John Hancock Mutual Life Insurance Co. v. Highley

445 P.2d 241
CourtSupreme Court of Oklahoma
DecidedSeptember 23, 1968
Docket40805
StatusPublished
Cited by5 cases

This text of 445 P.2d 241 (John Hancock Mutual Life Insurance Co. v. Highley) is published on Counsel Stack Legal Research, covering Supreme Court of Oklahoma primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
John Hancock Mutual Life Insurance Co. v. Highley, 445 P.2d 241 (Okla. 1968).

Opinion

LAVENDER, Justice:

This appeal is concerned with a money judgment in favor of the widow and two *243 minor children of Mont F. Highley, Jr., as the beneficiaries named in two policies of insurance on his life issued by the defendant and in full force at the time of the insured’s death, on claims against the insurer under the “Additional Benefit” (or “double indemnity”) provisions of the two policies. The face amounts of the policies had been paid by the company without question. The cause was tried to a jury, and the jury’s verdict, and the judgment of the trial court, based thereon, were for the plaintiffs and against the defendant for the amounts of the additional benefits provided for in the two policies.

Although the defendant presents its assignments of error under three propositions, it states in its reply brief herein that the sole question involved in this appeal is whether the proofs furnished by the plaintiffs to the defendant constituted the “due proof” required by the additional benefit provisions of the policies, so that the plaintiffs could be allowed to proceed with their action upon the defendant’s denial of liability under the additional benefit provisions of the policies.

The pertinent provisions of the two policies are, admittedly, substantially the same. One of them provides:

“The Company hereby agrees, subject to the conditions and the exceptions and exclusions herein set forth, and subject to the payment of any unpaid balance of the premium hereunder for the uncompleted current policy year, to pay in one sum to the beneficiary of the said policy an Additional Benefit of Five Thousand Dollars upon receipt at its Home Office in Boston, Massachusetts, of due proof on its prescribed forms, directly and affirmatively showing that (1) the Insured’s death was caused directly, independently and exclusively of all other causes, by a bodily injury sustained solely by external, violent, and accidental means, or, if death resulted from a disease caused by such a bodily injury, that such disease was the sole, direct and immediate result of such injury and had its inception within thirty days from the date on which such bodily injury was sustained as aforesaid, that (2) such death occurred within ninety days from the aforesaid date, and that (3) such bodily injury was evidenced by a visible wound or contusion on the exterior of the Insured’s body, unless death resulted from drowning or from an internal injury, revealed by an autopsy and consisting solely and exclusively of a contusion, a rupture or a fracture of an internal organ or part of the Insured’s body.
“EXCEPTIONS AND EXCLUSIONS: * * * nor shall such Additional Benefit be payable if death results, directly or indirectly, or wholly or partially, (1) from any bodily or mental disease or infirmity * *

The insured was injured in a head-on collision on a highway east of Midwest City, Oklahoma, between an automobile that he was driving and a pickup truck. He was taken directly to the emergency room of St. Anthony Hospital in Oklahoma City and after emergency treatment, including the suturing of a bruised, skull-deep gash, three to four inches long, on the side of his head from above his right eye toward his right ear, was admitted to the hospital as a patient. He was attended to by the same physician who had sutured the head laceration, and because of a pre-exist-ing heart condition for which he was taking medication, was also attended to by Dr. D. who had treated and advised him in connection with heart attacks for which he had been hospitalized six years, and four years, before. After several days, he was allowed to be up and walk around his room and go to the bathroom and after several more days, was allowed to take baths unattended and to take short walks in the hallway. About midafternoon of his tenth day in the hospital, after having eaten well at breakfast and at noon, and while resting in his bed, he suffered a mild convulsion, or shaking of most of his body, of about two minutes duration, and died within a matter of minutes thereafter.

*244 Upon learning of the death of the insured, the defendant’s General Agent in Oklahoma City provided the plaintiffs with two forms of “proof of death,” both of which, according to the instructions on the reverse side of one of them (Form 14R), were required in all cases of death of an insured. The pertinent instructions on the reverse side of the Form 14R read as follows :

“Proofs of death must be submitted to the Company at its Home Office, 200 Berkeley Street, Boston 17, Massachusetts, on the Company’s prescribed forms of Claimant’s and Attending Physician’s Statements on Form 14R and Form 15R, and a Funeral Director’s Statement on Form 16R when requested, and must be procured without expense to the Company.”
“CLAIMANT’S STATEMENT on Form 14R — Must be completed by the person or persons to whom the insurance is payable. If there is more than one claimant, additional statements will be furnished as desired, or one claimant, if of legal age, may make claim on behalf of himself and other claimants.”
“ATTENDING PHYSICIAN’S STATEMENT on Form 15R — Must be completed by the doctor in attendance during the last illness of the insured. An official death certificate will be accepted in lieu of this statement if the policy or policies are INCONTESTABLE, or if claim is not being made for any ADDITIONAL ACCIDENTAL DEATH BENEFIT.”
“AUTHORIZATION FORM, No. 1797 — Must be completed if DEATH occurred during the CONTESTABLE PERIOD of the policy, or any reinstatement thereof, or if claim is also made for any ACCIDENTAL DEATH BENEFIT.
“When an ACCIDENTAL DEATH BENEFIT claim is indicated, please furnish all available newspaper clippings which describe the circumstances surrounding the accident.
“The Company reserves the right to require or to obtain such additional information or certificates it deems necessary.”
“POLICY — or policies must be surrendered to the Company before payment can be made. * *

One of the attorneys for the plaintiffs, who had been appointed, and qualified, as the executor of the last will and testament of the insured, handled the matter of furnishing the proof deemed to be required.

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Cite This Page — Counsel Stack

Bluebook (online)
445 P.2d 241, Counsel Stack Legal Research, https://law.counselstack.com/opinion/john-hancock-mutual-life-insurance-co-v-highley-okla-1968.