Fisher, Exrx. v. Fid. and Cas. Co. of N.Y.

173 A. 320, 316 Pa. 183, 1934 Pa. LEXIS 690
CourtSupreme Court of Pennsylvania
DecidedApril 16, 1934
DocketAppeal, 158
StatusPublished
Cited by2 cases

This text of 173 A. 320 (Fisher, Exrx. v. Fid. and Cas. Co. of N.Y.) is published on Counsel Stack Legal Research, covering Supreme Court of Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Fisher, Exrx. v. Fid. and Cas. Co. of N.Y., 173 A. 320, 316 Pa. 183, 1934 Pa. LEXIS 690 (Pa. 1934).

Opinions

Opinion by

Mr. Justice Linn,

This suit on an accident insurance policy to recover specific injury indemnity is brought on the theory that the insured’s personal representative may exercise an option that the insured, if he had lived, might have exercised to recover for specific injury instead of under a total disability provision. The appeal is from the judgment for want of a sufficient affidavit of defense.

The statement of claim sets forth the circumstances in which the policy was issued, “in order that the terms and provisions of said policy may be properly understood and interpreted for the purpose of ascertaining such intention......” Among these circumstances were that, from November, 1911, until November, 1929, plaintiff held defendant’s policy “providing for full life-indemnity and disability” insurance. At that time he made a radical change in the form and scope of insurance taken out with defendant; he no longer took its policy providing for the payment of principal sum in the event of death by accident. The coverage formerly taken “was replaced” (the statement avers) by two policies; one, that in suit, providing insurance against accident, but not against death, and the other, a health policy. This insurance was kept alive thereafter by annual reneAvals. The assured also had a number of *185 policies issued by other insurers against death. He was seriously injured * in an automobile accident October 5, 1932, and, as a result, as we understand it, died nine days later. Among his injuries, classified in the schedule of injuries in the policy as a specific injury, was the loss of an eye which was removed October 7th.

The policy-form on which the policy was written was prepared to permit insurance in a principal sum on death by accident, and indemnity for disability, total and partial, and, in certain circumstances, for specific injuries according to a schedule. While providing for the payment of indemnity for disability, the policy distinctly stated that no principal sum should be paid at death. (Special Provisions, No. 11.) “The Insuring Clause,” at the beginning of the policy, was drawn to provide insurance “in the principal sum and weekly indemnity......AGAINST — Bodily injury sustained ......through accidental means......and resulting directly, independently and exclusively of all other causes, in — (a) Total disability [defined]......, (b) Partial disability [defined]......, (e) Specific injury [specified in the Schedule of Injuries set forth hereon] sustained within ninety days from the date of the accident, or at any time while the Assured suffers total disability as the direct result of the bodily injury causing the specific injury, (d) Death”; but this “insuring clause” was expressly agreed to be “subject to all the provisions and limitations hereinafter contained.” These “provisions and limitations” then follow in a number of articles. The first provides that total disability shall be paid as long as the insured “lives and suffers said disability.” The second provides for partial disability of various degrees. The third, which determines this suit, is as follows:

*186 “DEATH
“Article 3. If the Assured suffers total disability, and if, during the period of said disability, the Assured suffers death as the direct result of the bodily injury causing the said disability; or, if within ninety days from the date of the accident, irrespective of disability, the Assured suffers death as the direct result of a bodily injury: the Company will pay the Beneficiary
THE PRINCIPAL SUM and in addition The Weekly Indemnity
for that part of the period between the date of the accident and the date of death for which no weekly indemnity has been paid.”

The beneficiary named in the policy was the wife of the assured. As his death resulted from the accident, a direct obligation to her as beneficiary. arose under article 3. The policy also provided under “SPECIAL PROVISIONS,” as follows: “11. The principal sum of this policy is NONE dollars ($****)...... 12. The weekly indemnity of this policy is ONE HUNDRED AND 00/100 Dollars ($100.00) a week.” The amount therefore payable under article 3 was at the rate of $100 a week for the period prior to the assured’s death. This policy differed from the one in effect before 1929 in that the prior policy provided for the payment of $5,000 on death by accident.

When the scope of the insurance carried by the assured prior to 1929 was changed from provision for both life and accident insurance, to accident insurance alone, the intention of both assured and insurer was, in that respect, clearly embodied in the provision declaring that no principal sum should be payable at death, and retaining a primary liability to pay the weekly indemnity “for that part of the period between the date of the accident and the date of the death for which no weekly indemnity has been paid.” The insured’s death *187 as a result of the accident, matured the insurer’s obligation to pay the weekly indemnity to the beneficiary.

This suit was not brought by the beneficiary, but is brought by the insured’s executrix. The mere accident that the person named as beneficiary is also executrix can give no greater right to either than arises out of the contract. The beneficiary takes insurance clear of creditors, while, if the executrix recovers, distribution passes under the assured’s will and, if necessary, to creditors.

The executrix was allowed to recover in the court below by a misunderstanding of the provisions of article 4. It is entitled “OPTIONAL INDEMNITY FOR INJURIES,” and provides “If the Assured sustains a specific injury he may elect to receive either any indemnity to which he may be entitled under Articles 1 and 2 [referred to above] or such......[sum as is specified for specific injury in the schedule of injuries] ...... In addition to the payment of any indemnity that the Assured may be entitled to and may elect to receive hereunder, the Company will pay the Assured

The Weekly Indemnity

for the period between the date of the accident and the date that the Assured sustains the specific injury. If a claim is made for an injury defined in section 2 of the schedule, written notice of the Assured’s election must be given to the Company at its home office in New York City within twenty days from the date that the Assured suffers the said injury.”

If the assured had lived, he might or might not have elected, under article 4, to receive payment for specific injury, instead of taking the weekly indemnity. Until he died, article 1 was operative; his death thereafter, before any election was made, brought into immediate operation article 3, which fixed the insurer’s obligation to discharge the contract. Instead of giving effect to article 3, the learned court below was of opinion that, because, in his lifetime, the assured might have exercised *188 an option to substitute one form or measure of indemnity for another, the right to exercise the election passed to the assured’s personal representative. Such construction cannot be accepted, because it is obviously contrary to what the parties intended.

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Related

Kovacs v. John Hancock Mutual Life Insurance Co. of Boston
193 A. 529 (Supreme Court of New Jersey, 1937)
Browne v. John Hancock Mutual Life Insurance
180 A. 746 (Superior Court of Pennsylvania, 1935)

Cite This Page — Counsel Stack

Bluebook (online)
173 A. 320, 316 Pa. 183, 1934 Pa. LEXIS 690, Counsel Stack Legal Research, https://law.counselstack.com/opinion/fisher-exrx-v-fid-and-cas-co-of-ny-pa-1934.