Lacko v. Washington Nat'l Ins. Co.

175 A. 300, 115 Pa. Super. 194, 1934 Pa. Super. LEXIS 412
CourtSuperior Court of Pennsylvania
DecidedSeptember 27, 1934
DocketAppeal 31
StatusPublished
Cited by1 cases

This text of 175 A. 300 (Lacko v. Washington Nat'l Ins. Co.) is published on Counsel Stack Legal Research, covering Superior Court of Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Lacko v. Washington Nat'l Ins. Co., 175 A. 300, 115 Pa. Super. 194, 1934 Pa. Super. LEXIS 412 (Pa. Ct. App. 1934).

Opinion

Opinion by

Stadtfeld, J.,

This was an action of assumpsit on a combination health and accident policy for health benefits amounting to $600.

Plaintiff’s second amended statement averred, inter alia, the issuing on April 15, 1931, to plaintiff, of the policy in suit; that premiums were paid, $5.20 on April 8, 1931, $5.20 on May 5, 1931, and $5.20 on May 29,1931; that payments were made after May 29,1931, but were subsequently returned to the insured; that plaintiff, between May 19, 1931, and June 26, 1931, *196 developed or contracted tuberculosis, that he has been totally and continuously disabled from performing any work, and is under the care, and attendance once in every seven,days, of a legally qualified physician; that the disability began May 19, 1931, and has continued to the present time; that he has been confined since August 1, 1931, by reason of said sickness, in the Tuberculosis League Hospital at Pittsburgh; that, on May 20,' through his brother, and on or about May 27, and on or about June 7, through his father, plaintiff gave verbal notice to the manager of defendant’s office at Pittsburgh of the said sickness; that the said manager notified plaintiff that the company was under no liability to pay the indemnity contracted for, by reason of the fact that the defendant company believes the illness had been contracted within thirty days after April 15, 1931, and that it relied upon Paragraph “H” in the policy providing that the sickness must be contracted after thirty days from the date thereof; that plaintiff claimed the sum of $600, being the confining illness indemnity for the six months beginning May 19, 1931, and the further sum of $200 indemnity under the double hospital indemnity provided in,Paragraph “L” of the policy. .

The following are excerpts from the policy, material to the issues involved:

“Confining Illness Indemnity.

“ (H) At the rate of one hundred dollars per month for the number of consecutive days, and not exceeding six months, that the insured is necessarily, totally and continuously confined within the house and is under the care of and visited in the house at least once in each seven days by a legally qualified physician by reason of sickness or disease that is not venereal in character and is contracted and begins during the life of this policy and after thirty days from date hereof.

*197 Standard Provisions.

3. If default be made in tbe payment of the agreed premium for this policy, the subsequent acceptance of a premium by the company, or by any of its duly authorized agents shall reinstate the policy but only to cover accidental injury thereafter sustained and such sickness as may begin more than ten days after the date of such acceptance.

The affidavit of defense admitted the issuing of the policy; averred that the payment of premium under date of May 29, 1931, $5.20, was rejected by the company and returned to plaintiff; denied that plaintiff contracted tuberculosis between May 19, 1931, and June 26, 1931, and averred that plaintiff contracted the same a considerable length of time prior to May 19, 1931 ;■ admits that, by reason of said illness, plaintiff has been disabled and is under the care of a legally qualified physician, but denies that said disability began on May 19, 1931, and avers that it began at a date prior thereto; admits the confinement in the hospital; admits receipt of notice of the alleged illness, but not of the illness for which claim is made. Defendant further avers that, by reason of the fact that the premium for the month of May was not paid until May 5th, the first effective date after May 1st when the policy came into force and effect, placing any liability on the defendant, was full ten days beyond May 5th, or May 16th; that defendant was sick with tuberculosis prior to May 15, 1931; that, on May 15, 1931, plaintiff consulted his physician, Dr. Campbell, and that at that time he had a fever — pain—cough—chills and bloody sputum, and that said physician prescribed for him at that time; that said tuberculosis had been contracted by plaintiff a period of several weeks and perhaps months prior thereto, and that plaintiff was *198 suffering from said tuberculosis at and prior to May 5, 1931, and that, therefore, defendant is not liable under said policy by reason of “Standard Provision No. 3.”

The ease came on for trial before a court and a jury. The claim for $200 double hospital indemnity was abandoned at the trial.

The facts are undisputed that about May 15th the plaintiff consulted his family physician complaining of general disability and the fact that he was “catching cold.” He was ordered by his physician to return home,, to rest, and to take a prescription which was given him, and, if he did not feel better within a few days,, to call the doctor. The plaintiff did not carry out the instructions given by his physician but returned to work. On May 19, 1931, he was taken home from his work after a collapse at work, placed in bed, and his case diagnosed by the physician immediately called as lobar pneumonia. In the course of the treatment for lobar pneumonia, another physician was called who indicated that he believed the pneumonia to be tubercular in character. After convalescence from pneumonia his family physician caused sputum examinations to be made and then diagnosed his continued condition as one of tuberculosis.

Plaintiff, on his own behalf, testified that he had not been sick prior to May 15th, and that he did not have a cough prior to said date, and not between April 15th, the date of the policy, and May 1st, and that he was well until May 19th.

Dr. Robert A. Campbell, a witness on behalf of plaintiff, and who had been practising about forty years, testified that he had been the family physician for a good many years, that plaintiff came to his office on May 15th and was examined by him; that he thought he might have a slight attack of grippe; that he did not seem to be very sick at all; that the. lobar *199 pneumonia which he diagnosed on May 19th ran its regular course; that on May 15th there was “nothing you would suppose or cause you to suspect that there was any tuberculosis there;” the first time he suspected that plaintiff might have secondary infection of tuberculosis was after the 19th, “during his pneumonia attack on account of spitting of large quantity of blood different times. We then commenced to think there was possibility;” but “Not positively, until he was, however, over the pneumonia, until after I had the sputum examined,” well on in June; that you cannot be sure there is tuberculosis until the sputum test is taken; that pneumonia may so damage the lung that tuberculosis may show up or appear; that is what he thought occurred in this case.

Dr. Gfeorge E.

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123 A.2d 619 (District of Columbia Court of Appeals, 1956)

Cite This Page — Counsel Stack

Bluebook (online)
175 A. 300, 115 Pa. Super. 194, 1934 Pa. Super. LEXIS 412, Counsel Stack Legal Research, https://law.counselstack.com/opinion/lacko-v-washington-natl-ins-co-pasuperct-1934.