Davis v. Equitable Life Assurance Society of the United States

1 A.2d 105, 61 R.I. 414, 1938 R.I. LEXIS 82
CourtSupreme Court of Rhode Island
DecidedJuly 30, 1938
StatusPublished
Cited by2 cases

This text of 1 A.2d 105 (Davis v. Equitable Life Assurance Society of the United States) is published on Counsel Stack Legal Research, covering Supreme Court of Rhode Island primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Davis v. Equitable Life Assurance Society of the United States, 1 A.2d 105, 61 R.I. 414, 1938 R.I. LEXIS 82 (R.I. 1938).

Opinion

*415 Flynn, C. J.

This action of assumpsit, brought to recover payments alleged to be due under a certain accident and health insurance policy, was tried before a justice of the superior court, sitting without a jury, and resulted in a decision for the defendant. The case is before us on the plaintiff's exceptions to such decision and to certain other rulings relating to the introduction of evidence. The plaintiff has expressly waived all exceptions but the twenty-seventh, to the decision of the trial justice, and the following exceptions, to rulings admitting certain evidence, namely, the first to twelfth; fourteenth to sixteenth; seventeenth to twenty-sixth, all inclusive, with the exception of the twenty-second exception, which is also waived.

The evidence discloses that the defendant, an insurance company, issued to the plaintiff an accident and health insurance policy dated March 3,1922. “Part V'' of this policy, upon which the right of the plaintiff to recover depends, reads as follows: “If such disease shall wholly and continuously disable the insured and prevent him from performing any and every duty pertaining to his occupation, the society will pay for the period of such continuous disability but not exceeding fifty-two consecutive weeks the single weekly indemnity hereinafter specified. After the payment of weekly indemnity for fifty-two weeks as aforesaid the society will continue the payment of weekly indemnity of the same amount thereafter so long as the insured shall be wholly and continuously disabled by such disease from engaging in any occupation or employment for wage or profit.”

The plaintiff was stricken with acute poliomyelitis, commonly called infantile paralysis, about September 5, 1922. The defendant paid the plaintiff $50 weekly for the first fifty-two weeks of his disability, being the indemnity specified; and thereafter continued payments in the same amount, until about September 27, 1935, when it refused to make further payments on the ground that the plaintiff was no longer disabled to the degree required by the terms *416 of the policy. The present action was commenced June 1, 1936, to recover payments allegedly accrued under the policy for the period from September 27, 1935 to the date of the writ.

The defendant contends that the plaintiff has failed to establish by a preponderance of the evidence that he was “wholly and continuously disabled by such disease from engaging in any occupation or-employment for wage or profit.” The plaintiff contends that the intent of the policy is to provide payments, if the plaintiff is unable to perform the substantial duties of any such occupation or employment for which he is qualified; that mere ownership of a business is not being engaged in an occupation or employment; that the plaintiff is unable to engage in the occupation of operating the business owned by him; that no wage or profit results from the plaintiff’s alleged occupation or employment; that such a construction of the policy as he urges has been adopted by the parties for a number of years; and that the trial justice erred in his findings of fact and misconceived the law applicable to the evidence, and erred in admitting certain evidence relative to the financial aspects of the plaintiff’s business.

Treating first the ground of the plaintiff last above stated, we have examined the evidence specified in all the exceptions, previously set forth, to rulings admitting evidence concerning the financial aspects or profit of the plaintiff’s business, and we find no prejudicial error in the admission of any such evidence. The provisions of the policy, upon which the plaintiff’s right to recover depends, specifically bring into issue the question whether the plaintiff is wholly and continuously disabled from engaging in any occupation or employment for wage or profit. The evidence referred to in these exceptions all related to the financial aspects of the business conducted by the plaintiff and appears to us to be reasonably pertinent to the issues of the instant case. The objections generally go to the *417 weight to be given such evidence rather than to its admissibility. If any of it was admitted in error, it was at least not prejudicial. For this reason all of the plaintiff's exceptions now relied on, which are to the introduction of evidence, are overruled.

This leaves for consideration only the twenty-seventh exception, to the decision of the trial justice. He ruled that the burden was upon the plaintiff to show by a fair preponderance of the evidence that between September 27, 1935 and June 1, 1936, (the period for which recovery at the rate of $50 per week is sought) he was “wholly and continuously disabled . . . from engaging in any occupation or employment for wage or profit” to the extent that would require the defendant, under the policy, to pay the disability benefits specified therein; and, after discussing the law and evidence in a carefully prepared rescript, he set forth numerous findings of fact, upon which he reached the conclusion that the plaintiff had not shown by a preponderance of the evidence that he was so wholly and continuously disabled as to warrant his recovery under the terms of the policy.

From our examination of the evidence, we cannot say that the conclusion reached by the trial justice was erroneous. There is evidence to warrant the finding that the plaintiff was not wholly and continuously disabled within the degree contemplated by those terms in the policy, whereby the defendant would be required to continue to pay benefits' thereunder after September 27, 1935. The plaintiff, following the rule of liberal construction, urges that the words “wholly and continuously disabled . . . from engaging in any occupation or employment for wage or profit”, in this type of insurance policy, are not to be construed literally, but rather substantially so as to effect the object of the policy and the intent of the parties. Never-theless, conceding the rule advocated, the evidence here warrants the conclusion that the plaintiff on or after Sep *418 tember 21, 1935, was personally able to perform and did perform regular and important services as the proprietor and manager of a large garage business, from which he derived a reasonable livelihood; and further that, in the kind of occupation for which he was qualified and which was in contemplation of the parties when the policy was issued, he was able, after September 27, 1935, to perform and personally did perform in the customary way all of the substantial duties and requirements of such an occupation.

In his application for this policy of insurance, the plaiirtiff described his occupation as “chief executive with office and travel duties only”. The issuance of the policy thereon makes clear the intent of the parties thereby to insure the plaintiff against disability, of the nature described therein, which would affect his earning capacity in substantially that kind of occupation. While at that time he, also engaged in the selling of automobiles from a different headquarters, a venture which was shortly thereafter discontinued by receivership proceedings, he was spending approximately two-thirds of his working time in attending to the garage business.

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Related

Ratchford v. Mutual Benefit Health & Accident Ass'n
23 Conn. Supp. 51 (Pennsylvania Court of Common Pleas, 1961)
Ratchford v. Mutual Benefit Health Accident Assn.
176 A.2d 589 (Connecticut Superior Court, 1961)

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Bluebook (online)
1 A.2d 105, 61 R.I. 414, 1938 R.I. LEXIS 82, Counsel Stack Legal Research, https://law.counselstack.com/opinion/davis-v-equitable-life-assurance-society-of-the-united-states-ri-1938.