McNeill v. Continental Casualty Co.

244 So. 2d 693, 1971 La. App. LEXIS 6169
CourtLouisiana Court of Appeal
DecidedFebruary 8, 1971
Docket4308
StatusPublished
Cited by10 cases

This text of 244 So. 2d 693 (McNeill v. Continental Casualty Co.) is published on Counsel Stack Legal Research, covering Louisiana Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
McNeill v. Continental Casualty Co., 244 So. 2d 693, 1971 La. App. LEXIS 6169 (La. Ct. App. 1971).

Opinion

244 So.2d 693 (1971)

Margaret S. McNEILL
v.
CONTINENTAL CASUALTY COMPANY.

No. 4308.

Court of Appeal of Louisiana, Fourth Circuit.

February 8, 1971.
Rehearing Denied March 10, 1971.

*694 Steeg & Shushan, Mitchell Herzog, T. A., New Orleans, for plaintiff-appellee.

Deutsch, Kerrigan & Stiles, Francis G. Weller, New Orleans, for defendant-appellant.

Before REDMANN, STOULIG, and BOUTALL, JJ.

BOUTALL, Judge.

This appeal by defendant (Continental Casualty) is from the judgment of the trial court awarding plaintiff benefits in the amount of $6,948.10, which represents twenty-two monthly payments of $300.00 each, commencing June, 1968, subject to a credit of $110.00, plus the sum of $458.10, representing premiums paid by plaintiff under protest, with interest at the rate of 5% per annum on each of the past due payments from date due until paid. The judgment further provides that plaintiff receive payment of Monthly Accident Indemnity benefits at the rate of $300.00 per month commencing April, 1970 and continuing for the duration of the disability for a period not to exceed thirty-five months from April, 1970 and for all costs.

The facts are that plaintiff was employed as a field sales representative by Gerde Newman and Company for some nine months prior to an automobile accident which occurred on December 20, 1967. The nature of this employment was sales and public relations, calling on managers of restaurants, hotels and institutions to promote food lines. This employment necessitated eight to fifteen business calls per day. After the December accident, plaintiff alleged that she was unable to get in and out of her automobile, or sit or stand long enough to continue this type work at all. Prior to this employment, plaintiff purchased two identical individual health and accident policies from Continental Casualty Company, which policies were in effect at the time of the alleged accident and resulting disability.

It is the defendant's contention that the trial court erred in disregarding the fact that if any disability was established, it was the consequence of an accident which occurred on July 19, 1967, and did not commence until more than 30 days after the accident; therefore, any benefit to which plaintiff would be entitled must be deemed the result of sickness, not of accident, and limited to 24 months.

In determining whether the plaintiff is disabled within the terms of the policies, it is encumbent upon this court to examine the insurance policies. Policies #23577673 and 30022580, under Table of Coverages, Part 1, provide for monthly accident indemnity in the amounts of $200.00 and $100.00 respectively for total disability and for a lesser period for partial disability as defined within the policies. They further stipulate that the period of disability covered under Part IA must commence within 30 days after the date of the accident, otherwise such disability will be deemed as a result of sickness and thus, covered by provisions of Part II of these policies.

Under Part IA Total Disability is defined thus:

"When as the result of injury and commencing within 30 days after the date of the accident, the insured is totally disabled and continuously prevented from performing each and every occupation or employment for wage or profit for which the insured is reasonably qualified by reason of education, training or experience, the Company will pay for each month of such disability the Monthly Accident Indemnity stated in the Schedule as the result of any one accident; provided further, that for a period not to exceed the first 24 months of such disability *695 of the Maximum Period Accident Indemnity stated in the Schedule, whichever is lesser, the Company will pay Monthly Accident Indemnity for each month that the Insured is totally disabled and continuously prevented from performing each and every duty pertaining to his occupation as the result of such accident."

The accident elimination period is set forth in the second paragraph of Part IA:

"When any period of disability otherwise covered under Paragraph A of this Part commences more than 30 days after the date of the accident and while this policy is in force, such disability shall be deemed as a result of sickness and shall be covered by the provisions of Part II of this policy, but only if Monthly Sickness Indemnity is provided in the Schedule on the date of such accident."

Part I Section B distinguishes partial from total disability in these terms:

"* * * the insured is continuously disabled and prevented from performing one or more of the important duties of his occupation, the Company will pay periodically fifty percent of the Monthly Accident Indemnity stated in the Schedule for each month of such disability, not to exceed six consecutive months as the result of any one accident."

The defendant maintains that if any indemnity is due Mrs. McNeill it would not be due under the above provisions since Mrs. McNeill was disabled in an accident on July 19, 1967 and that her claim was not instituted until January, 1968. Such indemnification would be governed by the provisions of Part II Monthly Sickness Indemnity:

"The maximum period for which Monthly Sickness Indemnity is payable under this Part as the result of any one sickness shall in no event exceed the Maximum Period Sickness Indemnity stated in the Schedule. The Sickness Elimination Period, if any shall neither commence nor continue, nor indemnity be paid under this part, for any period of disability during which the Insured is not under the regular care and attendance of a currently licensed physician or surgeon, other than himself. Indemnity under this Part commences with the first day of disability following the Sickness Elimination Period, if any, stated in the Schedule.
When, as the result of sickness and commencing while this policy is in force, the Insured is totally disabled and continuously prevented from performing each and every occupation or employment for wage or profit for which the Insured is reasonably qualified by reason of education, training or experience, the Company will pay for each month of such disability the Monthly Sickness Indemnity stated in the Schedule for a period not to exceed the Maximum Period Sickness Indemnity stated in the Schedule as the result of any one sickness; provided further, that for a period not to exceed the first 24 months of such disability or the Maximum Period Sickness Indemnity stated in the Schedule, whichever is lesser, the Company will pay Monthly Sickness Indemnity for each month that the Insured is totally disabled and continuously prevented from performing each and every duty pertaining to his occupation as the result of such sickness."

In Felker v. Aetna Life Ins. Co., 234 So.2d 758 (La.App. 1st Cir. 1970); writ refused 256 La. 377, 236 So.2d 503 (1970), the court held that the rule of construction in matters of this nature has long since been established. The court therein cited Crowe v. Equitable Life Assur. Soc. of United States, 179 La. 444, 154 So. 52 (1934) in which a laborer, insured against total and permanent disability by injury or disease, was awarded recovery under a policy similar to the one involved herein.

The court held that it is well established jurisprudence that the provisions in life, *696

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Bluebook (online)
244 So. 2d 693, 1971 La. App. LEXIS 6169, Counsel Stack Legal Research, https://law.counselstack.com/opinion/mcneill-v-continental-casualty-co-lactapp-1971.