Jenkins v. New York Life Insurance

7 S.E.2d 343, 122 W. Va. 73, 1940 W. Va. LEXIS 16
CourtWest Virginia Supreme Court
DecidedFebruary 13, 1940
Docket8980
StatusPublished
Cited by9 cases

This text of 7 S.E.2d 343 (Jenkins v. New York Life Insurance) is published on Counsel Stack Legal Research, covering West Virginia Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Jenkins v. New York Life Insurance, 7 S.E.2d 343, 122 W. Va. 73, 1940 W. Va. LEXIS 16 (W. Va. 1940).

Opinion

Kenna, Judge:

This is a notice of motion proceeding, brought in the Court of Common Pleas of Kanawha County, in which the demurrer of the New York Life Insurance Company to the plaintiff’s notice was sustained, and the proceeding dismissed. The Circuit Court of Kanawha County having declined the plaintiff’s application for a writ of error, the prayer of the petition was granted by this Court.

According to the allegations of the notice, in December, 1923, the policy under the terms of which recovery is sought was issued. It remained in effect until the death of the insured in 1934. The only question involved in this proceeding is whether a notice of disability which the company received April 14, 1933, operated retroactively so that the insured was entitled to the monthly payment of disability insurance provided for in the policy from the inception of his total disability, which the notice alleges began June 21, 1929. Upon receiving the proof of disability, the New York Life Insurance Company waived premiums and made the monthly income payments from that time until the death of the insured. As stated, the insured’s personal representative *75 now seeks to recover payments which antedate the time of the proof of disability.

The material parts of the life insurance policy forming the basis for the recovery herein sought are contained in paragraph three and read as follows:

“3. Benefits. — Upon receipt at the Company’s Home Office, before default in payment of premium, of due proof that the Insured is totally and presumably permanently' disabled and that such disability occurred after the insurance under this Policy took effect and before its anniversary on which the Insured’s age at nearest birthday is sixty years, the following benefits will be granted:
“ (a) Income Payments. — The Company will pay to the Insured a monthly income of $10 per $1,000 of the face of the policy during his lifetime and continued disability, beginning immediately on receipt of said proof. Any income payment due before the Company approves the proof of disability shall be payable upon such approval. If disability results from insanity, income payments under this section will be paid to the bene- • ficiary in lieu of the Insured.”

The plaintiff in error (insured) advances three contentions:

(1) That the language of the policy in plain and unequivocal terms entitles the insured to disability insurance covering the full period of a disability arising during the life of the policy, if satisfactorily proven regardless of the time the insurer received the proof.

(2) That if the policy is not sufficiently explicit to clearly so provide, the language covering the disability provision is ambiguous, and for that reason is susceptible of that interpretation because the policy is to be read most favorable to the insured.

(3) That if both the preceding contentions are found against the plaintiff in error, because of the fact that the insured was mentally incapacitated from June, 1929, to and including the time when the company was given *76 notice of his disability, insured should be excused for the delay, and the notice when received should operate retroactively.

The first two questions raised, both of which involve language used in the disability benefit provision contained in the third part of the contract, may be dealt with together. Should we regard the language of paragraph (a) of that part of the contract as carrying a meaning plainly in favor of the insured’s contention or as being of uncertain meaning the consequence would be that a- dismissal of the plaintiff’s notice constituted error. Howevér, should the language of that clause be regarded as distinctly and plainly expressing the meaning placed upon it by the defendant in error, the only basis upon which the insured’s administrator could be considered, under the averments of his petition, as entitled to recover, would be because his disability had excused him from performing or executing the terms of the bilateral contract.

As we understand the plaintiff’s construction of that part of the policy now under consideration, it is to be read as providing for the insured in the event of total and presumably permanent disability a monthly income for the entire period coinciding with the existence of his disability, regardless of the time of filing his proof of loss, so that if the proof of loss were filed, as here, months after the disability accrued, although the filing of a proof of loss is an indispensable condition to the payment of that loss, if and when filed, it relates to the time the disability began and requires the payment of a monthly income covering the full period.

We think that taken in its usual and common meaning, which, of course, may exclude logical niceties, the part of this policy under consideration is plainly understandable. The word “income”, as we read it and its context, means recurrent periodical payments, and limited by the adjective “monthly” the time of payment ■ becomes fixed. It does not contemplate a lump sum payment in part or in whole, the plaintiff’s contention being that now *77 he is entitled to a lump sum payment for a period of approximately forty-six and one-half months amounting to the sum total of $1,161.67. The only recognition of an approach to a lump sum payment is the provision contained in this same paragraph to the effect that an income payment becoming due before the company approves the proof of loss shall be payable upon that approval. There is no recognition of payments that might otherwise accumulate, such as those becoming due from the time of disability and before a proof of loss is filed. The phrase “beginning immediately on receipt of said proof” relates only to “monthly income”, and not, as plaintiff contends, to all payments inclusive of a lump sum settlement covering the omitted period. A construction including a lump sum payment would constitute an unjustifiable interpolation altering the substantial meaning of the policy instead of merely adding an explanatory phrase. It is not necessary to comment upon the fact that prompt proofs of loss are essential and necessary not only to the welfare of a life insurance company, but for a proper protection of the rights of its policyholders in general. Theoretically, if the amount due under the disability clause is regarded as cumulative beyond the explicit terms of the policy, the fiscal status of the company might become uncertain and if the insured’s right to disability payments should relate back instead of being determined at the time he filed his proof of disability, the company’s facilities for examining the claim, if not obliterated, would be greatly impaired. Being of the opinion that the terms of the policy are not ambiguous, we are not favorably impressed by plaintiff’s first two positions.

Taking up the third question, at the outset attention should be directed to the fact that the question here involved is not whether the insured’s disability relieved him from performing a condition which went to his basic right under the contract, but only whether his disability relieved him of filing his proof of loss at its inception, so that when filed his right to recover, which *78

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Bluebook (online)
7 S.E.2d 343, 122 W. Va. 73, 1940 W. Va. LEXIS 16, Counsel Stack Legal Research, https://law.counselstack.com/opinion/jenkins-v-new-york-life-insurance-wva-1940.