New York Life Ins. Co. v. Sinquefield

163 So. 809, 26 Ala. App. 523, 1935 Ala. App. LEXIS 166
CourtAlabama Court of Appeals
DecidedJune 25, 1935
Docket4 Div. 71.
StatusPublished
Cited by2 cases

This text of 163 So. 809 (New York Life Ins. Co. v. Sinquefield) is published on Counsel Stack Legal Research, covering Alabama Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
New York Life Ins. Co. v. Sinquefield, 163 So. 809, 26 Ala. App. 523, 1935 Ala. App. LEXIS 166 (Ala. Ct. App. 1935).

Opinion

*524 BRICKEN, Presiding Judge.

Plaintiff (appellee), brought this suit, in the court below, against appellant, the New York Life Insurance Company, a corporation, to recover the sum of $375, as damages for the breach of the provisions of a certain life insurance policy issued by said company to. her on January 10, 1928. The damages sought to be recovered were alleged to have accrued from the breach by the defendant company of the provisions of a “Permanent Disability Clause,” contained in said policy of insurance, and which provided that disability should be considered total whenever the insured is so disabled by bodily injury or disease that she is wholly prevented from performing any work, from following any occupation, or from engaging in any business for remuneration or profit, provided such disability occurred after the insurance under the policy took effect and before the anniversary of the policy on which insured’s age at nearest birthday is sixty.

The policy further provided that upon receipt at the company’s home office, before default in payment of premium, of due proof that the insured is totally disabled,. as above defined, and will be continuously so disabled for life, or if the proof submitted is not conclusive as to the permanency of such disability, but establishes that the insured is, and, for a period of not less than three consecutive months immediately preceding receipt of proof, has been totally disabled as'above defined, the company would waive the payment of any premiums falling due during the period of continuous total disability and would pay to the insured a monthly income of $10 per one thousand of the face of the policy for each completed month from the commencement of, and during the period of, continuous disability.

Upon the trial of the case in the court below, the jury impaneled and sworn to try the issue between plaintiff and defendant returned a verdict for the plaintiff assessing her damages at $334.57, and judgment was accordingly entered for said sum, together with the cost which had accrued. Thereafter the defendant filed its motion for a new trial, which motion was overruled and denied by the trial court, to which the defendant duly and legally excepted. The appeal in this case is taken from the judgment for the plaintiff in said case, and from the judgment of the trial court in overruling and denying the motion for a new trial.

The errors insisted upon are: (1) The plaintiff failed to furnish the insurer with due proof of total and permanent disability as defined in the policy; (2) the plaintiff in the court below failed to prove total disability ; and (3) the trial court erred in overruling the defendant’s motion for a new trial.

The complaint filed by plaintiff, in the court below, seeks to recover damages for the breach by the defendant of the total disability clause contained in the policy of insurance issued by the defendant to the plaintiff.

The defendant’s answer to the complaint was, “The general issue with leave to give in evidence any matter that might be specially pleaded.”

The defendant did not offer any evidence, whatever, in the trial of the case in the court below. The defendant did not give, or offer in evidence, any matter that might be specially pleaded. The case, therefore, submitted to the court and jury was upon the complaint and the defendant’s plea of the general issue in response thereto. Any failure of the plaintiff to give the insurance company due proof that she was totally and permanently disabled, if there was such failure in the proof, was not available to defendant under the plea of the gen *525 eral issue, but the same should have been specially pleaded. Manhattan Life Ins. Co. v. Verneuille, 156 Ala. 592, 597, 598, 47 So. 72; New York Life Ins. Co. v. Turner, 213 Ala. 286, 287, 104 So. 643. We are further of the opinion that the “proof” offered was “due proof” within the meaning of the policy.

The trial court, therefore, did not err in refusing to give the affirmative charge, in its various aspects, and as applicable to the two counts of the complaint, nor in denying and refusing to grant the defendant’s motion for a new trial upon the ground that the plaintiff, as a condition precedent to her right to maintain this suit, did not give the insurer due proof of her total and permanent disability. That defense was not presented by any special plea.

The real question presented by this appeal is whether or not the plaintiff suffered a total and permanent disability against which she was insured by the defendant under the policy of insurance which was issued to her by the defendant.

This court, and the Supreme Court, have frequently defined “total disability” as that term is used in the policy of life insurance involved in this case.

In the case of New York Life Ins. Co. v. Torrance, 224 Ala. 614, 141 So. 547, 550, the court said: “The term ‘total disability’ is a relative term, depending in a measure upon the character of the occupation and the capabilities of the insured, and to a large extent upon the circumstances' of the particular case. Ordinarily it is a question of fact, and not of law.” Travelers’ Ins. Co. v. Plaster, 210 Ala. 607, 98 So. 909, 911; United States Casualty Co. v. Perry-man, 203 Ala. 212, 82 So. 462, 464. But where the evidence is without conflict, and a contrary inference cannot reasonably be drawn therefrom, the affirmative charge is properly given. Ellis v. New York Life Ins. Co., 214 Ala. 166, 106 So. 689; Metropolitan Life Ins. Co. v. Blue, 222 Ala. 665, 133 So. 707, 710, 79 A. L. R. 852; JEtna Life Ins. Co. v. Lasseter, 153 Ala. 630, 40 So. 166, 15 L. R. A. (N. S.) 252.

Again, in the Torrance Case, supra, the Supreme Court said: “A majority of the courts adhere to the liberal rule of construction that the ‘total disability’ contemplated in insurance policies does not mean, as its strict literal contruction would require, a state of absolute helplessness, but means inability to do substantially all of the material acts necessary to the prosecution of insured’s business or occupation, in substantially his customary and usual manner (Metropolitan Life Ins. Co. v. Bovello, 56 App. D. C. 275, 12 F. (2d) 810, 51 A. L. R. 1040 and note; Note, 41 A. L. R. 1376; Note, 24 A. L. R. 203; 1 Corpus Juris, 463), and this statement of the rule has been noted with approval by this court. United States Casualty Co. v. Perryman, supra. And in Metropolitan Life Ins. Co. v. Blue, supra, the court held that the words ‘prevented from engaging in any work or occupation,’ as then applied, meant ‘prevented from doing substantial and profitable work in his profession.’ ”

To the same effect is the case of Jefferson Standard Life Ins. Co. v. Simpson,- 228 Ala. 146, 153 So. 198.

The rule above declared was later followed by this court in the case of Pacific Mutual Life Ins. Co. v. Cotton, 25 Ala. App. 439, 148 So. 177, in which this court says that cases of total and permanent disability generally involve a question of fact. That is to say, whether or not a person is suffering a total and permanent disability as applied to insurance policies is usually a question of fact to be decided by the court or jury to which that issue may be submitted.

What does the proof in this case show? The plaintiff was injured in an automobile accident on March 3, 1932. On March 31, 1932, Mrs.

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

Related

New York Life Ins. Co. v. Mason
180 So. 775 (Supreme Court of Alabama, 1938)
New York Life Ins. Co. v. Sinquefield
163 So. 812 (Supreme Court of Alabama, 1935)

Cite This Page — Counsel Stack

Bluebook (online)
163 So. 809, 26 Ala. App. 523, 1935 Ala. App. LEXIS 166, Counsel Stack Legal Research, https://law.counselstack.com/opinion/new-york-life-ins-co-v-sinquefield-alactapp-1935.