Legg v. Mutual Benefit Health & Accident Assn.

184 Cal. App. 2d 482, 7 Cal. Rptr. 595, 1960 Cal. App. LEXIS 1895
CourtCalifornia Court of Appeal
DecidedSeptember 8, 1960
DocketCiv. 24416
StatusPublished
Cited by12 cases

This text of 184 Cal. App. 2d 482 (Legg v. Mutual Benefit Health & Accident Assn.) is published on Counsel Stack Legal Research, covering California Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Legg v. Mutual Benefit Health & Accident Assn., 184 Cal. App. 2d 482, 7 Cal. Rptr. 595, 1960 Cal. App. LEXIS 1895 (Cal. Ct. App. 1960).

Opinion

*484 WOOD, P. J.

Demurrer to complaint was sustained without leave to amend. Plaintiff appeals from the judgment of dismissal.

The first words in the complaint are: “Identification of Former Action Before Entry of Judgment, to witt : (a) In the former action Legg v. Mutual Benefit Health & Accident of Omaha, the several amended and supplemental complaint for accrued indemnification was filed in action No. 540669, and a second judgment was entered on the Sixth Amended & Supplemental Complaint based on the grounds that no fees had been paid to . . . County Clerk ... by this plaintiff prosecuting her appeal in forma pauperis . . . and defendant is freed from his obligation under his contract to pay plaintiff previous accrued indemnity to the date of entry of the judgment, (b) The former judgment of dismissal . . . does not act as an estoppel and is not res judicata to any claims for subsequent monthly indemnification thereafter accruing under the terms of said policy contract.”

Immediately following the above words of the complaint, the complaint recites: “Fob Cause of Action Against Defendant, fob Claims for Subsequent Indemnifications Accbuing Undeb Policy Contract :

I.
“That the defendant ... is an association organized . . . under . . . the laws ... of Nebraska ....
II.
“That . . . about the 7th day of November, 1944, in consideration of the payment by the plaintiff ... of $27 for the first quarter, and $17.50 for each quarter period thereafter, the defendant made and delivered to the plaintiff its . . . Policy Contract of Insurance . . . see—Paragraph III as follows.
III.
“That the plaintiff hereby adopts . . . and incorporates herein by reference ... as though fully set forth herein the several copies of documents identified as Exhibits as follows: 1. Exhibits, Case No. 540669-(a) Insurance Policy, Plaintiff’s Exhibit No. 1. (b) Receipt .... (c) Receipt . . . . (d) Receipt . . . .”

Allegations in other paragraphs of the complaint are in substance, as follows: On February 6, 1947, while the health *485 and accident insurance policy was in effect, the plaintiff received personal injuries which wholly and continuously disabled her. On several recent occasions she became disabled with sickness within the time period provided in the policy. By reason of the injuries and sickness she is under the care of a physician and is prevented from pursuing her occupation as a designer and stylist, or other employment. Immediately after the injuries and sickness she gave to defendant due notice and proof thereof, and she has performed all the conditions of the policy to be performed by her, and she demanded payment by defendant of all sums accruing under the policy. The policy provides that in the event of disability of plaintiff the defendant will pay to plaintiff $100 a month so long as she suffers total loss of time. Demand has been made upon defendant for payment of all sums accruing under the policy, but payment has been refused, except $100. “ [S]inee the entry of judgment as aforesaid, subsequent accrued disability benefits” have become due in the sum of $3,045.63. After the filing of the complaint, and prior to the trial, additional sums will become due and, at the trial, plaintiff will ask permission to amend the complaint to include the additional sums.

The introductory recital in the complaint, which is labeled “Identification of Former Action Before Entry of Judgment,” shows that in a former action, numbered 540669, plaintiff sought recovery of amounts which allegedly had accrued under the insurance policy involved herein; and that the judgment therein was that defendant was not required “to pay plaintiff previous accrued indemnity to the date of entry of judgment” in the former action. Also, that recital in the complaint herein states that the former judgment of dismissal is not res judicata “to any claims for subsequent monthly indemnification thereafter accruing” under the insurance policy. In other words, in that introductory recital, plaintiff herein has alleged in effect that the judgment in action No. 540669 was res judicata as to amounts which allegedly accrued under the insurance policy prior to the judgment in that former action; but, that the judgment was not res judicata as to amounts allegedly accruing after the judgment. Paragraph III of the present complaint alleges that plaintiff incorporates in the present complaint, by reference, the documents which were exhibits in ease No. 540669, namely, the insurance policy and three receipts. Al *486 though those documents, which are in the other case, cannot be made a part of a pleading in this case by such reference to them, such an allegation was in effect an invitation for the trial court herein to take notice of those documents and the other case. Such an allegation is in effect an allegation that the policy involved in the other case is the same policy that is involved herein. It is implicit in the present complaint that the basis upon which plaintiff is seeking herein to recover insurance payments allegedly accruing after the former judgment is the same basis upon which she sought to recover insurance payments allegedly accruing prior to the former judgment. As above indicated, the complaint herein shows that plaintiff concedes that the judgment in the former case was a final determination that plaintiff was not entitled to recover, under the insurance policy, any payment allegedly accruing prior to that former judgment. By reason of plaintiff’s alleged “identification of” and references to the former judgment, it is apparent that plaintiff was anticipating the defense of res judicata, and she was endeavoring to by-pass, on demurrer, the effect of the former judgment on the present action. Her theory of the complaint is indicated by a statement in her brief that “Successive actions may be made upon the same contract or transaction whenever, after the former action, a new cause of action arises therefrom. ’ ’ Those quoted words are the words of section 1047 of the Code of Civil Procedure. She argues to the effect that a new cause of action arose from the insurance policy when, after the former adverse judgment, several months elapsed and she was still disabled from the alleged injury and sickness, and the insurance company had not paid her $100 a month. The question presented is, of course, whether a new cause of action arose. The only reasonable conclusion to be drawn from the allegations of her complaint, and particularly the allegation that by the former judgment the defendant was “freed” from its obligation to make indemnity payments which accrued prior to the judgment, is that the former action, which was based on the same policy and disability, was tried on the merits with the result that plaintiff was not entitled to recover payments under the policy. Since it appears from the complaint that it was judicially determined that defendant was not liable under the provisions of the policy for indemnity payments allegedly accruing before the former judgment, it necessarily follows that a new cause *487

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Bluebook (online)
184 Cal. App. 2d 482, 7 Cal. Rptr. 595, 1960 Cal. App. LEXIS 1895, Counsel Stack Legal Research, https://law.counselstack.com/opinion/legg-v-mutual-benefit-health-accident-assn-calctapp-1960.