Guarantee Trust Life Insurance v. Patterson

406 S.W.2d 338, 56 Tenn. App. 301, 1966 Tenn. App. LEXIS 227
CourtCourt of Appeals of Tennessee
DecidedJune 24, 1966
StatusPublished
Cited by3 cases

This text of 406 S.W.2d 338 (Guarantee Trust Life Insurance v. Patterson) is published on Counsel Stack Legal Research, covering Court of Appeals of Tennessee primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Guarantee Trust Life Insurance v. Patterson, 406 S.W.2d 338, 56 Tenn. App. 301, 1966 Tenn. App. LEXIS 227 (Tenn. Ct. App. 1966).

Opinion

PURYEAR, J.

This suit involves application of certain provisions of a sick and accident policy and we will refer to the parties as complainant and defendant as they appeared in the trial Court.

Defendant is a foreign corporation qualified to do business as an insurance company in the State of Tennessee. In consideration of an annual premium of $133.50 for the first year and $123.50 for each succeeding year, defendant issued to complainant a sick and accident policy which became effective on July 15, 1962.

Among other benefits, this policy provides for payment of a $100.00 monthly benefit for total disability, which disability provisions are set forth in parts J and K of the policy as follows:

“PART J CONFINING DISABILITY BENEFITS FOR LIFE
[303]*303If the insured, because of such sickness, shall be continuously confined within doors and regularly attended therein by a legally qualified physician, other than himself, the Company will pay indemnity for one day or more (Benefits begin with the first medical treatment during disability) at the rate of the Monthly benefit thereafter so long as the Insured lives and suffers continuous confinement; provided such sickness causes continuous total disability and total loss of time. ’ ’
“PART K NONCONFINING DISABILITY BENEFITS
If the insured, because of such sickness, shall not be continuously confined within doors but shall be under the professional care and regular attendance of a legally qualified physician, other than himself, the Company will pay indemnity for one day or more (benefits begin with the first medical treatment during disability) at the rate of the Regular Monthly Benefit during the period of disability, but not to exceed two months for any one sickness; provided such sickness causes continuous total disability and total loss of time. ’ ’
(B. of E. p. 25; Ex. #1 to original bill)

On January 18, 1964, the complainant, Charlie Patterson, 64 years of age, had an attack of congestive heart failure, at which time his family physician, Doctor F. T. Rutherford, Jr., attended him. It is admitted by defendant that the above mentioned policy of insurance was in force at the time of the onset of complainant’s illness.

After examining and treating complainant for several days, Doctor Rutherford sent him to Nashville to be treated by Doctor Frederic Cowden, a heart specialist.

[304]*304Doctor Cowden examined complainant on January 30, 1964, as a result of which examination he diagnosed complainant’s condition as follows:

‘ Hypertensive and arteriosclerotic heart disease with history of congestive heart failure; two, aortic valvular disease with aortic stenosis and aortic insufficiency; three, benign prostatic hypertrophy; and four, Parkin-sonism. ’ ’
(Tr. p. 44)

Complainant continued to remain under the care of Doctor Cowden for several months and his condition was finally diagnosed by that physician to be as follows:

“ ‘It’s my opinion that Mr. Patterson is totally and permanently disabled due to organic heart disease, and while he is fairly well compensated on a medical program of salt-restrictions, digitalis, dieuretics, and limited activities, I do not feel that he is capable of any significant work. His previous employment has been in farming and carpentry work, and I do not feel that he is capable of any productive activity in either of these fields.’ ”
(Tr. pp. 47-48)

The diagnosis of Doctor Cowden is not disputed by defendant and, in fact, defendant concedes that complainant is totally and permanently disabled.

Complainant contends that he is totally and permanently disabled as a result of his illness and substantially confined within doors so as to place him within the provisions of Part J of the insurance policy and that he is entitled to collect from the defendant insurance company the sum of $100.00 per month from January 18, 1964.

[305]*305Defendant contends that, as a result of complainant’s illness, he is not continuously confined within doors and therefore, the only disability benefit to which he is entitled is $100.00 per month for two months under Part K of the policy, for which he has been paid. However, defendant admits complainant is entitled to recover some hospital benefits under other provisions of the policy. Therefore, defendant paid complainant $200.00 benefits under Part K of the policy and $50.00 for some benefits under another provision of the policy, thus making total payments of $250.00.

On January 26, 1965, this suit was instituted by complainant filing his bill in Chancery by which he sought to recover benefits of $100.00 per month from January 18, 1964, to the date of filing of the bill, less the $200.00 previously paid under Part K of the policy, and also to recover the additional sum of $16.65 hospital benefits due under another provision of the policy.

To this bill, defendant filed its answer, expressly denying that complainant was, by reason of his illness, continuously confined within doors and, therefore, denying liability under Part J of the insurance policy.

On October 20, 1965, complainant filed a supplemental bill seeking recovery of the $100.00 monthly benefits under Part J of the policy up until the date of the filing of such supplemental bill.

Complainant demanded a trial of the issues by jury, which demand was allowed by the Court and the case was tried with the following issue of fact being submitted to the jury:

“Has the complainant, Charlie Patterson, been substantially continuously confined within doors as a result of his sickness?”
[306]*306(Tr. p. 28)

The case was tried upon oral and documentary evidence, with the exception, of the testimony of Doctor Oowden, which, was by deposition, and after being instructed by the Chancellor, the jury answered “yes” upon the issues submitted to them. (Tr. p. 28)

Upon this verdict of the jury, the Chancellor rendered a decree in which he ordered, adjudged and decree as follows :

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Related

Pennsylvania Life Insurance v. Bumbrey
665 F. Supp. 1190 (E.D. Virginia, 1987)
Crowell v. Federal Life & Casualty Co.
247 N.W.2d 503 (Michigan Supreme Court, 1976)

Cite This Page — Counsel Stack

Bluebook (online)
406 S.W.2d 338, 56 Tenn. App. 301, 1966 Tenn. App. LEXIS 227, Counsel Stack Legal Research, https://law.counselstack.com/opinion/guarantee-trust-life-insurance-v-patterson-tennctapp-1966.