Metropolitan Life Insurance Co. v. Heavener

24 N.E.2d 813, 107 Ind. App. 695, 1940 Ind. App. LEXIS 85
CourtIndiana Court of Appeals
DecidedJanuary 22, 1940
DocketNo. 16,203.
StatusPublished
Cited by2 cases

This text of 24 N.E.2d 813 (Metropolitan Life Insurance Co. v. Heavener) is published on Counsel Stack Legal Research, covering Indiana Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Metropolitan Life Insurance Co. v. Heavener, 24 N.E.2d 813, 107 Ind. App. 695, 1940 Ind. App. LEXIS 85 (Ind. Ct. App. 1940).

Opinion

Dudine, J.

This is an action by appellee, Robert W. Heavener, against appellant, Metropolitan Life Insurance Company, to recover payments allegedly due appellee under the terms of a group insurance policy issued by appellant to the F. W. Woolworth Co. which policy allegedly covered appellee, as an employee of said F. W. Woolworth Co., against total and permanent disability.

It would serve no good purpose to discuss the pleadings. They are not attacked upon appeal. The issues having been formed by a complaint in one paragraph and an answer in general denial the cause was submitted for trial to a court without a jury and the court found for appellee- that he should recover the sum of $2160.00 and rendered judgment in accordance with such finding.

There is but one error assigned upon appeal and that is contended error in overruling a motion for new trial filed by appellant. The causes for new trial which are presented upon appeal are: 1 — The decision is not sustained by sufficient evidence; 2 — The decision is contrary to law, and 3 — Errors in the admission of certain evidence.

In support of each of said first and second assigned causes for new trial appellant contends that the evidence conclusively shows that appellee was not “totally and permanently disabled”, within the meaning *697 of that term as used in paragraph “13” of said group insurance policy, on or before the 9th day of January, 1936, when liability under the policy ceased. That is appellant’s primary contention upon appeal.

The provisions of said insurance policy which are particularly pertinent to this appeal are:

“13. Total and Permanent Disability Benefits : — Upon receipt, at the Home Office in the City of New York, of due proof that any Employee, while insured hereunder, and prior to his sixtieth birthday, has become totally and permanently disabled, as the result of bodily injury or disease, so as to be prevented thereby from engaging in any occupation and performing any work for compensation or profit, the Company will, in lieu of the payment at death of the insurance on the life of the said Employee, as herein provided, pay equal monthly instalments, as hereinafter described, to the said Employee,... ”.
“6. Insurance to Be Discontinued.— . . . (a) ... The insurance hereunder, as to each such Employee, shall be discontinued as of the date when such Employee left the employ of the Employer. . . .”.

The evidence indisputably shows that appellee was employed by the P. W. Woolworth Co. as manager of its store in New Castle, Indiana, from September 1928, until January 9, 1936.

The evidence further shows that in 1931 appellee injured himself while lifting something in the store and the injury caused a pain in his back which continued about a month. In the spring of 1933 there was a recurrence of the pain and it lasted about six weeks. In the fall of 1933 there was another recurrence of the pain; it started about the 1st of October and continued intermittently until sometime in January, 1934. Appellee again suffered the pains in the spring and fall of 1934. In January 1935, upon the advice of his *698 doctor, lie had his tonsils removed and was off work about two weeks. He thereby obtained- relief from the pains but in May 1935 the pains recurred and appellee became “quite nervous”. That condition continued throughout the summer and fall of 1935. Appellee was suffering from pains in his back “all the time”. In the summer of 1935 he suffered headaches and “along in August and September (1935) they (the headaches) became quite severe and in December (1935) . . . (he) couldn’t work without sedatives.” In December 1935 appellee couldn’t keep food on his stomach; he lost eighteen pounds; he frequently took an extra hour for lunch and came home in the middle of the afternoons to take infra-red light treatments and to rest. Appellee “went through the (1935) Christmas rush (in the store) and inventory in rather a dazed condition . . . (he) couldn’t seem to know what was going on about him a good deal of the time . . . (he) couldn’t . . . answer questions straight... ”; he was very forgetful; the pains were severe and continuous during the time he was awake except when they were relieved by medicine. He continued to work in spite of severe headaches and in a dazed condition until January 9,1936 when a supervisor of the F. W. Woolworth Co. approached him at the store and delivered to him a letter from the company asking him to resign, whereupon he did resign on that date. (The evidence does not show why appellee was asked to resign.) During the next two months appellee was confined to his home. From that date until the date of the trial (July 1937) he was able to “get around” but suffered the pains and took medicine to relieve the pains. He did not perform any steady work in that period of time.

A doctor who treated him in 1935 for rheumatoid symptoms found him “very nervous, very exhausted” *699 at that time and treated him throughout November, December and January of 1936. That doctor also ex-' amined appellee shortly before trial (July 1937) and testified that he thought appellee was totally disabled on January 1,1936.

Another doctor, who had examined appellee but once, and that being shortly before trial, testified in effect that, in his opinion, appellee was totally disabled when he quit working.

It should be noted that this appeal is not based upon the contention that the evidence shows that appellee’s disability, which existed on January 9, 1936, was not “permanent” but it is based upon the contention that the evidence indisputably shows that appellee’s said disability was not “total” within the meaning of that word as used in paragraph “ 13 ” supra of the policy.

“The rule prevails in this and most jurisdictions that provisions in a policy for total disability, irrespective of the technical variations in the language employed, should be given a rational and practical construction; that the phrase “total disability” is a relative term, depending in a measure upon the nature of the employment, the capabilities of the injured person, and likewise the circumstances and peculiar facts of each particular case. It is usually a question of fact to be determined by the court or jury trying the case......” American Liability Co. v. Bowman (1917), 65 Ind. App. 109, 114 N.E. 992.

In the instant case the question as to whether or not appellee was “totally disabled” was a question of fact to be determined by the court.

Commercial Travelers, etc., Association v. Springsteen (1899), 23 Ind. App. 657, 55 N. E. 973, was a suit upon an accident insurance policy which provided that “no claims of any character shall accrue upon *700 this contract unless it arises from bodily injury . . . (which) immediately and wholly disables the insured from performing any and every kind of business pertaining to his occupation as above stated. ’ ’ The trial court instructed the jury, with reference to said provision, as follows (p. 671):

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Cite This Page — Counsel Stack

Bluebook (online)
24 N.E.2d 813, 107 Ind. App. 695, 1940 Ind. App. LEXIS 85, Counsel Stack Legal Research, https://law.counselstack.com/opinion/metropolitan-life-insurance-co-v-heavener-indctapp-1940.