Potts v. Barrett Div., Allied Chemical & Dye Corp.

138 A.2d 574, 48 N.J. Super. 554, 1958 N.J. Super. LEXIS 332
CourtNew Jersey Superior Court Appellate Division
DecidedFebruary 4, 1958
StatusPublished
Cited by4 cases

This text of 138 A.2d 574 (Potts v. Barrett Div., Allied Chemical & Dye Corp.) is published on Counsel Stack Legal Research, covering New Jersey Superior Court Appellate Division primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Potts v. Barrett Div., Allied Chemical & Dye Corp., 138 A.2d 574, 48 N.J. Super. 554, 1958 N.J. Super. LEXIS 332 (N.J. Ct. App. 1958).

Opinion

The opinion of the court was delivered by

Goldmann, S. J. A. D.

Defendants Barrett Division of the Allied Chemical & Dye Corporation, and its insurer, The Travelers Insurance Company, appeal from a determination and order of the Division of Employment Security, Disability Insurance Service, in the Department of Labor and Industry, granting plaintiff Potts disability benefits under the Private Plan section of the Temporary Disability Benefits Law, N. J. S. A. 43:21-25 et seq.

Travelers had in October 1952 issued a policy under the Private Plan section (N. J. S. A. 43:21-32 to 36) covering Barrett Division’s employees. The policy provided, in part, that the company would pay certain disability benefits

“If an Employee shall be disabled and prevented from performing any and every duty pertaining to the Employee’s work or employment as result of accidental bodily injury or bodily disease not hereinafter excepted, * * (Italics ours)

We are advised that there apparently was some question as to whether this provision was sufficiently broad to cover mental disease. At the request of the Approval and Termination Section of the Division of Employment Security, Travelers on October 20, 1955 amended the paragraph to provide that disability benefits would be paid

“If an insured Employee shall be disabled and prevented from performing the duties of his employment as a result of injury or sielmess not hereinafter excepted, * * (Italics ours)

On December 21, 1956 Potts, an employee of the Barrett Division, shot and killed a woman and then, in an apparent attempt to commit suicide, turned the gun upon himself and shot out his right eye. He was charged with murder and confined to the city hospital until Eebruary 7, 1957, when he was transferred to the county jail after arraignment. He re-entered the hospital on May 1, 1957 because of an infection in the wound, and remained there under [557]*557medical care and treatment until May 10 when he was returned to the jail. Potts had meanwhile been indicted for murder and pleaded not guilty, but he later withdrew the plea, entered a plea of non vult to second degree murder, and received a sentence of 15 to 20 years in State Prison.

Potts filed a claim for disability benefits on February 27, 1957, describing his disability as “Self inflicted wound.” Travelers denied payment, claiming that a self-inflicted wound was not covered under its policy. Potts then filed a complaint with the Division of Employment Security, Disability Insurance Service. A hearing was held and a determination of facts and order filed awarding disability benefits to Potts from December 21, 1956 through February 28, 1957, and from May 1 through May 9, 1957, less the required waiting period. From this order defendants appeal.

The first reason assigned by the hearing officer for awarding disability benefits was the above-quoted change in the coverage of the policy. lie held that the insurer, by removing the words “accidental bodily injury or bodily disease” from its policy and substituting in their place the words “injury or sickness,” indicated an intention to pay disability benefits under circumstances such as are here present.

The hearing officer next pointed out that although the Legislature had provided that no benefits were payable under the State Plan “for any period of disability due to willfully and intentionally self-inflicted injury, or to injury sustained in the perpetration by the claimant of a high misdemeanor,”' N. J. 8. A. 43:21-39(d), it had not extended this exception to Private Plan policies. A Private Plan insurer could be more liberal in its policy limitations than the State Plan, and this by reason of N. J. 8. A. 43:21-32(5), which provides that the Division of Employment Security shall approve a private plan if it finds that the eligibility requirements for benefits thereunder “are no more restrictive than is provided in this act for benefits payable by the State plan.” Although N. J. 8. A. 43 :21-39 lists eight exclusions under the State Plan, Travelers had chosen to include only five in its Barrett Division policy. Among the three omitted was [558]*558exclusion (d), above. The hearing officer held that if the insurer wanted to take advantage of any of the State Plan exceptions it should have included them in its own policy, and this would have been approved since they were no more restrictive than the State Plan. The omission of exception (d), he said, indicated a waiver of the exception by Travelers.

Finally, the hearing officer ruled that payment of disability benefits in this case would not be against public policy. He found no relationship in the application of the stated purposes of the Temporary Disability Benefits Law, as set out in N. J. 8. A. 43 :21-26, to the facts of the case. In his view, the public policy of the law, as declared by that section, “requires payment of reasonable cash sickness benefits to eligible individuals suffering an accident or illness which is not compensable under the Workmen’s Compensation Act.”

In seeking a reversal of the agency order and a judgment dismissing the Potts’ claim, defendants contend that one who willfully injures himself in the course of committing a crime is not entitled to benefits, because public policy precludes recovery. They further argue that self-inflicted injuries are not within the intendment of the Temporary Disability Benefits Law. The Attorney-General, appearing for the Division of Employment Security, contends that benefits were properly awarded to Potts because (1) the policy being unambiguous, the court is bound to enforce the clear terms of the contract as it finds them; (2) insurance contracts should be liberally construed in favor of the beneficiary, exclusion clauses being strictly construed against the insurer; and (3) because of the reasons given by the hearing officer.

The Private Plan policy issued by Travelers had, of course, been submitted to and approved by the Division of Employment Security under N. J. S. A. 43 :21-32, relating to the establishment of private plans. Since it was issued pursuant to the Temporary Disability Benefits Law, it is to be read in the light of the stated purposes of the act, as Set out in N. J. S. A. 43:21-26. This section provides that the act “shall be liberally construed as remedial legisla[559]*559tion enacted upon the following declarations of public policy and legislative findings of fact,” which are then set out. The public policy of New Jersey is declared to be the protection of employees against the "suffering and hardship generally caused by involuntary unemployment.” The Legislature found that the Unemployment Compensation Law, R. S. 43 :21-1 et seq., as amended, failed to provide protection against wage loss suffered because of inability to perform the duties of a job interrupted by illness. Nor was there "any other comprehensive and systematic provision for the protection of working people against loss of earnings due to nonoccupational sickness or accident.” Finding that the prevalence and incidence of nonoccupational sickness and accident among employed people was greatest among the lower income groups, the Legislature declared that it was therefore "desirable and necessary to fill the gap in existing provisions for protection against the loss of earnings caused by involuntary unemployment,

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Bluebook (online)
138 A.2d 574, 48 N.J. Super. 554, 1958 N.J. Super. LEXIS 332, Counsel Stack Legal Research, https://law.counselstack.com/opinion/potts-v-barrett-div-allied-chemical-dye-corp-njsuperctappdiv-1958.