Prince v. United States Life Insurance

Appellate Division of the Supreme Court of New York

Prince v. United States Life Insurance

23 A.D.2d 723, 257 N.Y.S.2d 891, 1965 N.Y. App. Div. LEXIS 4537

CourtAppellate Division of the Supreme Court of the State of New York

DecidedApril 1, 1965

StatusPublished

Cited by7 cases

This text of 23 A.D.2d 723 (Prince v. United States Life Insurance) is published on Counsel Stack Legal Research, covering Appellate Division of the Supreme Court of the State of New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

Prince v. United States Life Insurance, 23 A.D.2d 723, 257 N.Y.S.2d 891, 1965 N.Y. App. Div. LEXIS 4537 (N.Y. Ct. App. 1965).

Pincite

Opinions

Appeal from a judgment of the Supreme Court in favor of plaintiff, entered February 25,1964, in New York County, upon a decision of the court at a Trial Term, without a jury.

Memorandum by the Court. Judgment affirmed, with $50 costs to respondent. The defendant’s policy is written to cover loss “ resulting from injury or sickness ”, with “ injury ” defined as meaning an “ accidental bodily injury ” and with “ sickness ” defined as “sickness or disease”. The medical expense for which plaintiff has recovered judgment was a “ covered expense ” arising from an “ accidental bodily injury ” and not arising from “ sickness or disease ”. The undisputed medical testimony was that the expense for physician’s services was incurred in treating a psychoneurotic reaction resulting from “ a traumatic injury ”, 'The defendant’s claimed exemption from liability under the policy rests solely upon the effect of an exception clause excluding coverage for “ mental disease or deficiencies, psychotic or psychoneurotie disorders or reactions”. But the plaintiff’s expert testified that the psychoneurotic reaction arising from the injury was not a “ mental disease or deficiency For the reasons more fully developed in the opinion at Special Term, we conclude that [724]*724tile “ average man ” (see McGrail v. Equitable Life Assur. Soc., 292 N. Y. 419, 424), in reading the policy as a whole, would believe that the exclusion of coverage for loss occasioned by “ psychotic or psyehoneurotic disorders or reactions ” was intended to apply only where the disorders or reactions resulted from “ sickness or disease ” — “ mental disease and deficiencies disassociated with bodily injury; that he would be entitled to assume that he was covered for all disorders or reactions, psyehoneurotic or otherwise, directly resulting from an accidental bodily injury.

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

Appeal from a judgment of the Supreme Court in favor of plaintiff, entered February 25,1964, in New York County, upon a decision of the court at a Trial Term, without a jury.

Memorandum by the Court. Judgment affirmed, with $50 costs to respondent. The defendant’s policy is written to cover loss “ resulting from injury or sickness ”, with “ injury ” defined as meaning an “ accidental bodily injury ” and with “ sickness ” defined as “sickness or disease”. The medical expense for which plaintiff has recovered judgment was a “ covered expense ” arising from an “ accidental bodily injury ” and not arising from “ sickness or disease ”. The undisputed medical testimony was that the expense for physician’s services was incurred in treating a psychoneurotic reaction resulting from “ a traumatic injury ”, 'The defendant’s claimed exemption from liability under the policy rests solely upon the effect of an exception clause excluding coverage for “ mental disease or deficiencies, psychotic or psychoneurotie disorders or reactions”. But the plaintiff’s expert testified that the psychoneurotic reaction arising from the injury was not a “ mental disease or deficiency For the reasons more fully developed in the opinion at Special Term, we conclude that [724]*724tile “ average man ” (see McGrail v. Equitable Life Assur. Soc., 292 N. Y. 419, 424), in reading the policy as a whole, would believe that the exclusion of coverage for loss occasioned by “ psychotic or psyehoneurotic disorders or reactions ” was intended to apply only where the disorders or reactions resulted from “ sickness or disease ” — “ mental disease and deficiencies disassociated with bodily injury; that he would be entitled to assume that he was covered for all disorders or reactions, psyehoneurotic or otherwise, directly resulting from an accidental bodily injury.

Cite This Page — Counsel Stack

Bluebook (online)

23 A.D.2d 723, 257 N.Y.S.2d 891, 1965 N.Y. App. Div. LEXIS 4537, Counsel Stack Legal Research, https://law.counselstack.com/opinion/prince-v-united-states-life-insurance-nyappdiv-1965.

Opinions

Related

Cite This Page — Counsel Stack