Equitable Life Assur. Soc. v. Mercantile-Commerce Bank & Trust Co.

155 F.2d 776, 1946 U.S. App. LEXIS 2279
CourtCourt of Appeals for the Eighth Circuit
DecidedJune 4, 1946
DocketNo. 13167
StatusPublished
Cited by5 cases

This text of 155 F.2d 776 (Equitable Life Assur. Soc. v. Mercantile-Commerce Bank & Trust Co.) is published on Counsel Stack Legal Research, covering Court of Appeals for the Eighth 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. Mercantile-Commerce Bank & Trust Co., 155 F.2d 776, 1946 U.S. App. LEXIS 2279 (8th Cir. 1946).

Opinion

JOHNSEN, Circuit Judge.

The action is by an insured’s executors, on two life-insurance policies, under Missouri law, to recover' payment of benefits from March, 1932, to April, 1939, for the insured’s total and permanent disability, and return of premiums for that period, which he was entitled to have had waived. From a judgment for the amount of the benefits and the premiums, D.C., 59 F.Supp. 787, the insurer has appealed.

The case has been here on a previous appeal, 143 F.2d 397, in which we upheld a finding by the trial court that the insured had been totally and permanently disabled during the period involved. Other findings and conclusions not of present importance were also sustained, but we reversed and remanded the case for findings, conclusions, and resulting judgment, on the question whether the proof of disability submitted by the insured in 1930, after his total and permanent disability began, and which the insurer had accepted and recognized as sufficient for benefit-payments and premium-waivers from 1930 to March, 1932, would support his right to such payments and waivers for his continuing disability through the period in suit. The trial court had not passed upon that question but had disposed of the case on another theory, which we regarded as erroneous.

[778]*778It is necessary here only to discuss the insurer’s contention that the holding of the trial court after the remand, that the initial proof was legally sufficient to support the insured’s right to continued payments and waivers, is clearly erroneous. The basis of the insurer’s argument is that the proof did not show that the disability was reasonably certain to continue for the remainder of the insured’s life and hence was insufficient.

The proof of 1930 consisted of forms furnished by the insurer and executed by the insured and his attending physicians. To the inquiry “State date you expect to resume some business duties,” the insured had answered “Have no idea.” To a similar question in the medical forms as to when the insured would be “able to resume any busmess,” his two doctors had both answered “Do not know.” To the question whether the total disability was only temporary, one doctor had answered “Probably” and the other “Don’t know.” To the further question “Is it possible that he will be prevented for life .from following ANY occupation?” one doctor had answered “Possibly” and the other “Yes.” The proof also contained the information that the insured had had a complete heart-block ever since 1917 and that at the time of his disability in 1930 he had developed Adams-Stokes attacks. The insurer in fact had known of the existing heart-block from the time it wrote the policies, because it originally rejected the insured’s application for that reason but later agreed to issue the insurance on a higher-premium basis.

It will be noted that the proof did not purport to fix a date beyond which the disability would not extend (if the fixing of such a date could at all have had any significance except as an expression of medical opinion). Nor was there anything else in the proof from which the insurer could then say that the disability would cease at a certain time. And when the insurer accepted and recognized the proof as establishing a covered disability under the policies, it could not nor did it declare that March, 1932, would mark the limit of its liability on the proof submitted. Again, when the insurer cut off benefit-payments and premium-waivers in 1932, it did not do so on the basis that this date was as far as the proof legally could support the disability, but the cut-off was made only because the insured, under the erroneous impression that if he performed any of his former duties his right to disability-benefits ceased, fair-mindedly informed the insurer that he was attempting to carry on part of his previous work and indicated that he assumed that he therefore was not entitled to receive further benefits.

The point that is here important is that the insurer accepted and recognized the insured’s initial proof as sufficient to establish a covered disability. Under the terms of the policies, as we shall presently discuss, such a disability was required to be regarded as a total and permanent one unless it thereafter ceased to be total.

The policies provided that disability benefits should be “effective upon receipt of due proof, before default in the payment of premium, that the Insured became totally and permanently disabled by bodily injury or disease after this policy became effective and before its anniversary upon which the Insured’s age at nearest birthday is 60 years”; that all premiums would be waived “falling due after the receipt of such proof and during the continuance of such total and permanent Disability”; that benefits in specified amounts would be paid, “the first payment to be payable upon receipt of due proof of such Disability and subsequent payments monthly thereafter during the continuance of such total and permanent Disability”; that “Total Disability shall be presumed to be Permanent when it is present and has existed continuously for not less than three months”; that the insurer should have the right “at any time or times during the first two years after receipt of such proof of disability, but thereafter not more frequently than once a year, to require proof of the continuance of such total disability”; and that, if the insured should “fail to furnish satisfactory proof thereof,” or if it should appear at any time that the disability was no longer total, no further premiums would be waived or benefits paid “on account of such disability.”

These provisions reasonably would seem to have been intended to mean that the [779]*779insured would be entitled to benefit-payments and premium-waivers for total and permanent disability occurring before age 60; that the payments and waivers should become effective upon receipt of due proof of the existence of such a disability; that for these purposes proof that total disability had existed for not less than three months and was still present was required to be accepted by the insurer as proof of permanent disability and would entitle the insured to continuous benefit-payments and premium-waivers thereafter, unless the disability should cease to be total, or unless the insured should fail to furnish proof of its continuance at any time that the policy authorized the insurer to make request for such subsequent proof.

We recognized in our previous opinion, 143 F.2d at page 401, that the initial furnishing of proper proof of disability is, under Missouri law, a condition precedent to legal liability under such a policy-provision as is here involved. But, in its relation to the other provisions of the policies, which have been set out above, once a proof of disability has been furnished, which is sufficient to give rise to a right to benefit-payments and premium-waivers, the condition precedent or foundation of liability for the disability involved must be held to have been legally met.

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Cite This Page — Counsel Stack

Bluebook (online)
155 F.2d 776, 1946 U.S. App. LEXIS 2279, Counsel Stack Legal Research, https://law.counselstack.com/opinion/equitable-life-assur-soc-v-mercantile-commerce-bank-trust-co-ca8-1946.