Ginsburg v. Prudential Insurance Co. of America

13 N.E.2d 792, 294 Ill. App. 324, 1938 Ill. App. LEXIS 592
CourtAppellate Court of Illinois
DecidedMarch 16, 1938
DocketGen. No. 39,689
StatusPublished
Cited by8 cases

This text of 13 N.E.2d 792 (Ginsburg v. Prudential Insurance Co. of America) is published on Counsel Stack Legal Research, covering Appellate Court of Illinois primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Ginsburg v. Prudential Insurance Co. of America, 13 N.E.2d 792, 294 Ill. App. 324, 1938 Ill. App. LEXIS 592 (Ill. Ct. App. 1938).

Opinion

Mr. Justice Denis E. Sullivan

delivered the opinion of the court.

This action was commenced on May 8,1935, for total and permanent disability payments under a life insuranee policy issued by the defendant, The Prudential Insurance Company of America, on the life of Abraham H. Ginsburg, plaintiff. A trial was had without a jury, resulting in a judgment on the finding in favor of plaintiff and against the defendant in the sum of $2,018.80, from which defendant brings this appeal:

An amended statement of claim was filed on December 4, 1936, in which the plaintiff alleges the issuance of the policy containing the total and permanent disability “riders” and that the defendant from May 18, 1934 until October 1, 1935, failed and refused to pay under said policy and that the sum of $1,650 has become due under the total and permanent disability provision ; that the plaintiff had paid premiums of $127.50 and $241.30 and was entitled to recover these premiums also.

The affidavit of merits filed to the amended statement of claim denied that there was liability for $1,650 and also denied the premium payments were voluntarily made and that the plaintiff was totally and permanently disabled.

Plaintiff’s theory of the case is that under the policy, proof of total disability for a period of 90 days raises the presumption of permanency within the meaning of the clause granting disability benefits, and upon receipt of proof thereof the insurer becomes obligated to make payments until the state of continuous total disability shall have terminated; that the total disability for this period confers upon the insured the absolute and indefeasible right to benefit until the period of total disability shall have ended.

Defendant’s theory of the case is that the benefits under the total and permanent disability provision of the policy are payable only if the plaintiff is totally and permanently disabled as therein provided and not if the disability is temporary; that there is no ambiguity in the policy and that the plaintiff is not entitled to recover the premiums paid which are voluntary pay- . ments; that it was error for the trial court to permit recovery for any amount alleged to be due after the date the suit was filed.

The evidence shows that the policy in this case was dated July 9, 1930 and was issued to Abraham Ginsburg for the sum of $10,000, payable upon receipt of proof of death; that the policy also contained what is known as “total and permanent disability riders” which provide for payments of $100 monthly and a waiver of premiums if the insured becomes totally and permanently disabled to such an extent that he is rendered wholly, continuously and permanently unable to engage in any occupation or perform any work for any kind of compensation of financial value during- the remainder of his lifetime; that if proof submitted shall not be due proof of the permanency of such disability but shall be due proof that total disability as defined exists and has existed continuously during a period of not less than 90 consecutive days immediately preceding- receipt of such proof, that such disability shall be presumed to be permanent and the company , will grant the said benefits dating from the end of 90 days from the commencement of the period of total disability which has existed continuously to the date of such proof.

The policy further provides that notwithstanding the acceptance by the company of proof of total and permanent disability, or of proof of the duration of total disability for a period of 90 consecutive days, the insured, upon demand by the company from time to time, but not oftener than once a year after such disability has continued for two full years, for the- purpose of verifying that such disability is actually permanent and not temporary, shall furnish due proof that he actually continues in the state of disability defined above and that in case of failure to furnish such proof, no further monthly premiums shall be waived and no further payments made.

The evidence further shows that Abraham Ginsburg became ill on Decémber 1,1932; that between that date and December 12, 1932, the large toe on his right foot became swollen and on December 13,1932 an operation was performed; that subsequently, 13 additional operations were performed during the period of 11 weeks when he was in the hospital; that after leaving the hospital his leg* was kept bandaged and elevated and he remained at home using a wheel chair until about August, 1933; that he used crutches until January, 1934 and thereafter he used a cane; that during* the day he kept his foot elevated about 90 per cent of the time.

The evidence further shows that Ginsburg* had been employed by his father in a retail store selling men’s furnishings; that at the time of the trial he was working in an office furniture store and managing a men’s furnishing* store in which he was interested, known as Ginsburg, Incorporated.

The evidence further shows that plaintiff was treated by a Dr. Gaynes from September, 1934 until April, 1935, on an average of three times weekly, during* which time the wound remained open and the limb swollen; that in April, 1935, he returned to work for approximately 4 days for a period of from 3 to 4 hours daily; that the wound became larger and the swelling increased and he was taken to the Michael Reese Hospital and two skin graft operations were performed on his right foot and he left the hospital, in May or June of 1935; that on September 13, 1935, he saw Dr. Levinthal, at which time, the wound was almost closed, although the leg remained swollen; that he started to work on October 1,1935, for a few hours each day until January 1, 1936, at which time he commenced to work regularly.

Dr. Daniel H. Levinthal, a witness on behalf of plaintiff, testified that on June 9,1934, he examined plaintiff and found that he had lymphedema of the lower right extremity due to impaired circulation and multiple scars, particularly on the outer aspect of the dorsum of the right foot; that he prescribed rest and elevation during the greater part of the day, with an occasional lowering of the limb; that he made another examination on October 1, 1934, and found a denuded area on the outer aspect of the dorsum of the right foot and again prescribed elevation of the limb during the greater part of the day; that on April 26,1935, he performed a pedicle skin graft which required that both of the patient’s limbs remain in a cast until May 13, 1935; that he examined the patient on September 13, 1935, and finding the wound healed, referred him back to his attending physician for the healing of the wound did not mean that it was covered with sldn.

In answer to a hypothetical question, the doctor testified that the hypothetical man was totally disabled from December 1, 1932 to October 1, 1935, and stated that in his opinion the man was permanently disabled to the time that he returned to work.

Dr.

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Bluebook (online)
13 N.E.2d 792, 294 Ill. App. 324, 1938 Ill. App. LEXIS 592, Counsel Stack Legal Research, https://law.counselstack.com/opinion/ginsburg-v-prudential-insurance-co-of-america-illappct-1938.