Laventhal v. Fidelity & Casualty Co. of New York

98 P. 1075, 9 Cal. App. 275, 1908 Cal. App. LEXIS 138
California Court of Appeal·Decided November 5, 1908·No. Civ. No. 473.·Published·Cited by 14 cases

Opinion

*276 COOPER, P. J.

Plaintiff recovered judgment for $1,475 upon an accident insurance policy. This appeal is from the judgment on the judgment-roll with a bill of exceptions.

On January 2, 1903, the defendant issued to plaintiff an accident insurance policy, which provided that the company “does insure the person described in said schedule [the plaintiff herein] for the period of one year from noon, standard time, the day this contract is dated, against disability or death resulting directly, and independently of all other causes, from bodily injury sustained through external, violent and accidental means ... (1) If said injuries shall immediately, continuously and wholly disable and prevent the insured from performing every and any kind of duty pertaining to his occupation, the company will pay ... (3) If such injuries shall not wholly disable the insured, but shall prevent him from performing fully work essential to his duty or duties, the company will pay the insured. ...”

On November 10, 1903, while the policy was still in force, the plaintiff received an injury, while on a railroad train at San Jose, by being bruised in the abdomen by coming in contact with a suit case. He returned to San Francisco, and thereafter went as usual to the office of the company by which he was employed, and attended to his duties there until December 1, 1903, when he became totally disabled from the injury he had received, and thereafter could not leave his bed for twenty-seven weeks. The complaint alleged that “in consequence of which said injuries he was totally disabled from performing any work whatsoever from and after the 1st day of December, 1903, and said total disability continued from said 1st day of December, 1903, to and including the 9th day of June, 1904, to wit, for a period of 27 weeks and 3 days.” Among the special interrogatories submitted to the jury was the following: “How much time elapsed between the date of. the accident complained of and the beginning of the continuous disability?” To the above interrogatory the jury answered ‘ ‘ 22 days. ’ ’ The question, and the only question, in the case is as to whether or not the defendant is liable under the total disability clause in the policy.

The policy is but a contract, and, like all other contracts, it must be construed from the language used; when the terms are plain and unambiguous, it is the duty of courts to hold *277 the parties to such contract. The defendant agreed, in case the plaintiff by accident should receive a bodily injury, that “if said injury shall immediately, continuously and wholly disable and prevent the insured from performing every and any kind of duty pertaining to his occupation, the company will pay. ...” Plaintiff received a bodily injury. The injury, however, did not immediately and wholly disable and prevent the plaintiff from performing every duty pertaining to his occupation. The language is plain, and anyone can at once see that the plaintiff was not immediately disabled and prevented from performing the duties or part of the duties pertaining to his occupation. The defendant had the right to make its liability depend upon the fact as to whether or not the plaintiff was immediately disabled by the injury from performing every duty pertaining to his occupation. It had the right to take the question out of the category of such uncertainties as might be raised by experts, or oral testimony as to whether or not the final total disability was caused by the injury or by other complications or conditions. It made its insurance policy with these conditions, and evidently fixed its rate or premium in accordance with the risk it assumed. To these conditions the plaintiff gave his assent when he accepted the policy. If he was not immediately disabled, he cannot in law or in morals hold the defendant liable. If we were to adopt the rule contended for here by plaintiff, it would place such a contract in the realm of uncertainty. If, where twenty-two days elapsed before the injury finally overpowered and disabled the plaintiff, we should hold that such disability was immediate, the same reasoning would apply if the period had been fifty days, and so on for months and perhaps years. It is said by medical writers that eases have been known where a slight injury received in youth, from which the patient apparently recovered, has been the proximate cause of death in old age. After days and months, and perhaps years, have elapsed it is evident that the question as to whether or not the injury of itself finally wholly disabled the party would be a question, at least in many cases, difficult to determine. It might finally be solved in favor of the party who was most industrious in procuring witnesses, and particularly expert witnesses. We are of opinion that it is a much safer rule to hold the parties to the plain, unambiguous reading of their contract. The policy here contained a provision as to the lia *278 bility for injuries which shall not wholly disable the assured; and this shows that the injuries insured against were of two classes.

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Laventhal v. Fidelity & Casualty Co. of New York, 98 P. 1075, 9 Cal. App. 275, 1908 Cal. App. LEXIS 138 (Cal. Ct. App. 1908).

98 P. 1075 (Laventhal v. Fidelity & Casualty Co. of New York) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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