Cassady v. United Insurance Company of America

370 F. Supp. 388, 1974 U.S. Dist. LEXIS 12385
CourtDistrict Court, W.D. Arkansas
DecidedFebruary 5, 1974
DocketHS 73-C-4
StatusPublished
Cited by15 cases

This text of 370 F. Supp. 388 (Cassady v. United Insurance Company of America) is published on Counsel Stack Legal Research, covering District Court, W.D. Arkansas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Cassady v. United Insurance Company of America, 370 F. Supp. 388, 1974 U.S. Dist. LEXIS 12385 (W.D. Ark. 1974).

Opinion

OPINION

JOHN E. MILLER, Senior District Judge.

On March 5, 1973, plaintiff, Kenneth L. Cassady, commenced this action against United Insurance Company of America for recovery on a policy of insurance issued by defendant August 28, 1967, insuring the plaintiff for loss of life, limb, sight or time, resulting solely from bodily injury, or for loss of time by illness and other specified benefits.

The material and relevant portion of the policy involved herein, Part Three, provides:

“The Company will pay, except as provided in Part Four and Part Seven from the first treatment of the attending physician at the rate of the Weekly Benefit stated in the Schedule on Page 4, if the Insured suffers ‘Such Sickness’ which shall wholly and continuously disable the Insured so as to prevent him from performing every duty pertaining to his occupation and cause him to be confined inside the house under the regular care and attendance of a legally-qualified physician or surgeon, during the period of such disability. This benefit is not payable during any period for which the Hospital Residence Benefit is payable.
“The term ‘confined inside the house’ is hereby defined as confinement of the Insured continuously inside the house because of ‘Such Sickness,’ except that the right of the Insured to recover under the policy shall not be defeated because he visits his physician for treatment or goes to a hospital for treatment when such treatment cannot be administered in the Insured’s home.
«•«****
“The maximum benefits payable under this Part Three, including Hospital Residence Benefits provided under Part One, will be thirty (30) weeks during any policy year for any sickness or sicknesses.”
(The schedule on page 4, referred to above, provides for payment of weekly benefits of $42.00 for disability.)

The case was tried to the court without the intervention of a jury on January 22, 1974. Prior to the trial the attorneys for the parties had each served and submitted trial briefs. At the conclusion of the evidence the court suggested to the attorneys that if either of them desired to submit to the court additional or supplemental briefs containing a discussion of the evidence that they should do so within ten days. Such supplemental briefs have been received by the court and considered along with the original briefs, the record and the testimony of the witnesses, together with the exhibits thereto.

In the supplemental brief of plaintiff, he states that the primary issues in the case are:

1. Whether or not the plaintiff was “disabled and confined to the house” within the meaning of the terms as construed by the courts.
2. Whether the defendant’s discontinuance of payments to the plaintiff constitutes an anticipatory breach.
3. Is the plaintiff entitled to recover a 12 percent penalty and a reasonable attorney’s fee.
4. Has the defendant intentionally and maliciously inflicted mental anguish upon the plaintiff by its wrongful denial to pay the benefits due under the policy, and if so, is plaintiff entitled to recover for this intentional tort.
5. Do the facts justify the imposition by the court of punitive damages upon the defendant for the intentional tort of malicious infliction of mental anguish.

*391 The defendant in its supplemental brief states that the principal issue is whether plaintiff, since September 7, 1971, has been continuously confined inside the house under the regular care and attendance of a legally qualified physician or surgeon, and steadfastly denies any liability. On pagé 1 it states:

“If the insured has been prevented by sickness from performing every duty pertaining to his occupation and if he has been confined inside the house under the regular care and attendance of a legally qualified physician during the period of his disability, the policy provides that he is entitled to recover $42.00 a week for a maximum of 30 weeks each policy year ($1,260.00 per policy year). Since September 7, 1971, two full policy years have gone by and as of the date of trial, 137 days of the third policy year (19% weeks) had expired. Based upon 19 full weeks, the maximum accrual of weekly benefits would be $798.00. Thus, the most that the plaintiff could expect to collect from United would be 79 weeks at $42.00 per week for a total of $3,318.00, less the $294.00 which has been paid for a net total of $3,024.00.”

FINDINGS OF FACT

The evidence introduced at the trial contains no substantial material dispute.

The disability claimed by plaintiff began on September 7, 1971, and plaintiff began filing claims on September 24, 1971, for benefits under the policy. Between October 6, 1971, and December 16, 1971, the defendant paid seven of the claims, or a total of $294.00. After that date the defendant has continuously refused to make any further payments and has denied liability under the facts and provisions of the policy.

The plaintiff, Cassady, at the time of the trial was 50 years of age. He had earned his living and that of his family by physical labor. From 1959 to April 1971 he worked as a linen route man for Howlett Linen Company of Hot Springs, at which time the Merritt Linen Company became the owner of the plant. Cassady continued to work in the same capacity until early August 1971, when he changed jobs and went to work for Craighead Linen Company. He had been working for the latter company for about three weeks when on August 31, 1971, he suddenly became exhausted and unable to continue. He called on Dr. Jerry Hoyt, a well qualified internist of Hot Springs, who upon examination found him suffering from a rather mild attack of angina pectoris. Dr. Hoyt examined him and continued to advise him regularly from time to time over the next few months and up to the present time. He was not confined continuously to his home but the doctor would not allow him to return to work. As a result of a Masters Two Step test, he was advised to take moderate exercise every day and remain outside as much as his condition permitted.

On January 3, 1972, Dr. Hoyt reported by letter the illness of Mr. Cassady to the defendant company, in which he said:

“Mr. Kenneth Cassady has been a patient of mine since September of 1971. In September of this year I ran a Masters Two Step and at that time he had a positive Masters. I have not allowed him to return to work. I have not seen him since December 7, 1971, but at that time he was still having angina.
“If you want more information on the man I can have him come into the office and run a Masters Two Step with continuous oseillscope monitoring. The charges for this would be $50.00.”

Following the receipt of the report from Dr. Hoyt, the defendant on May 1, 1972, contacted Dr. Driver Rowland of Hot Springs. Dr. Rowland is a highly qualified physician and enjoys a large practice in Hot Springs. In the report of Dr. Rowland to the defendant of May 5, 1972, he stated:

“Present History: Since Sept., 1971, the patient has had intermittent chest pain.

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

Related

Cite This Page — Counsel Stack

Bluebook (online)
370 F. Supp. 388, 1974 U.S. Dist. LEXIS 12385, Counsel Stack Legal Research, https://law.counselstack.com/opinion/cassady-v-united-insurance-company-of-america-arwd-1974.