Little v. Stuyvesant Life Ins. Co.

67 Cal. App. 3d 451, 136 Cal. Rptr. 653, 1977 Cal. App. LEXIS 1241
CourtCalifornia Court of Appeal
DecidedFebruary 24, 1977
DocketCiv. 15685
StatusPublished
Cited by67 cases

This text of 67 Cal. App. 3d 451 (Little v. Stuyvesant Life Ins. Co.) 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
Little v. Stuyvesant Life Ins. Co., 67 Cal. App. 3d 451, 136 Cal. Rptr. 653, 1977 Cal. App. LEXIS 1241 (Cal. Ct. App. 1977).

Opinion

Opinion

KAUFMAN, J.

Claiming to be totally disabled and, thus, entitled to benefits under a group disability insurance policy issued by defendant, plaintiff sought declaratory relief and compensatory and punitive damages for intentional infliction of emotional distress. A jury trial resulted in a special verdict that plaintiff was totally disabled and general verdicts in favor of plaintiff for $172,325 in compensatory damages and $2.5 million in punitive damages. Judgment was entered on the jury verdicts. 1 Defendant’s motion for new trial as to the issue of damages was denied. Defendant appeals from that portion of the judgment awarding plaintiff $172,325 compensatory damages and $2.5 million punitive damages. 2

Factual Summary

Although some factual details will be set forth in our discussion of several of the issues, we shall make no attempt to detail all of the facts. The following summaiy will suffice.

From 1958 until August 7, 1970, plaintiff was employed as a draftsman by C. M. Engineering in San Bernardino. On September 1, 1967, she became insured under a group life, hospitalization and disability insurance program sponsored by a trade association of which C. M. *457 Engineering was a member. The disability insurance portion of the program was underwritten by defendant. It provided for combined disability payments by defendant and social security of 60 percent of normal salary. Benefits were payable for two years if the insured was disabled from performing the usual and customary duties of her occupation. Thereafter payments would continue until the insured reached age 65 only if the insured was disabled from “engaging in each and every occupation or employment ... for which [s]he is reasonably qualified by training, education or experience....”

The evidence that plaintiff was in fact totally disabled was overwhelming. Her medical history is almost unbelievable. Prior to the effective date of the insurance, she had undergone abdominal surgery in 1954, bunion surgery in 1955, a hysterectomy in May 1960, a myelogram and a lumbar laminectomy performed by Dr. Ballard, an ortheopedic surgeon, in the fall of 1965, a second myelogram and a lumbar fusion performed by Dr. Ballard in late 1966. Although she continued working, she wore a brace while working and took medication to relieve her pain on a daily basis.

In the spring of 1969 plaintiff noticed severe pain in her right elbow, radiating down into her hand. Dr. Ballard gave her injections of estrogen and later cortisone. She also experienced pain in her neck, which gradually got worse in January 1970. The pain extended from her neck across her shoulder and into the right arm and hand. Dr. Ballard prescribed home traction three times a day, but this treatment increased the pain. The pain became worse, and during the course of an examination by Dr. Ballard in July 1970 plaintiff experienced such extreme pain that she passed out. Dr. Ballard immediately referred her to Dr. Estridge, a neurosurgeon.

Dr. Estridge hospitalized her and on August 12, 1970, performed an anterior fusion of C5-6. On December 2, 1970, following another myelogram, Dr. Estridge performed a second fusion at the level of C6-7. The plug on the lower fusion worked out, necessitating another fusion of plaintiff’s cervical spine on February 22, 1971. On October 5, 1971, Dr. Estridge performed a fourth surgeiy to relieve the nerve roots of scar tissue.

Plaintiff continued to work until she was hospitalized by Dr. Estridge in about August 1970. At that time she applied for state disability benefits as well as disability benefits from defendant under the policy. *458 After six months she applied for social security disability which was awarded her. Additionally, based upon her total disability, she applied for and was granted a waiver of premiums on the life insurance portion of the insurance program.

In July 1972, Dr. Estridge wrote to the referring physician, Dr. Ballard, expressing the opinion that plaintiff continued to have symptoms of nerve root irritation which precluded her occupation as a draftsman. In September 1972, Dr. Estridge reported that plaintiff’s condition was permanent and stationary and that she was completely disabled from her regular work. In December 1973, he reported that she continued to have disabling pain caused by perineural fibrosis, requiring pain medication and precluding any activity. At trial Dr. Estridge testified that there had been little change in plaintiff’s condition, that he anticipated no further improvement and that it was very unlikely that she would ever be able to be gainfully employed. Her condition precluded even general sedentary work.

At trial plaintiff testified she suffered constant pain in her right shoulder, neck and low back which was aggravated severely upon exertion, walking, standing or sitting. She took daily doses of painkillers and tranquilizers. Although she could bathe and dress herself and do light housekeeping, she was unable to read because she could not hold a book. She could not do sewing for more than 20 minutes at a time because her arms and fingers, neck and shoulders ached. She was unable to write letters because the position led to spasms in her shoulders and arms. She could not shop without help. She had difficulty sleeping at night, even after taking medication. She could not sleep on her back, and when sleeping on her side, the opposite arm became numb.

Defendant knew or is charged with knowledge of most of these facts. The insurance was sold to plaintiff by Lawrence O. Graeber, Jr., defendant’s agent. Mr. Graeber knew of plaintiff’s past medical history at the time she obtained coverage. Indeed, her medical history was used as a selling point. Mr. Graeber told plaintiff that some day the insurance would be a “godsend” to her. Copies of Dr. Estridge’s reports of September 1972 and December 1973 were furnished to defendant. In addition, Mr. Graeber informed defendant that plaintiff had been classified as totally disabled by the Social Security Administration and that the premiums on the life insurance portion of the insurance program had been waived on the basis of plaintiff’s total disability.

*459 From sometime in the fall of 1970 to October 10, 1972, defendant paid plaintiff disability benefits under the policy. In August or September 1972, the initial period of two years was drawing to a close. Defendant employed Retail Credit Company to conduct an investigation into plaintiff’s claim of total disability. The resulting report tended to substantiate plaintiff’s claim.

Thereafter defendant had plaintiff examined by Dr. Haft, an ortheopedic surgeon in Los Angeles. Dr. Haft found plaintiff to have approximately 50 percent limitation of motion in her cervical spine, but opined that she was not disabled from employment as a draftsman. Dr. Haft did not know, however, what physical activity work as a draftsman entailed. Neither was he supplied with any of plaintiff’s medical records or any of the medical reports from plaintiff’s treating physicians.

On the basis of Dr.

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Bluebook (online)
67 Cal. App. 3d 451, 136 Cal. Rptr. 653, 1977 Cal. App. LEXIS 1241, Counsel Stack Legal Research, https://law.counselstack.com/opinion/little-v-stuyvesant-life-ins-co-calctapp-1977.