Free v. United Life Accident Ins. Co.

182 S.E. 754, 178 S.C. 317, 1935 S.C. LEXIS 151
CourtSupreme Court of South Carolina
DecidedDecember 11, 1935
Docket14192
StatusPublished
Cited by5 cases

This text of 182 S.E. 754 (Free v. United Life Accident Ins. Co.) is published on Counsel Stack Legal Research, covering Supreme Court of South Carolina primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Free v. United Life Accident Ins. Co., 182 S.E. 754, 178 S.C. 317, 1935 S.C. LEXIS 151 (S.C. 1935).

Opinion

T'he opinion of the Court was delivered by

Mr. Justice Baker.

The respondent brought this action against appellant upon three policies of insurance wherein and whereby the appellant insured the respondent, among other risks, for accident, disability provision, which provision is set out in full hereafter, under the terms of which the appellant agreed to pay the respondent the sum of $10.00 per week on each policy for accident disability; the respondent alleging disability for a period of ten weeks from February 11, 1934, due to an injury to his legs when he slipped and fell upon ice and sleet in front of his home. The appellant denied liability; its defense being briefly stated in the two questions, arising out of the exceptions presented to this Court for determination, to wit: (1) Was the plaintiff-respondent wholly and continuously disabled from the date of accident, so as to bring him within the terms of the policies? and (2) Is the plaintiff-respondent estopped from recovering by reason of his failure to give notice of the accident within twenty days from the date of the injury, in view of the fact that it was not physically impossible for him so to do?

If the respondent is estopped from recovering by reason of his failure to give the notice within the required time, then the question of his disability becomes academic. Consequently the two questions presented will be discussed in inverse order.

On or about February 11, 1934, respondent slipped down on some ice in front of his home and injured one of his legs. He admitted he kept on working and continued to go to his store off and on until about the 1st of March, but did not put in full time nor did he do his accustomed work. About the 1st of March his leg had swollen up and he con- *319 suited a physician, as he did on the date of the accident, and it being the same physician. Ón said March 1 the physician advised him to stay at home and off of his feet, but it appears that respondent did not carry out these instructions, and on the 15th of March his leg was in worse condition. On March 7, respondent went to the office of the agent of appellant and renewed a note. From March 15 to March 31, respondent was confined to his bed in his home under the care of his physician, and on March 31 he was removed to a hospital due to an inflammatory mass in his groin, an abscess due to the infection from his injured leg, and on said last-mentioned date at the hospital the abscess was opened, respondent remaining in the hospital until April 14, and then returning to his home and remaining in bed Until May 1, 1934.

Notice of the accident or injury was not given appellant until April 2, 1934. Respondent gave as his reason for delaying the notice, to the appellant of his injury that he had not intended filing a claim unless he had to go to bed, and that he did not intend to put in a claim for a “little accident.”

The disability clause in policy No. 55450 reads somewhat differently from the disability clauses in policies Nos. 19584 and 19585, but the difference is not sufficiently material to set out separately such clauses. The clauses of the contract of insurance, relied upon by the appellant, and as contained in the last two numbered policies above referred to, are as follows:

“The company agrees to pay to the insured as herein limited and provided a weekly indemnity at the rate of ten dollars per week during the time the insured shall be totally and continuously unable from the date of accident to pursue any gainful occupation for not to exceed fifty-two weeks, and thereafter at the rate of five dollars per week throughout the period of such disability; but all such weekly-indemnities are payable only in case the disability is caused directly and exclusively by bodily injuries sustained solely through ex *320 ternal, violent and accidental means, not including injuries sustained while enrolled in military or naval service, etc.
“(4) Written notice of injury on which claim may be based must be given to the company within twenty days after the date of the accident causing such injury.
“(5) Such notice given by or in behalf of the insured or beneficiary as the case may be, to the company at Concord, New Hampshire, or to any authorized agent of the company, with particulars sufficient to identify the insured, shall be deemed to be notice to the company. Failure to give notice within the time provided in this policy shall not invalidate any claim if it shall be shown not to have been reasonably possible to give such notice and that notice was given as soon as was reasonably possible.”

The two clauses, Nos. 4 and 5, just above quoted, are contained in all three policies.

The clauses with reference to notice of injury, as quoted, aré generally used in insurance contracts and are principally for the benefit of the insurer to prevent fraud or imposition. The Court, in the case of Craig v. Insurance Co., 80 S. C., 151, 61 S. E., 423, 425, 18 L. R. A. (N. S.), 106, 128 Am. St. Rep., 877, 15 Ann. Cas., 216, has construed similar provisions as follows:

“The provision on which the defendant relies is not unreasonable, but, on the contrary, it is evident some such stipulation is necessary to the protection of the defendant as an insurer against sickness to- enable it to investigate alleged illness, and thus protect itself against imposition. Of course, the insured would be excused from giving the notice if, from sudden and extreme illness or other cause it became impossible for him to comply with the contract. Stickley v. Ins. Co., 37 S. C. [56], 69, 16 S. E., 280, 838; Johnson v. Maryland Cas. Co., 73 N. H., 259, 60 A., 1009, 111 Am. St. Rep., 609; Whalen v. Equitable Acc. Co., 99 Me., 231, 58 A., 1057; Trav. Ins. Co. v. Thornton, 119 Ga., 455, 46 S. E., 678.
*321 “The respondent relies on the case of Woodmen Acc. Ass’n v. Pratt 62 Neb., 673, 87 N. W., 546, 55 L. R. A., 291, 89 Am. St. Rep., 777, as authority for the proposition that, where the contract provides for notice within a specified time, notice within a reasonable time is sufficient. That decision is rested almost entirely on the authority of cases like Edgefield Mfg. Co. v. Maryland Cas. Co., 78 S. C., 73, 58 S. E., 969, holding a requirement for immediate notice does not mean literally without the lapse of any time, but with all reasonable promptness under the circumstances. But none of these cases support the proposition that, where the párties themselves choose to fix the limit within which notice must be given, the Court can annul their agreement, and substitute its own motion of what would have been a proper provision on the subject.”
The first paragraph above set forth, taken from the Craig case, was quoted with approval in the case of Levan v. Insurance Co., 138 S. C., 253, 136 S. E., 304, and, in addition thereto, the Court quoted with approval from the language used in North American Accident Insurance Co. v. Watson, a Georgia case, reported in 6 Ga. App., 193, 64 S.

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Cite This Page — Counsel Stack

Bluebook (online)
182 S.E. 754, 178 S.C. 317, 1935 S.C. LEXIS 151, Counsel Stack Legal Research, https://law.counselstack.com/opinion/free-v-united-life-accident-ins-co-sc-1935.