Liberty Mutual Insurance v. Jones

130 S.W.2d 945, 344 Mo. 932, 125 A.L.R. 1149, 1939 Mo. LEXIS 689
CourtSupreme Court of Missouri
DecidedJuly 5, 1939
StatusPublished
Cited by85 cases

This text of 130 S.W.2d 945 (Liberty Mutual Insurance v. Jones) is published on Counsel Stack Legal Research, covering Supreme Court of Missouri primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Liberty Mutual Insurance v. Jones, 130 S.W.2d 945, 344 Mo. 932, 125 A.L.R. 1149, 1939 Mo. LEXIS 689 (Mo. 1939).

Opinions

The appellants are six mutual casualty insurance companies doing business in this State, and their respective Missouri claims managers. They appeal from a decree of the Circuit Court of Boone County, which dismissed their petition for a declaratory judgment under Laws 1935, page 218 (Mo. Stat. Ann., sec. 1097a et seq., p. 1388), and granted an injunction prayed by respondents' cross-bill. The injunction enjoined appellants from adjusting claims against their insured (and other related activities) through lay employees, on the ground that such acts constitute "law business" and the performance thereof is the unlawful "practice of law." The respondents are the General Chairman of the Bar Committees of the State of Missouri and the members of his Advisory Committee, appointed under subdivisions 13 and 14 of Rule 36 of this court. By stipulation the parties adopted the unusual course, not provided for by the law of this State, of trying the case before three circuit judges: Hon. Walter M. Dinwiddie, regular judge of the Boone County Circuit Court, together with Hon. James Wesley McAfee of St. Louis, one of the judges of the Eighth Circuit, and the late Hon. E.M. Dearing of Potosi, judge of the Twenty-first circuit, sitting as "advisory" judges. Judge McAfee filed an opinion substantially concurring in the decree. Judge Dearing filed an opinion dissenting therefrom.

The record is long, containing 1053 pages. In addition to the elaborate briefs of counsel for the respective parties, briefs have been filed supporting the position of the appellants byamici curiae representing the Association of Farmers' County Mutual Fire Insurance Companies of Missouri; the American Federation of Labor; five casualty insurance companies and the Association of Casualty Surety Executives; and the American Transit Association. In support of respondents' contentions briefs are filed by amici curiae: Hon. A.A. Carmichael, Attorney General of Alabama, representing the Alabama State Bar Association and the Birmingham Bar Association; the Committee on Claims Adjusters of the State Bar of California; the Junior Association of the Milwaukee Bar; Hon. R.M. Kelly, President of the State Bar of Mississippi; and Hon. Cuthbert S. Baldwin, individually *Page 948 and as President of the New Orleans Bar Association. Altogether the briefs contain 1205 pages.

The appellant companies are licensed under Section 5854, Revised Statutes 1929 (Mo. Stat. Ann., p. 4472), and have been doing business in this State for periods ranging from four to eighteen years, each maintaining one or more claims offices in charge of a manager who is not a lawyer. Altogether they employ 33 claims adjusters, of whom 19 are laymen. Under authority of Section 5844, Revised Statutes 1929 (Mo. Stat. Ann., p. 4468), they write numerous kinds of casualty insurance including that protecting the insured against liability to third persons for negligence in specified circumstances, or under the Workmen's Compensation Act; also insurance protecting the insured against bodily injury or death by accident, disability by sickness, and damage to his own property from various causes.

Where the insurance protects the insured against liability to third persons, under Section 5898, Revised Statutes 1929 (Mo. Stat. Ann., p. 4499), the obligation of the insurance company runs directly to the third party claimant — it is not a mere indemnitor of the insured. The same is true under the Compensation Act. [Sec. 3325, R.S. 1929, Mo. Stat. Ann., p. 8262.] The insurance company adjusts all such claims or assumes the defense thereof in court through its own counsel, even though the amount of the claim exceeds the insurance coverage and the policyholder is personally liable for the excess. In such event, however, the company usually invites the insured to employ personal counsel representing him in the trial. Sometimes, where the company disputes or is doubtful of its liability for the casualty, it defends the case under a "non-waiver agreement," whereby it reserves the right to dispute liability on any judgment that may be recovered by the claimant. In this case we are chiefly if not entirely concerned with the handling of claims before they enter litigation.

Taking the usual course of a typical claim, suppose John Smith has a policy in the Alpha Casualty Company protecting him against liability to third persons for negligence in the operation of his automobile, and also insuring him against property damage thereto. He has a collision with another motorist, and sends in a notice to the company stating the facts. On receipt thereof a clerk makes up a file including the office copy of any applicable policy, and presents it to the claims manager. The latter, for technical and administrative reasons, first makes a tentative "reserve" or estimate of what the claim will cost, and sends it in to the home office. Unless it is clear that there is no liability, as where the policy has lapsed, or covers some automobile other than the one mentioned in the notice, the manager next assigns the claim to an adjuster for investigation.

The adjuster interviews the insured, the claimant, the witnesses, takes statements, makes measurements, photographs and the like. He views the wrecked automobiles, consults experts as to the amount *Page 949 of property damage and the extent of the personal injuries, and makes a report to the claims manager, giving his views as to the probable amount required to settle the claim. But he expresses no opinion on legal questions to the company or the claimant, though he may quote what counsel for the company has said. In each claims office there is a salaried attorney who passes on all legal questions arising there. Subject to supervision of the home office the lay claims manager passes on the amount to be paid in the settlement of all claims. The facts are digested in the claims office and perhaps referred to the home office. Thereafter, the adjuster is sent out again to negotiate with the claimant for a settlement. If he succeeds, he selects the appropriate form of release out of a number prepared by the insurance company's counsel, fills in the blanks, has it executed by the claimant, gives him a voucher or draft, and closes the case. Lay employees may participate in informal conferences with or before the Workmen's Compensation Commission but not in formal hearings. Within limits, the claims manager and his adjusters have authority to settle claims without communicating with the home office. In a typical set-up shown in evidence the limit for the claims manager was $500, for one adjuster $200, and for another $100. In 60 per cent of the claims under public liability, third party policies no payment at all is made. In 19 per cent of the claims the payments do not exceed $10; in 6 per cent do not exceed $25; in 3 per cent are not over $50; in 3 per cent not over $100; and only 3 per cent are more than $100.

Early in 1937 the then General Chairman of the Bar Committees and his Advisory Committee, after study of the course followed by casualty companies in the adjustment of claims, instituted certain legal proceedings against several of them, one for a declaratory judgment and three charging contempt of court. Two of the latter were severally against two of the appellants. In view of this aggressive action the appellant companies in May, 1937, adopted a so-called code of procedure putting the above routine in force, which is set out below:* *Page 950

This code was submitted by appellants to the respondent General Chairman and Advisory Committee in May, 1937, but they declined to approve it, saying the question was one for judicial determination.

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Cite This Page — Counsel Stack

Bluebook (online)
130 S.W.2d 945, 344 Mo. 932, 125 A.L.R. 1149, 1939 Mo. LEXIS 689, Counsel Stack Legal Research, https://law.counselstack.com/opinion/liberty-mutual-insurance-v-jones-mo-1939.