Metropolitan Life Ins. Co. v. Delgado

77 S.W.2d 539
CourtCourt of Appeals of Texas
DecidedNovember 8, 1934
DocketNo. 3080
StatusPublished
Cited by1 cases

This text of 77 S.W.2d 539 (Metropolitan Life Ins. Co. v. Delgado) is published on Counsel Stack Legal Research, covering Court of Appeals of Texas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Metropolitan Life Ins. Co. v. Delgado, 77 S.W.2d 539 (Tex. Ct. App. 1934).

Opinion

PELPHREY, Chief Justice.

Prior to his death on the 4th of December, 1932, Francisco Delgado was employed by the Southern Pacific Company. He was working shortly before his death three days per week, Mondays, Tuesdays, and Wednesdays. The last day he actually worked was Wednesday, October 26, 1932. The Southern Pacific Company had a group insurance policy with appellant, and Delgado held a certificate thereunder in the sum of $1,500, with appellee as beneficiary. While Delgado did no actual work for the Southern Pacific Company after October 26th, yet on November 14th he received his pay check for the latter part of October. On November 22d, Delgado’s foreman, Mr. Chamberlain, reported him to the superintendent of motive power as discharged for being absent from duty without permission of his foreman from October 26th. This discharge was approved by the superintendent of motive power on November 24th. On November 21st notice of the termination of Delgado’s employment was executed and mailed to the Southern Pacific Company’s accounting office in San Francisco, and was received there on November 29th. This notice recited that- Delgado’s employment had been terminated on October 26th. On January 16, 1933, Charles Owen, as attorney for appellee, wrote appellant as follows:

“January 16, 1933.
“Metropolitan Life Insurance Co.,
“1 Madison Avenue,
“New York, N. Y.
“Gentlemen:
“Petra Zapata Delgado of El Paso, Texas, desires to notify you of the death of her husband, Francisco Delgado, holding you- policy Serial 116509. Group'Policy 2000-G for $1,-500.00.
“We are discussing. this. matter with the Southern Pacific Railway Company and it is possible that they have notified you of his death. :
“If you desire us to fill out form please forward them to me and they will be returned to you properly executed.
“Yours very truly,
[Signed] Chas. Owen.”

On February 8, 1933, appellant wrote the following letter to Mr. Owen:

“Southern Pacific Company
“El Paso, Tex., Feb. 8, 1933.
“Mr. Charles Owen, Attorney,
“519 Capíes Bldg.,
“El Paso, Texas.
“Dear Sir:
“Replying to your letter January 13, concerning Francisco Delgado, deceased:
“Prior to receipt of your letter we had made a thorough investigation in this case and found the facts were as follows: (Portion omitted.)
“Under the circumstances claim is not payable.”

On June 2, 1933, appellee filed her original petition in this suit and sought to recover the face of the certificate for the death of Francisco Delgado. January 26, 1934, she filed her first amended petition in which she alleged that Francisco Delgado became totally and permanently disabled on October 26, 1932, and sought recovery on that basis, together with penalty and attorney’s fees.

Appellant, in answer, pleaded various provisions of the policy and denied liability on the ground that Delgado’s employment had ceased on October 26th, and hence that in [541]*541accordance with the terms of the policy his insurance expired on October 81, 1932. Appellant further pleaded lack of written notice and proof to it of Delgado’s alleged total and permanent disability within one year after premium payments on his account had been discontinued.

In response to special issues a jury found: That Delgado became totally and permanently disabled prior to December 4, 1932; (2) that such disability commenced on November 29, 1932; (3) that no written notice of such disability was given to appellant; and (4) that $350 would be a reasonable attorney’s fee. Prom a judgment in favor of appellee for $1,500 this 'appeal has been prosecuted.

Opinion.

Appellant’s point of error 11 reads: “The court erred in overruling defendant’s general demurrer because the. petition having referred to and exhibited the policy, and its terms showing that notice and proof of disability are conditions precedent, and there being no allegations of giving notice and proof of disability, the petition stated no cause of action.”

That portion of the policy relative to notice and proof of loss, reads:

“(b) Total and Permanent Disability Benefit — Upon receipt by the Company of due notice and proof — both in writing — that any Employee, not working in Mexico, while insured hereunder and prior to his sixtieth birthday has become totally and permanently disabled as a result of bodily injury or disease, so as to be prevented thereby from engaging in any business or occupation and performing any work for compensation or profit for the remainder of his life, provided.:
“(A) The disability for which claim is made commenced after the Employee had been continuously insured hereunder for a period of one year, and
“(B) Written notice of such disability was received by the company not more than one year after premium payment on account of the employee had been discontinued.”

Under the general provisions of the policy here sued on it appears that there were two contingencies upon the happening of which appellant would become liable to Delgado or to his beneficiary, viz.: First, for the full amount of the policy in case of his death; and, second, for a certain number of installments for amounts shown by a table included in the policy in case of his total and permanent disability. It appears to be admitted here, and the case was tried below upon the theory, that appellant was not liable under the first provision; that is, on account of the death of Delgado. This being true, we must, as far as the question of notice and proof is concerned, view the question as arising under the second provision.

Paragraph 8 of appellee’s amended petition reads: “Plaintiff further says that after the death of Francisco Delgado she made due proof of death and filed claim for the payment of said policy of insurance, and made demand therefor as required by law, and more than 30 days elapsed before bringing this suit but that defendant, Metropolitan Life Insurance Company, has failed and refused and still fails and refuses to pay the same, or any part thereof.” But there is nowhere any allegation that notice was given or proof made that Delgado had suffered total and permanent disability.

It is well settled, we think, that where a policy is referred to and exhibited by plaintiff and contains provisions as' to proof of loss, the petition must either allege the making of such proof or facts which would excuse the making thereof. Ætna Casualty & Surety Co. v. Austin (Tex. Civ. App.) 285 S. W. 951, affirmed (Tex. Com. App.) 300 S. W. 638; Missouri State Life Ins. Co. v. Le Fevre (Tex. Civ. App.) 10 S.W.(2d) 267 (writ dismissed); Mutual Benefit Health & Accident Ass’n v. Shelton (Tex. Civ. App.) 27 S.W.(2d) 845.

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Related

Metropolitan Life Ins. Co. v. Greene
93 S.W.2d 1241 (Court of Appeals of Texas, 1936)

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77 S.W.2d 539, Counsel Stack Legal Research, https://law.counselstack.com/opinion/metropolitan-life-ins-co-v-delgado-texapp-1934.