Lauren v. AUTOMOBILE OWNERS'ASSOCIATION

92 N.W.2d 659, 77 S.D. 400, 1958 S.D. LEXIS 32
CourtSouth Dakota Supreme Court
DecidedOctober 24, 1958
DocketFile 9688
StatusPublished
Cited by4 cases

This text of 92 N.W.2d 659 (Lauren v. AUTOMOBILE OWNERS'ASSOCIATION) is published on Counsel Stack Legal Research, covering South Dakota Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Lauren v. AUTOMOBILE OWNERS'ASSOCIATION, 92 N.W.2d 659, 77 S.D. 400, 1958 S.D. LEXIS 32 (S.D. 1958).

Opinion

RENTTO, P. J.

In this action the judgment awarded plaintiff hospital expenses and confinement benefits under a policy of insurance issued by the defendant Association. In its answer the defendant admitted some liability under these features of the policy but in each instance in an amount less than the judgment. However, this appeal by the Association questions the judgment only insofar as it allowed confinement benefits for the period from August 4th through September 17, 1956.

The policy in question insured against loss from accidental bodily injury sustained while driving or riding within any automobile, truck or bus for business or pleasure. The benefit provision thereof material to this appeal reads thus:

“If ‘Such Injury’ as described in the Insuring Clause, and not hereinafter excepted or for which indemnity is provided in Part Two shall immediately after accident wholly and continuously disable and prevent the Insured from performing any and every duty pertaining to any business or occupation, and as the result thereof is thereby necessarily confined within doors and requires regular visits therein by a legally licensed medical or osteopathic physician or surgeon, the Company will pay for any one accident an indemnity for one day or more at the rate of One Hundred Fifty Dollars ($150.00) per month even for life, so long as such disability and confinement continues.”

*402 The insured was in an automobile accident on February 17, 1956, in which he injured his right hip and the right side of his chest. On the same day he was admitted to the hospital at Hettinger, North Dakota, where he re-, mained until February 21, 1956. On that date he was taken by ambulance to the hospital at Bismarck, North Dakota. The X-ray pictures led his doctor to believe that his hip was fractured. Subsequent examination and manipulation caused the doctor to1 be in doubt as to whether the fracture was old or new. The insured was confined to bed rest with the lower extremity of his right leg in traction. He was released on March 20, 1956 and ordered to be on crutches at all times and not to take any weight on his foot.

At the time of the accident he was living on a stock and grain farm near Bison, South Dakota, which he operated with his son-in-law and hired help. Upon his release from the hospital he returned thereto-but because of his injury was unable to do anything in the operation of the farm, except that he consulted with his son-in-law on matters concerning their farm activities and wrote checks in payment of some of the expenses of its operation. From the time of his release until June 6, 1956, he went to see his doctor on three occasions. Some time after this date he was taken by car to Denver, Colorado and Thermopolis, Wyoming to see other doctors. At these places he also took baths which relieved him of some of the pain he was suffering. At the latter place X-rays were taken which indicated that the fracture of his hip was of recent origin and he was advised to have it operated on.

After his return from this trip he was readmitted to the Bismarck hospital on August 4th and remained through September 17, 1956. During this stay an operation was performed on his hip. The injury which made this necessary resulted from the accident of February 17, 1956. After his release from the hospital he remained in Bismarck almost two months as an outpatient to receive daily physical therapy treatments. During all of this time he was on crutches. In the opinion of his doctor he was totally disabled during this period of hospitalization and while an *403 outpatient. In the course of the trial plaintiff limited his claim for confinement benefits to the periods during which he was in hospital confinement. This appeal concerns only the second period of confinement in the Bismarck hospital.

We think it clear that while the insured was in the hospital on this occasion he was necessarily confined within doors. Annotation 29 A.L.R.2d 1427. This apparently is not questioned by the Association but it does contend that it is not liable for such period of confinement because the insured was not continuously within doors from the time of the accident. In our view the policy provision in question does not require such continuity to render a period of confinement compensable.

It is to be observed that under this policy the Association agrees to pay benefits so long as such disability and confinement continues. In other words, before the Association is liable for confinement 'benefits there must be both disability and confinement. This disability in the terms of the policy must be such as to “immediately after accident wholly and continuously disable and prevent the Insured from performing any and every duty pertaining to any business or occupation.” Clearly, the requisite disability must be continuous from the time of the accident.

However, the confinement that is essential to its liability is not similarly limited. As to this the policy provides only that it be such that as a result of the injury the insured is “necessarily confined within doors and requires regular visits therein by a legally licensed medical or osteopathic physician or surgeon,”. There is no requirement that the confinement be continuous from the time of the accident. This contract was prepared by the Association. Had it intended the limitation contended for, such could have been readily inserted. It did so concerning the disability essential to liability under this provision. Many of the cases in this field involve policies wherein compensable confinement is so described.

The Association also suggests that it is not liable because the injury did not “wholly and continuously disable and prevent the Insured from performing any and *404 every duty pertaining to any business or occupation,”. We think the record compels the conclusion that it did so disable him. In making this contention it is urging that this policy provision be construed in its literal sense which would require a state of absolute helplessness in order for the insured to recover. We decline to so construe this provision.

In several cases under total disability provisions of life and accident policies this court has consistently rejected the rule of literal c'onstruction. In those cases it has applied the liberal rule which seems to be the rule generally applied in other jurisdictions. These cases are cited in Robinson v. New York Life Insurance Company, 69 S.D. 30, 6 N.W.2d 162. While the language of the disability provisions in this policy differs somewhat from that in the provisions with which this court has been previously concerned, we think it too must be looked at liberally.

The policy states that the requisite disability is such as will “prevent the Insured from performing any and every duty pertaining to any business or occupation,”. From this basis the Association proceeds to urge that since the insured was able to perform some of the duties of his farming operation it was not liable under the policy. Or putting it another way, the Association seems to claim that if the insured is able to perform any of the duties of any occupation or business, he is not disabled. We do not agree.

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Cite This Page — Counsel Stack

Bluebook (online)
92 N.W.2d 659, 77 S.D. 400, 1958 S.D. LEXIS 32, Counsel Stack Legal Research, https://law.counselstack.com/opinion/lauren-v-automobile-ownersassociation-sd-1958.