Equitable Life Assur. Soc. v. MacKirgan

86 F.2d 271, 1936 U.S. App. LEXIS 3714
CourtCourt of Appeals for the Fifth Circuit
DecidedNovember 10, 1936
DocketNo. 8195
StatusPublished
Cited by5 cases

This text of 86 F.2d 271 (Equitable Life Assur. Soc. v. MacKirgan) is published on Counsel Stack Legal Research, covering Court of Appeals for the Fifth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Equitable Life Assur. Soc. v. MacKirgan, 86 F.2d 271, 1936 U.S. App. LEXIS 3714 (5th Cir. 1936).

Opinion

SIBLEY, Circuit Judge.

Mrs. Laura Kear MacKirgan, as beneficiary of her husband’s life insurance policy for $10,000 issued by the Equitable Life Assurance Society, recovered judgment for the insurance less a loan against tlie policy. The errors assigned on this appeal are a refusal to direct the verdict for the defendant, and two refusals to charge as requested and two charges otherwise. The pleadings admit that the insured failed to pay the quarterly premium which was payable February 2, 1932, that he made no claim of disability under the [272]*272provisions of the policy relating thereto until January 25, 1933, that the company declined to recognize this claim, that the insured then brought a suit for disability benefits which was pending when he died January 30, 1934, and is yet undetermined. Mrs. MacKirgan’s claim as beneficiary of the life insurance was declined. Her petition sets up that the insured became totally disabled and presumptively permanently so under the terms of the policy by January 15, 1932, before the premium payable February 2 was due, and in consequence the policy did not lapse for nonpayment of that premium but was in force at the insured’s death. The issue of fact is when such disability began. The questions of law are at what date the disability must have existed under a proper construction of the policy in order to prevent a lapse, and whether working at the expense of health and under necessity when really unable necessarily defeats a claim of disability. The defendant requested the judge to charge that total disability must be proven to have existed thirty days before February 2, 1932, when the premium was payable, and he charged instead that the critical date was the expiration of the grace of thirty-one days thereafter; and defendant requested him to charge that no matter what the insured’s physical and mental condition was, if he continued in any occupation or to perform any work for compensation of financial value he was not totally disabled under the policy, but the judge charged instead: “Such disability means one ‘which prevents the insured from engaging in any occupation or performing any work for compensation of financial value’ and it must be total as distinguished from partial disability. Of course the work must be substantial and not trivial, amount to a job, an occupation, and a disability under this policy does not necessarily imply an incapacity to do any work at all, or that the person must be bedridden, or that he must'work where to do so would shorten his life or seriously impair his health; and the fact that he did do some work because forced thereto by absolute necessity when he was really not able to work would not change a total disability to a partial one. The fact that one has done some work just before or after the alleged lapse of his policy is not of itself sufficient to defeat his claim of total and permanent disability. He may have worked when really unable and at the risk of endangering his life or health.”

On the question of disability the evidence very briefly stated tended to show that the insured began to have severe pains in his back and head in the spring of 1931 which steadily grew worse. Although he certified to the insurance company in October that he was in good health in order to have some change made in his policy, by December he was unable to sleep much at night or even to remain lying in bed or to sit up to play cards; he had lost flesh and become very irritable, his spine had become greatly curved and his chest sunken, he suffered constant pain thought to be arthritis, could hardly get in or out of an automobile or walk. Nevertheless he continued in January and February, 1932, to have his daughter drive him around in an effort to get orders for printing, which was his business, on which he received commissions. During January and February he is shown to have thus earned commissions of about $5 on each of five orders, and in February, May, July, and October to have gotten fopr orders from a medical inspector for this appellant on which he received commissions, besides some other orders mostly from Yaarab Temple of the Shriners, of which he was a member. There was, however, evidence from which the jury could conclude that these were all due more to friendship and to pity for the insured than to any effort he put forth. He drove a car to Florida during the summer, but there is testimony that he was in a very bad condition in Florida. He became bedridden in October, 1932. He exercised no options about his policy after failing to pay the premium payable February 2, 1932. In January, 1933, he claimed disability benefits beginning January 15, 1932. He died in January of 1934, and on a post mortem examination it was found that' he had tuberculosis of lungs, liver, spine, and brain, and calcium protuberances had formed on the vertebrae of his spine. A physician testified that this last was no doubt his trouble all along, and would cause great pain, and that he thought insured’s undertaking to work substantially affected his health and tended to shorten his life, and that he should have been in some institution at rest instead of going about.

The policy provisions here applicable, descriptive of the total and permanent disability which comes within it, are these: “For the purposes of this policy (A) disability is total when it prevents the insured from engaging in any occupation or per[273]*273forming any work for compensation of financial value, and (B) total disability is presumably permanent only under the circumstances and from the date (herein called the effective date) as follows: (1) * * * (2) When it has existed continuously for three months — then from the date of the completion of one month of such continuous total disability.” From the evidence recited it is plain that MacKirgan’s disability did become total, and that it was continuous for more than three months and until his death, so that a presumption of permanency arose dating back to thirty days after it first became total. The question is: At what stage is the disability to be considered as having become total? The insurer says only when the insured is positively and literally prevented from doing any work for compensation of financial value, and that this came about first in October, 1932. The judge charged those words of the policy, but explained and qualified them as above quoted. In doing so he apparently followed expressions of this court in the case of Metropolitan Life Insurance Company v. Foster, 67 F. (2d) 264, where the policy definition of total disability was quite like that now before us though the disablement was of a different sort. The policies which have come before the courts have used varying terms, such as “disabled from,” “unable to,” or, as here, “prevented from” working. They are all capable of a rigid literal construction so as to exclude from the benefit, of the insurance cases where any work is done even though very slight and at the expense of health or under pain so great that work ought not to be expected of the sufferer. But the weight of authority is that the terms are not intended in that rigid sense, and that one whose work is only trivial or is done under the pressure of necessity and at "the expense of health or great pain is disabled or unable or prevented from working within the real meaning of the insurance. Cf. United States v. Martin (C.C.A.) 54 F.(2d) 554. We adhere to this view, which was expressed in the Foster Case, supra, after examination of the collections of the cases there referred to. In Georgia, where this contract was made, total disability provisions are construed with great liberality. Prudential Ins. Co. v. South, 179 Ga. 653, 177 S.E. 499, 98 A.L.R. 781.

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

Related

Blaustein v. Connecticut General Life Insurance
207 F. Supp. 223 (District of Columbia, 1962)
Love v. Northwestern Nat. Life Ins.
119 F.2d 251 (Fifth Circuit, 1941)
De Long v. Jefferson Standard Life Insurance
109 F.2d 585 (Fifth Circuit, 1940)
New York Life Ins. v. Jackson
94 F.2d 288 (Seventh Circuit, 1938)
Ratliff v. Kentucky Home Mut. Life Ins.
87 F.2d 965 (Fifth Circuit, 1937)

Cite This Page — Counsel Stack

Bluebook (online)
86 F.2d 271, 1936 U.S. App. LEXIS 3714, Counsel Stack Legal Research, https://law.counselstack.com/opinion/equitable-life-assur-soc-v-mackirgan-ca5-1936.