Harasymczuk v. Massachusetts Accident Co.

127 Misc. 344, 216 N.Y.S. 97, 1926 N.Y. Misc. LEXIS 982
New York Supreme Court·Decided May 27, 1926·Published·Cited by 22 cases

Opinion

Lee, J.

This is an action brought by the plaintiff against the defendant on an accident insurance policy, the plaintiff’s contention being that he is entitled to recover the sum of $50 per month between September 24, 1924, and the 1st day of May, 1925, or a sum which plaintiff claims is $361.65. Upon the trial the plaintiff waived any claimed indemnity under the policy as to hospital treatment.

The insurance policy under which the plaintiff endeavors to recover in this action was issued to him by the defendant on the 18th day of August, 1924, and the policy under paragraph C thereof provides as follows:

u zpx In the sum of fifty dollars per month for t ) total loss ¡0ss of time for a period not exceeding op ti e five consecutive years, resulting directly or independently of all other causes from bodily injury sustained during the life of this Policy, caused solely through external, violent and accidental means (excluding suicide, sane or insane),, and such as shall immediately, continuously and wholly disable and prevent [346] the insured, from the date of the accident, from performing every duty pertaining to any business or occupation, and not resulting in any loss specified in Paragraph E.”

The defendant raises several questions, claiming plaintiff is not entitled to further remuneration than he has already received under the policy in question. The defendant paid to the plaintiff indemnity for forty-two days or one and one-third months under clause C above quoted, paying him sixty-six dollars and sixty-six cents, and the agent took from the plaintiff a receipt or release which defendant claimed was in full.

The question was submitted to the jury as to whether or not defendant’s agent had procured the receipt or release through fraud, and the jury found that it was procured by fraud. This disposed of the question as far as the release was concerned. (Rocci v. Massachusetts Accident Co., 222 Mass. 336.) This was the only question that either party asked to have submitted to the jury. Upon the trial the defendant took the position that all questions were for the court and the plaintiff did likewise except that he asked a special verdict of the jury on the question of fraud relating to the alleged release. Hence, it is my understanding under the method and manner in which the parties tried the action that all other questions were for the court. (Jones v. Brooklyn Life Insurance Co., 61 N. Y. 79; Kinner v. Whipple, 128 App. Div. 736.)

Plaintiff was injured on July 22, 1924, by falling a considerable distance while at work. He was first away from the plant of his employer forty days for which he was paid the sixty-six dollars and, sixty-six cents and then from September 2, 1924, to September 24, 1924, he endeavored to work. Plaintiff’s foreman testified plaintiff did very light, work and that plaintiff did not perform any substantial part of his former work as a bench hand. The plaintiff has not worked or been employed since September 24, 1924, and claims total disability under clause C of the policy. At the end of the two weeks’ period mentioned plaintiff was again confined to the hospital where he was operated upon because his right kidney was loose and out of position. Such injuries resulted from the fall he received on July 22, 1924, there being no controversy on the trial on this question. The defendant raises the question that because the plaintiff went back to the plant of his employer and endeavored to work for two weeks he is now prevented from recovering under clause C above quoted. In analyzing the policy of insurance between the parties to this action this court must start off with a cardinal rule of construction as to policies of insurance that a construction must be made which is most favorable [347] to the insured. Policies of insurance are to be liberally construed and the conditions therein are to be construed strictly against those for whose benefit they are reserved. Construction should be made most favorable to the insured where any doubt or ambiguity arises as to the meaning of any clause. (Schumacher v. Great Eastern Casualty & Indemnity Co. of N. Y., 197 N. Y. 58; Marshall v. Commercial Travelers’ Mutual Accident Assn., 170 id. 434; Lowenstein v. Fidelity & Casualty Co. of N. Y., 88 Fed. 474.)

Clause C provides, referring to the accident, that it “ shall immediately, continuously and wholly disable and prevent the insured from the date of the accident from performing every duty pertaining to any business or occupation * * *.”

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Harasymczuk v. Massachusetts Accident Co., 127 Misc. 344, 216 N.Y.S. 97, 1926 N.Y. Misc. LEXIS 982 (N.Y. Super. Ct. 1926).

127 Misc. 344 (Harasymczuk v. Massachusetts Accident Co.) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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