voluntarily paid plaintiff the sum of $105, the amount which would be due plaintiff at $6 a week for the 21 weeks, which had elapsed during the period in which these premiums were paid, and thus it appears that the defendant itself at one time believed plaintiff entitled to the benefits of the provision relied on. However that may be, we will first discuss the total disability clause from the standpoint of whether plaintiff’s injury was the direct and independent cause of his disability. We have already held that he was totally disabled. ' '

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

Carnelious v. Louisiana Industrial Life Ins., 138 So. 533, 18 La. App. 739, 1931 La. App. LEXIS 385 (La. Ct. App. 1931).

138 So. 533 (Carnelious v. Louisiana Industrial Life Ins.) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

Related

Moore v. Prudential Insurance Company of America
278 So. 2d 481 (Supreme Court of Louisiana, 1973)
Duhon v. COLONIAL LIFE AND ACCIDENT INSURANCE CO.
277 So. 2d 234 (Louisiana Court of Appeal, 1973)
McCray v. National Life & Accident Insurance Co.
244 So. 2d 342 (Louisiana Court of Appeal, 1971)
Burgett v. Stuyvesant Life Insurance
236 So. 2d 306 (Louisiana Court of Appeal, 1970)
Dennis v. Business Men's Assurance Company of Amer.
175 So. 2d 431 (Louisiana Court of Appeal, 1965)
Towner v. Prudential Insurance Company of America
137 So. 2d 449 (Louisiana Court of Appeal, 1962)
Richard v. Southern Farm Bureau Casualty Ins. Co.
128 So. 2d 806 (Louisiana Court of Appeal, 1961)
Thibodeaux v. Pacific Mutual Life Insurance Co.
112 So. 2d 423 (Supreme Court of Louisiana, 1959)
Hughes v. Standard Life Insurance
139 F. Supp. 490 (W.D. Louisiana, 1956)
Franklin v. Mutual Life Ins. Co. of New York
45 So. 2d 624 (Supreme Court of Louisiana, 1950)
Lipscomb v. Equitable Life Assur. Soc. of United States
18 So. 2d 167 (Supreme Court of Louisiana, 1944)
Jones v. Washington Nat. Ins. Co.
2 So. 2d 696 (Louisiana Court of Appeal, 1941)
Williams v. General Accident Fire & Life Assurance Corp.
62 P.2d 866 (Supreme Court of Kansas, 1936)
De Blieux v. Travelers Ins. Co.
170 So. 14 (Supreme Court of Louisiana, 1936)
Marshall v. Metropolitan Life Ins. Co.
164 So. 441 (Louisiana Court of Appeal, 1935)