Mutual Ben. Health & Accident Ass'n v. Mathis

142 So. 494, 169 Miss. 187, 1932 Miss. LEXIS 6
CourtMississippi Supreme Court
DecidedJune 13, 1932
DocketNo. 30079.
StatusPublished
Cited by20 cases

This text of 142 So. 494 (Mutual Ben. Health & Accident Ass'n v. Mathis) is published on Counsel Stack Legal Research, covering Mississippi Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Mutual Ben. Health & Accident Ass'n v. Mathis, 142 So. 494, 169 Miss. 187, 1932 Miss. LEXIS 6 (Mich. 1932).

Opinion

Cook, J.,

delivered the opinion of the court.

*189 The appellee, C. H. Mathis, instituted this suit in the circuit court of Alcorn county against the appellant, the Mutual Benefit Health & Accident Association, on an insurance policy issued by the appellant, which provided for certain disability benefits to the appellee. At the conclusion of the testimony, the court directed a verdict for the appellee for one hundred seventy dollars and eighty-three cents for disability and hospital expenses, while he was continuously confined within doors, and five hundred ninety dollars and sixty-seven cents for the time that he was totally disabled and suffered total loss of time, but was not confined within doors; and, from the judgment entered for the aggregate amount of seven hundred sixty-one dollars and fifty-one cents, this appeal was prosecuted.

The clauses of the policy upon which the judgment was based, are parts I and J thereof, which read as follows:

“Illness Indemnities.

“Part I. Confining illness one hundred dollars per month for life.

“The association will pay, for one day or more, at the rate of one hundred (100.001) dollars per month for disability resulting from disease, the cause of which originated more than thirty days after the date of this policy, and which confines the insured continuously within doors and requires regular visits therein by legally qualified physician; provided said disease necessitates total disability and total loss of time.”

“Part J. Non-confining illness fifty dollars per month.

“The association will pay, for one day or more at the rate of fifty dollars per month, but not exceeding one month, for disability resulting from disease, the cause of which originates more than thirty days after the date of this policy, and which does not confine the insured continuously within doors but requries regular medical *190 attention; provided said disease necessitates total disability and total loss of time.”

Part J of the policy, above quoted, was extended to cover the entire life of the insured by a rider indorsed on the policy, which is as follows: “In consideration of an additional premium of four dollars annually or one dollar quarterly, the association will pay to the insured, the monthly indemnity as specified in this policy, in part J, so long as the insured shall live and suffer the disability therein described. ’ ’

The appellee had been engaged in the laundry business for fifteen years, and for eight years prior to the beginning of his disability was the owner of a steam laundry in Corinth, Mississippi, and had been engaged in the active discharge of the duties of manager of said laundry. This laundry contains about twenty-five machines, which are operated by different employees, and which are located in a building with a floor space of seventy-five by one hundred seventy-five feet, with the business office of the laundry located at the front of this floor space. In the operation of the laundry it is necessary for the manager to be on his feet almost continuously from eight to ten hours per day while engaged in the supervision of the machines and the employees in order to see that the machines are properly operated and the work properly performed.

In October, 1930, the appellee was stricken with a disease which his family physician and another Corinth physician diagnosed as acute diabetes. These physicians advised him to consult a specialist in Birmingham who operated a clinic and hospital for the treatment of such diseases. He then went to Birmingham for examination by this specialist, who confirmed the diagnosis of the local physicians, and prescribed a very strict diet. He made several trips to Birmingham, and each time remained in the hospital several days. Later he was confined to his bed at home for eighteen days; and it is con *191 ceded by the appellant that he is entitled to recover one hundred seventy dollars and eighty-three cents, under part I of the policy, for hospital expenses and disability while confined within doors. The appellee’s several physicians testified that common care and prudence, and due regard for the preservation of his health and prolongation of his life, required that he give up all work, avoid all exertion and worry, and take a complete rest, and that they advised and urged him to do so; but, over the protest of these physicians, he continued to go to his place of business early in the morning and to remain there throughout the working hours. He turned the active management of the business over to another, but remained in the office. During the hours before noon, in a limited way, he attended to some duties in his office such as answering the telephone, writing an occasional letter, .checking receipts from his drivers once a week, checking the pay roll once a month, buying supplies and paying bills, and occasionally advising with his manager and drivers. He placed a cot or bed in his office, and after lunch spent from two to three hours lying down. None of the duties performed by appellee required that he stand on his feet, and the testimony was to the effect that he was not physically able to perform any substantial part of the duties of manager of the business. With the organization the appellee was compelled to employ after he became ill, the business went as well during his absence from the plant as when he was present, and, if he had been able to perform .the usual and ordinary duties of manager, he could have dispensed with the service of two employees. The proof shows that after his illness beg’an the appellee lost more than forty pounds in weight, but at the time of the trial he had regained some of this loss of weight, and the state of his health was somewhat improved.

It is settled doctrine in this state that, in order for one to be totally disabled within the meaning of a health or *192 accident insurance policy, it is not necessary that he he wholly incapacitated to perform any duty incident to his usual employment or business, but, if the insured is prevented by his injury or illness from doing the substantial acts required of him in his business, or if his physical condition is such that, in order to effect a cure or prolongation of life, common care and prudence require that he cease all work, he is totally disabled within the meaning of such policies. Metropolitan Cas. Insurance Co. v. Cato, 113 Miss. 283, 74 So. 114; Equitable Life Insurance Society v. Serio, 155 Miss. 515, 124 So. 485, 486; Metropolitan Life Insurance Co. v. Lambert, 157 Miss. 759, 128 So. 750, 752.

In the Cato case, supra, it was held that, under a clause in an accident insurance policy giving a weekly indemnity if the injuries continuously and totally disabled and prevented the insured from performing any and every kind of duty pertaining to his occupation, an insured was totally disabled when he was prevented by his injury from doing all the substantial acts required of him in his business, nothwithstanding the fact that he occasionally was able to perform some single act connected with his business.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Ard v. Marshall Durbin Companies
818 So. 2d 1240 (Court of Appeals of Mississippi, 2002)
Piggly Wiggly v. Houston
464 So. 2d 510 (Mississippi Supreme Court, 1985)
Sawyer v. Washington National Insurance Company
429 P.2d 901 (New Mexico Supreme Court, 1967)
Prudence Life Insurance v. Wooley
182 So. 2d 393 (Mississippi Supreme Court, 1966)
United Insurance Company of America v. Ray
155 So. 2d 514 (Supreme Court of Alabama, 1963)
Ross, Dependent of v. Ross
126 So. 2d 512 (Mississippi Supreme Court, 1961)
Lucedale Veneer Co. v. Keel
79 So. 2d 232 (Mississippi Supreme Court, 1955)
Walker v. Equitable Life Assur. Soc.
123 F. Supp. 306 (E.D. Illinois, 1954)
M. T. Reed Const. Co. v. Martin
61 So. 2d 300 (Mississippi Supreme Court, 1952)
Weum v. Mutual Benefit Health & Accident Ass'n
54 N.W.2d 20 (Supreme Court of Minnesota, 1952)
Lipnick v. New York Life Ins. Co.
52 So. 2d 916 (Mississippi Supreme Court, 1951)
American Life Ins. v. Byrd
48 So. 2d 614 (Mississippi Supreme Court, 1950)
Mutual Life Ins. Co. of New York v. Baker
19 So. 2d 739 (Mississippi Supreme Court, 1944)
Woodmen of the World Life Ins. Soc. v. Johnson
16 So. 2d 285 (Mississippi Supreme Court, 1944)
Pacific Mut. Life Ins. Co. v. Arnold
90 S.W.2d 44 (Court of Appeals of Kentucky (pre-1976), 1935)
Reliance Life Ins. v. Cassity
163 So. 508 (Mississippi Supreme Court, 1935)
American Bankers' Ins. v. White
158 So. 346 (Mississippi Supreme Court, 1935)
New York Life Ins. Co. v. Bain
152 So. 845 (Mississippi Supreme Court, 1934)
Clarkson v. New York Life Ins.
4 F. Supp. 791 (S.D. Florida, 1933)

Cite This Page — Counsel Stack

Bluebook (online)
142 So. 494, 169 Miss. 187, 1932 Miss. LEXIS 6, Counsel Stack Legal Research, https://law.counselstack.com/opinion/mutual-ben-health-accident-assn-v-mathis-miss-1932.