Provident Life & Accident Insurance v. Ramsey

75 S.W.2d 781, 256 Ky. 126, 1934 Ky. LEXIS 368
CourtCourt of Appeals of Kentucky (pre-1976)
DecidedNovember 2, 1934
StatusPublished
Cited by6 cases

This text of 75 S.W.2d 781 (Provident Life & Accident Insurance v. Ramsey) is published on Counsel Stack Legal Research, covering Court of Appeals of Kentucky (pre-1976) primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Provident Life & Accident Insurance v. Ramsey, 75 S.W.2d 781, 256 Ky. 126, 1934 Ky. LEXIS 368 (Ky. 1934).

Opinion

Opinion op the Court by

Judge Thomas

Reversing.

In 1925, the National Life & Accident Insurance Company of Nashville, Tenn., issued its accident- and sick benefits policy to the appellee, John Ramsey. The initial sum was $2,000. It was kept in force by the payment of the premiums until after the happenings in 1930 hereinafter referred to, and upon which this action is based. In the meantime, the obligations of the policy were assumed through a reinsurance transaction by ;the *128 appellant and defendant below, the Provident Life & Accident Insurance Company, etc., whereby it became the insurer in the policy. 'In addition to an agreement to pay the initial sum in case of the accidental death of the insured, the policy provided for both sick and accident benefits, the first of which obligated the insurer to pay to the insured $60 per month for twelve months, on the terms stated in the policy, for total disability resulting from sickness while the policy was in force, and which we will hereinafter refer to as obligation (a). It also provided for the payment of accident benefits to the insured if he was not killed but totally disabled from performing any part of his occupation by reason of the described accidental means set forth in the policy, and which payments were to continue for two years after the disability arose, if it continued that long, but at which time the insurer could terminate all liability under (the policy by paying to the insured twenty times the amount of the monthly payment, which would have been a total sum of $1,200 in this case, the monthly payments being $60, and which will hereinafter be referred to as obligation (b).

In March, 1930, the insured (to whom we will hereinafter refer as plaintiff) became afflicted with what he and his physician stated in his application for benefits under obligation (a) was “a sort of paralysis.” He manifested in his application that he was totally disabled by reason thereof, and he sought the payment of sick benefits as provided in that obligation. His application was approved, and the monthly sick indemnity benefits were paid to him for six months. Prior thereto plaintiff applied to the local agent of the insurer (to whom we will refer as defendant) for a lump sum settlement of all the obligations that were due him from defendant under the policy. The local agent informed him that he (agent) possessed no authority to make such a settlement, but informed plaintiff that it could be done by the proper officer at the home office in Chattanooga, Tenn., whose name was Webb. Whereupon plaintiff agreed to pay all of the expenses of the agent if he would carry plaintiff to Chattanooga with the view of making such a settlement. The trip was made, but, before reaching the home office, plaintiff told the agent that he thought he was entitled to the sum of $500 in full compromise and settlement of all obligations under the policy, in .addition to what had been paid him in monthly install *129 ments. After meeting Mr. Webb and conversing with him, an agreement was reached whereby defendant paid to plaintiff, pursuant to his agreement to accept it, the sum of $450, which was made by check, and he indorsed it and obtained the cash thereon. At the same time he executed receipts acknowledging the payment, and that it was in full settlement of all of his rights under the policy, and he also signed a writing cancelling it and delivered it, with its cancellation, to the defendant, and all of which occurred on or about September 30, 1930.

Slightly more than a year thereafter, and on October 6, 1931, this court rendered its opinion in the case of Woods v. this same appellant, reported in 240 Ky. 398, 42 S. W. (2d) 499, in which it was held that paralysis produced by drinking and consuming fluid extracts of Jamaica ginger of the variety commonly known as “Jake,” when the consumer at the time was unaware of such probable effect, should be classified as an accident, for the consequences of which obligation (b), supra, indemnified against. Plaintiff was well satisfied with his settlement, and made no complaint of it whatever until after the Woods opinion became final, and then he made efforts to procure the setting aside of the compromise settlement and to assert his rights under obligation (b), supra, upon the ground that his paralysis was produced in the same manner as set out in the Woods opinion, and for the reason therein stated his affliction was accidentally produced so as to entitle him to the benefits of that obligation of the policy instead of being confined to obligation (a) thereof.-

Being unable to accomplish that result by agreement, he filed this equity action in the Knox circuit court against defendant on May 11, 1932, and in his petition, after setting forth his policy, his disability, and the settlement referred to, he attempted therein to rescind and repudiate the latter by averring that “at said time the plaintiff was physically and mentally unable to take care of himself. He had no lawyer or person present to assist him in taking care of his rights. He had no business experience. He had been a laborer for the railroad company at Corbin, Kentucky, for many years. He had a family and they were practically on sufferance. The said Webb represented to plaintiff at said time and place that his doctors had given assurance that within sixty days there would be a permanent cure for the condition with which plaintiff was suffering and *130 he would be restored to full health again. Plaintff relied upon said statements and representations and there and then signed a release and surrendered his policy, believing that he was suffering with sickness and not from an accident and believing the representations of said Webb that he could be permanently cured within sixty days and at a time when he was in distressing need of said funds for the support of himself and his family. Altogether he was paid under said policy the sum of $790.00, and no more — six monthly payments of sixty dollars each and $430.00 at the end of said six months period at the time when he surrendered the policy and executed a release against the provisions thereof. Plaintiff believed, in good faith that he was suffering from sickness and not from accident and he verily believes and charges that the defendant in good faith so believed and through mutual mistake the said writing was executed, the said settlement made and policy surrendered. If that is not true as to the defendant, it is true as to the plaintiff and the defendant through fraud, covin, deceit, misrepresentation and overreaching procured plaintiff to sign said settlement and surrender his said policy.”

He prayed for a rescission and cancellation of the settlement, because of the alleged fraud and mistake, and that he be decreed the right to all of the benefits of obligation (b) in the policy, and for judgment accordingly. The demurrer of defendant filed to the petition ■was overruled, and by answer it denied the material averments of the petition with reference to the fraud and mistake averred therein, and in another paragraph pleaded the settlement made between it and plaintiff in bar of the action.

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Cite This Page — Counsel Stack

Bluebook (online)
75 S.W.2d 781, 256 Ky. 126, 1934 Ky. LEXIS 368, Counsel Stack Legal Research, https://law.counselstack.com/opinion/provident-life-accident-insurance-v-ramsey-kyctapphigh-1934.