Home Life Ins. Co. of New York v. Stewart

114 F.2d 516, 1940 U.S. App. LEXIS 3158
Court of Appeals for the Tenth Circuit·Decided September 3, 1940·No. No. 2068·Published·Cited by 13 cases

Opinion

BRATTON, Circuit Judge.

The policy of disability insurance sued upon contains this provision: “The irrecoverable loss of sight in both eyes or the total and permanent loss by accident or disease of the use of both hands, or both feet, or of one hand and one foot, shall constitute total and permanent disability within the meaning of this agreement without prejudice to any other cause of disability, and in any such case the benefits will accrue from the date of such disability, anything to the contrary hereinbefore notwithstanding; provided, however, that benefits shall not accrue more than six months prior to the date of receipt of such due proof.”

The case was submitted to the trial court on stipulated facts. It was stipulated that prior to the filing of the complaint the lens in the left eye of plaintiff was removed by operative surgery because ©f a cataractous condition; that at the time the complaint was filed a cataract existed in the right eye and its lens was later removed in like manner; that for the purpose of the case the condition of both eyes should be considered as identical; that by reason of plaintiff’s inability properly to get an exact focus on the retina of the eye as the result of the removal of the natural lens, vision in each eye was less than 294ooths without the use of artificial lens; that by means of artificial lens used externally in the same manner that spectacles are used, plaintiff can and does focus rays of light on the retina of each eye with practically the same effect and result as through the medium of a normal, natural lens; that the word “sight”, as used in the policy, means (for the purpose of this case) useful sight in the economic or industrial sense; that without the use of artificial lenses plaintiff has no useful sight in an economic or industrial sense, but with the use of such lenses he has (for the purpose of this case) normal vision; and that plaintiff has been able to engage and is engaging in an occupation for compensation or profit. The court concluded that plaintiff had suffered the irrecoverable loss of sight in both eyes within the meaning of the policy and rendered judgment in his favor.

It is well settled in Colorado that in case of doubt or ambiguity a contract of insurance is to be construed in favor of the insured and against the insurer. National Optical Co. v. United States Fidelity & Guaranty Co., 77 Colo. 130, 235 P. 343; Denton v. Prudential Ins. Co., 100 Colo. 293, 67 P.2d 77; Equitable Life Assurance Society v. Hemenover, 100 Colo. 231, 67 P.2d 80, 110 A.L.R. 1270. But that rule does not go to the extent of making a plain contract doubtful or ambiguous and then interpreting it in favor of the insured. Too, the natural and obvious meaning of the provisions in a contract is to be adopted in preference to a fanciful, curious or hidden meaning.

The provision of the policy in question does not insure against the loss of the lens or any other physical part of the eye. It insures against the loss of sight. The coverage is limited by the plain language of the contract to the loss of function, and does not embrace the loss of any part of the physical eye. And the loss must be irrecoverable. Through a cataractous condition the insured lost substantially all of the sight in both eyes. And it may be that under the law of Colorado he was not obligated to submit to surgery as a prerequisite to recovery upon the policy, Pacific Mutual Life Ins. Co. v. Matz, 102 Colo. 587, 81 P.2d 775. But we do not explore that question because with commendable courage [518] he voluntarily underwent two operations for the removal of the lenses. He wears glasses, and it is stipulated that with their use he has normal vision. No case cited by the parties or discovered through our own research is squarely in point. But in Southland Life Ins. Co. v. Dunn, Tex.Civ.App., 71 S.W.2d 1103, recovery was sought upon a disability policy which provided that, without prejudice to any other cause of disability, the entire and irrecoverable loss of sight in both eyes would be considered.as total and permanent disability. Due to a cataractous condition, plaintiff had suffered such impairment of sight in both eyes as to prevent him from performing the substantial duties of any occupation or labor, and his condition was permanent. But the undisputed evidence was that through removal of the cataracts by surgery, and the use of glasses, the restoration of normal or substantially normal vision could reasonably be expected. The court held that the loss 'of sight was not irrecoverable within the meaning of the policy, that instead it was wholly or partially recoverable, and that in either ,event recovery could, not be had. That case seems to bear analogous application.

Free access — add to your briefcase to read the full text and ask questions with AI

Home Life Ins. Co. of New York v. Stewart, 114 F.2d 516, 1940 U.S. App. LEXIS 3158 (10th Cir. 1940).

114 F.2d 516 (Home Life Ins. Co. of New York v. Stewart) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

Related

William Scallion, Jr. v. Hartford Life & Accident
375 F. App'x 431 (Fifth Circuit, 2010)
Buchanan v. Reliance Standard Life Insurance
5 F. Supp. 2d 1172 (D. Kansas, 1998)
Colorado-Ute Elec. Ass'n, Inc. v. Envirotech Corp.
524 F. Supp. 1152 (D. Colorado, 1981)
Crim v. National Life & Accident Insurance Co.
605 S.W.2d 73 (Supreme Court of Missouri, 1980)
Aurelian Roy v. Allstate Insurance Company
383 A.2d 637 (Connecticut Superior Court, 1977)
Reliable Life Insurance Company v. Steptoe
435 S.W.2d 630 (Court of Appeals of Texas, 1968)