Reserve Life Insurance Co. v. Gay

101 S.E.2d 158, 96 Ga. App. 601, 1957 Ga. App. LEXIS 646
CourtCourt of Appeals of Georgia
DecidedOctober 16, 1957
Docket36896
StatusPublished
Cited by12 cases

This text of 101 S.E.2d 158 (Reserve Life Insurance Co. v. Gay) is published on Counsel Stack Legal Research, covering Court of Appeals of Georgia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Reserve Life Insurance Co. v. Gay, 101 S.E.2d 158, 96 Ga. App. 601, 1957 Ga. App. LEXIS 646 (Ga. Ct. App. 1957).

Opinion

*603 Townsend, J.

Code § 81-105 provides in part: “Copies oí contracts, obligations to pay, or other writings should be incorporated in or attached to the petition in all cases in which they constitute the cause of action, or the relief prayed for must be based thereon. In suits to recover money on an insurance policy it shall be necessary to attach a copy of only what appears upon the face or in the body of the policy.” However, failure to attach what appears in the body of the policy is a subject for special, not general demurrer. Riley v. Royal Arcanum, 140 Ga. 178 (1) (78 S. E. 803). And a special demurrer, being a critic, must itself be perfect. Monday v. Life & Casualty Ins. Co. of Tenn., 82 Ga. App. 650 (62 S. E. 2d 197). The defendant’s special demurrer was directed only to paragraph 8 of the petition on the ground that the required part of the insurance policy had not been pleaded. When the plaintiff by amendment struck these allegations from paragraph 8, and introduced other allegations regarding the issuance of the policy in paragraph 9, and there was no demurrer to paragraph 9 as amended nor any renewal of the special demurrers previously filed, the demurrer as it existed before amendment, even if not abandoned by failure to renew, was not sufficient to attack the defect in the petition in its amended form. There was accordingly no error in overruling the demurrer and refusing to dismiss the petition because of failure to comply with Code § 81-105.

As to the plaintiff failing to comply with a proper notice requiring the production of papers, Code § 38-803 provides as follows: “If the plaintiff or his attorney, being so notified, shall fail or refuse to comply with such order, the court shall, on motion, give judgment against such plaintiff as in case of non-suit.” The defendant insurance company served upon the plaintiff W. T. Gay, through his attorney of record, a notice to produce the insurance policy on which the plaintiff was proceeding. The policy was not produced, the plaintiff stating that he had given it to his attorney, and the attorney stating that he did not “now” have it in his possession. Regardless of whether the whereabouts of the policy was satisfactorily accounted for, the -defendant shows no reversible error in this connection because it failed to procure a pre-emptory order from the court for the production of the policy and failed to make any motion for *604 nonsuit, both of which are essential before this statutory remedy can be invoked. See National Bondholders Corp. v. Austell Bank, 190 Ga. 411 (9 S. E. 2d 637). The remedy for failure to comply with a notice to produce lies by pursuing Code § 38-803, not by a motion for new trial. Special ground 14 is without merit.

On the trial of a case the burden rests on the plaintiff throughout to establish the material allegations of his cause of action. The plaintiff here alleged in substance that the defendant had issued to him and his family a policy of insurance No. J-390535 insuring them against expenses incurred because of hospitalization, doctors’ fees and ambulance bills; that hospital expenses were incurred because of his wife’s admittance to a named hospital from May 22, through May 31, 1956; that she incurred hospital expense of $200, doctor bills of $260, ambulance bills of $8.50, and that a named physician attended her each day during said period until her discharge. The plaintiff then attempted to prove that he was entitled to reimbursement under the terms of the policy of insurance by means of admissions of the defendant, and without ever introducing the policy in evidence. The defendant admitted, either in its pleadings, answers to requests for admissions, or answers to interrogatories, that it issued to the plaintiff and his family on December 28, 1953, a policy as to certain expenses incurred because of hospitalization, doctors’ fees and ambulance bills; that the plaintiff’s claim for hospital, medical and ambulance expenses arises by virtue of her being hospitalized between May 22 and 31, 1956, for an operation known as hysterectomy, benefits for which are provided on page 2 of the policy in part 3 thereof, and that the plaintiff’s wife did become indebted for treatment to a medical doctor for some amount during that period. The defendant further admitted the provisions of part 3 of the policy as follows: “If as a result of such . . sickness . . the insured, or any member of the family group, shall have a surgical operation performed by a licensed physician or surgeon who is a doctor of medicine or osteopathy, the company will pay the insured (or will pay the physician or surgeon authorized by the insured to do so) for the fee charged by such physician or surgeon for such operation not to exceed the amount set opposite the name of the operation in the schedule of operations *605 below . . the following schedule shows the maximum amount payable as indemnity for the expense of the operation performed and is not intended to fix or govern the fee to be charged by the physician or surgeon . . Pelvis, Hysterectomy . . $100.” There follows a schedule of hospital benefits, including room at $4 per day, and other specific benefits, and a benefit for ambulance expense not to exceed $5 per trip. The plaintiff testified that he paid an ambulance fee of $8.50, a medical bill of $200, and hospital expenses of “two hundred and some odd dollars.” The plaintiff failed to prove any itemization of hospital expenses, or that any expenses on which coverage existed,, other than the hospital room occupied by his wife for 9 days, were in fact incurred. The plaintiff was entitled under the policy provisions admitted and the proof offered to $36 for a hospital room at $4 per day, $100 of his medical bill for the operation,, and $5 of the ambulance bill, or a total principal sum of $141. There was testimony in the record that a reasonable attorney’s fee for prosecuting the action was $400, and the penalty for refusal to pay, if allowable, would be 25% of $141 or $35.25, making a total possible recovery of $576.25. Accordingly, special grounds 7, 12 and 16, insofar as they raise the question that a verdict of $800 is not sustainable under the evidence, are meritorious.

Special grounds 4, 5, and 6 complain of the charge of the court as follows: “If you find that the plaintiff has carried the burden of proving that the defendant is liable to him in any sum by a preponderance of the testimony, it would be your duty to fix that sum that you find from the evidence, and if you find that the sum is due and that the defendant failed to make payment within 60 days, then you would be authorized to penalize them for 25% of the amount that you find is due, and if you so find that it was done in bad faith, you may add attorney’s fees to the amount that you believe from the evidence, has been proven by a preponderance of the evidence.” These special grounds are meritorious insofar as they contend that the court erred in instructing the jury that they might add the 25% penalty for failure to pay within 60 days regardless of whether the refusal was in bad faith or not. Code § 56-706 provides that in all cases when a loss shall occur and the insurer shall refuse *606

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Bluebook (online)
101 S.E.2d 158, 96 Ga. App. 601, 1957 Ga. App. LEXIS 646, Counsel Stack Legal Research, https://law.counselstack.com/opinion/reserve-life-insurance-co-v-gay-gactapp-1957.