Lindskog v. Equitable Life Assurance Society of United States

295 N.W. 70, 209 Minn. 13, 1940 Minn. LEXIS 488
Supreme Court of Minnesota·Decided December 6, 1940·No. 32,497·Published·Cited by 6 cases

Opinion

*14 Loring, Justice.

This case comes here upon appeal from a judgment after trial by the court where plaintiff sought recovery of disability benefits claimed under the provisions of four identical life insurance policies issued on April 11, 1924, by the defendant to Erik G. A. Lindskog, who died May 4, 1938, aged 49 years, while such policies were in full force and effect. The death benefits have been paid, leaving a part of the disability benefits in controversy. It is conceded that Lindskog became totally and permanently disabled on August 20, 1937, and that such disability continued without interruption until his death. No notice of disability was given to the defendant until the day on which he died. Formal proofs were furnished later. The trial court found in favor of the plaintiff, and judgment was entered accordingly.

The disability provisions which accompanied the life insurance provisions of the policies provided for the payment of $25 a month on each policy and the waiver of subsequent premiums upon the occurrence of total and permanent disability, “subject to the terms and conditions contained on the third page hereof.” On the third page appeared provisions that “disability benefits before age 60 shall be effective upon receipt of due proof * * * that the insured became totally and permanently disabled * * the first payment to be payable upon receipt of due proof of such disability and subsequent payments monthly thereafter.” The defendant, evidently considering that under our decisions in Floyd M. Andrews, Inc. v. Aetna L. Ins. Co. 198 Minn. 1, 268 N. W. 415, 106 A. L. R. 1085, and Barron v. Equitable L. Assur. Soc. 197 Minn. 367, 266 N. W. 845, it was required to pay one month’s disability, mailed to the plaintiff a check for $100, which she has not cashed, probably for the reason that she did not agree to the terms of the endorsed release. The case was tried upon a stipulation of facts and accompanying exhibits, which do not fully set out the history of the negotiations which occurred subsequent to Lindskog’s death; but, on July 27, 1938, the defendant’s representative wrote the plaintiff a letter upon which plaintiff now relies as a waiver *15 of notice of tlie claim of disability. The letter is set out in full in the record and, after noting the plaintiff’s intent not to accept settlement, undertakes to explain the defendant’s position as follows:

“The disability features incorporated in these contracts, provide for the waiver of premiums and the payment of 1% of the face amount of each policy, per month, upon receipt of proof of a condition of total and permanent disability. Total disability is presumed to be permanent when it is present and has existed continuously for three full months.

“You will see, therefore, that the whole matter depends upon the time the Society is furnished with proof of the condition required for the payment of benefits.

“In this particular case, the claim was accepted as of May 4, 1938, and the benefits under the policies were paid as of that date. Now in approving this claim as of May 4, 1938, a more liberal action was taken because as of that date we were only furnished with notice of the claim and did not receive due proof of the required condition of total disability until Dr. Moir’s statement was received at this office on May 25, 1938. We assure you that we Avould be glad to be of assistance in this case if this were in any way possible, but we cannot set aside the specific provisions of the policy contract for one particular claim unless we are prepared to take similar action on every disability claim presented.”

The plaintiff contends that the relevant terms of the policies are in conflict with 1 Mason Minn. St. 1927, § 3417(7) (B) 7, which provides: “Affirmative proof of loss must be furnished to the insurer at its said office Avithin ninety days after the termination of the period of disability for which the company is liable”; that the case is not controlled by Floyd M. Andrews, Inc. v. Aetna L. Ins. Co. 198 Minn. 1, 268 N. W. 415; and, further, that the provisions of 1 Mason Minn. St. 1927, § 3417 (4) (C) 4, requiring notice of disability, were waived by the defendant and, consequently, do not preclude recovery. The trial court took the position that “the very moment the insured suffered a permanent disability the insurer *16 became liable for the payments as provided in the policies, and such liability continued until such payments were fully made.”

1 Mason Minn. St. 1927, §§ 3415 to 3427, constitutes what is intended to be a code with reference to accident and health insurance. This code provides for standard provisions to be incorporated in three classes of policies, those which cover loss by accident only, those which cover disability due to sickness only, and those which cover both injury and sickness. This classification is carried out through most of the parenthetically numbered requirements for standard provisions, usually under the letters A, B, and C, Avith numbered subdivisions. This results in much repetition and is likely to confuse rather than clarify. It is to be noted that the statute makes no standard provision as to the period of disability to be covered but leaves that to the contract, Avhich, while fixed in the policies as to commencement as of the time for furnishing proof, has been construed by this court to relate back to a time ten days prior to notice in cases of disability due to sickness. 2 Barron v. Equitable L. Assur. Soc. 197 Minn. 367, 266 N. W. 845. The policies under consideration covered disability due to either injury or sickness.

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Lindskog v. Equitable Life Assurance Society of United States, 295 N.W. 70, 209 Minn. 13, 1940 Minn. LEXIS 488 (Mich. 1940).

295 N.W. 70 (Lindskog v. Equitable Life Assurance Society of United States) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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