Mitchell v. Equitable Life Assurance Society of United States

245 N.W.2d 618, 310 Minn. 219, 1976 Minn. LEXIS 1824
CourtSupreme Court of Minnesota
DecidedSeptember 3, 1976
Docket46126
StatusPublished
Cited by3 cases

This text of 245 N.W.2d 618 (Mitchell v. Equitable Life Assurance Society of United States) is published on Counsel Stack Legal Research, covering Supreme Court of Minnesota primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Mitchell v. Equitable Life Assurance Society of United States, 245 N.W.2d 618, 310 Minn. 219, 1976 Minn. LEXIS 1824 (Mich. 1976).

Opinion

Todd, Justice.

Constance Grace Mitchell (Mitchell), an employee of Twin City Federal Savings and Loan Association (TCF), sought to recover disability benefits from The Equitable Life Assurance Society of the United States (Equitable) under a group long term disability income policy furnished by Equitable to TCF to cover TCF employees. The lower court denied recovery, finding that Mitchell failed to prove total disability and that she had failed to conform to the policy requirements as to medical treatment, notice of injury, and proof of disability. Mitchell appeals from the judgment. We affirm on the ground that Mitchell did not comply with the policy requirements as to proof of disability, and therefore principles similar to those underlying the doctrine of laches dictate that she should be barred from asserting this claim.

Mitchell was employed by TCF in its cafeteria. In May 1970, she was hospitalized and treated for phlebitis of the left leg, varicose veins, and obesity. A claim based on the expenses of this hospitalization was timely submitted to Equitable on Mitchell’s behalf by TCF, and such claim was duly paid. On June 2, 1970,. Mitchell’s treating physician reported that she had recovered and was capable of returning to work, although a subsequent re *221 port by this same physician in November 1970 stated that Mitchell should avoid prolonged sitting or standing in one place. Mitchell sought to return to work at TCF on a part-time basis in June 1970, but was informed there was no part-time work available, and her employment was terminated by TCF.

In August 1970, Mitchell inquired of TCF regarding possible disability claims. Equitable’s notice-of-claim form under the disability policy was comprised of three parts: An employer’s statement, an employee’s statement, and a physician’s certificate. By letter dated August 13, 1970, TCF transmitted the employee’s statement and the physician’s certificate to Mitchell’s attorney, who delivered them to Mitchell. In addition, TCF at that time mailed to Equitable the employer’s statement relating to Mitchell’s potential disability claim. That statement notified Equitable that Mitchell claimed disability, but also contained ■ TCF’s recommendation that no benefits be paid because Mitchell could obtain full-time employment at the time and had requested part-time employment with TCF. Mitchell never furnished TCF or Equitable with the employee’s statement or the physician’s certificate. Equitable made several requests of TCF for the employee and physician statements and was finally advised by TCF in early 1971 that Mitchell had abandoned her claim, a fact which is not disputed in the record by Mitchell. Accordingly, Equitable closed its file on Mitchell’s claim.

In March 1973, Mitchell commenced this action against Equitable, seeking recovery for long term disability benefits as provided in the policy. 1 The policy provides that an employee *222 is totally disabled and thus entitled to receive benefits under the following circumstances:

“* * * [I]f he is wholly and continuously unable (i) during the- first two years of any one period of disability, to perform any and every duty pertaining to his employment, and (ii) during the remainder of such period of disability, to engage in any occupation or perform any work for compensation or profit for which he is or may become reasonably fitted by education, training or experience.”

The trial court found that Mitchell was “totally disabled” under the policy definition for the first 2 years, but that she did not qualify thereafter since she was suitable for other employment. The trial court also found that Mitchell was not “under the regular care and attendance of a legally qualified physician” as required by the policy. Further, the trial court found that she had not complied with policy provisions requiring that the claimant' submit notice of injury and proof of disability to Equitable. Mitchell appeals from the judgment entered for defendant pursuant to these findings, challenging principally the findings as to notice of injury and proof of disability.

With respect to notice, we hold that the lower court erred in finding lack of proper notice. The policy provision as to notice of claim states:

“Written notice of injury or sickness upon which claim may be based must be given to the Society at its Home Office in the City of New York no later than one month prior to the expiration of the qualifying period, or as soon thereafter as is reasonably possible.” (Italics supplied.)

The employer’s statement furnished to Equitable by TCF in-August 1970 satisfied the notice requirement of the policy. The policy does not require that the notice be supplied specifically by the claimant rather than by his employer, and if it did, the validity of such a limitation would be open to serious question. Here, the facts that Equitable sought additional information're *223 garding Mitchell’s potential claim on several occasions, and that it only closed its files in the matter in early 1971 upon being advised that the claim had been abandoned, confirm that the purpose of the notice requirement — that Equitable be informed of the possible claim — was adequately served by the duly completed and transmitted employer’s statement.

Equitable asserts that the notice of claim was due by July 13, 1970, in which case the employer’s statement, which was not sent to Equitable until August 12, 1970, would not comply with the policy’s notice requirement. However, as the emphasized portion of the foregoing provision indicates, the policy affords sufficient leeway in defining the time when notice must be filed to render the notice provided in the instant case timely.

We concur with the finding of the trial court that Mitchell did not furnish Equitable with proper proof of disability. The policy provision as to proof of disability states in part:

“Written proof of total disability * * * must be furnished to the Society at its Home Office in the City of New York on the Society’s forms within ninety days after the termination of the first monthly period of benefits following the expiration of the qualifying period.”

The contrast between this provision and the one governing notice of injury, in terms of specificity, should be noted. Unlike the latter, the proof-of-disability provision designates a specific manner in which the required information must be provided— namely, completion of three forms by the employee, the employer, and the attending physician, respectively. In addition, the proof-of-disability provision differs from the notice provision in that it does not provide a flexible extension of the period during which the required information must be received, but imposes an absolute deadline. While it is not necessary for us to determine, in light of the facts involved herein, whether Equitable may insist on a rigid, literal compliance with the precise terms of this provision, we conclude that Mitchell failed to do anything *224 which can be construed as complying with this provision’s spirit and purpose.

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Cite This Page — Counsel Stack

Bluebook (online)
245 N.W.2d 618, 310 Minn. 219, 1976 Minn. LEXIS 1824, Counsel Stack Legal Research, https://law.counselstack.com/opinion/mitchell-v-equitable-life-assurance-society-of-united-states-minn-1976.