Rubenstein v. Metropolitan Life Insurance

190 S.E. 531, 118 W. Va. 367, 1937 W. Va. LEXIS 27
CourtWest Virginia Supreme Court
DecidedMarch 16, 1937
Docket8456
StatusPublished
Cited by4 cases

This text of 190 S.E. 531 (Rubenstein v. Metropolitan Life Insurance) is published on Counsel Stack Legal Research, covering West Virginia Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Rubenstein v. Metropolitan Life Insurance, 190 S.E. 531, 118 W. Va. 367, 1937 W. Va. LEXIS 27 (W. Va. 1937).

Opinion

Riley, Judge:

The plaintiff, Ruby Rubenstein, instituted this action in assumpsit against the defendant, Metropolitan Life Insurance Company, on the total disability clause of a life insurance policy. To a judgment in favor of the plaintiff in the amount of $607.50, based upon a jury verdict, the defendant obtained this writ of error.

The declaration, which was filed in statutory form, alleged, among other things, that the plaintiff was totally and permanently disabled and that claim for said dis *369 ability had been made and proof thereof furnished to the defendant.

In addition to pleas of non-assumpsit and non-liability, defendant filed a specification of defense, alleging, among other things, that proof of total and permanent disability had not been furnished as required by the policy, and that at the time of the institution of suit and at all times since the plaintiff was able to perform work and engage in business for compensation or profit. No written reply or replication to this specification of defense had been filed by the plaintiff prior to the trial. On the first day of the trial, an objection having been made to the introduction of testimony on behalf of the plaintiff, bearing on the furnishing blanks for proof of claim by the company, plaintiff’s counsel notified the court and opposing counsel that on the following day they would tender a written replication to the specification of defense. On the day designated, the plaintiff filed, over defendant’s objection, a replication to the specification of defense, alleging that the plaintiff had made demand on the defendant for the blanks upon which to make a proof of claim; that the defendant had not furnished the blanks and at all times denied the claim of the plaintiff for disability benefits, whereby the defendant had waived its right to demand proof of claim and was estopped from defending said action on the ground that proof of claim was not filed. Defendant’s counsel then moved for a continuance on the ground of surprise, which motion was overruled by the court. Exceptions were taken to both rulings of the court.

The provisions of the policy of insurance sued on, relating to disability benefits, read:

“METROPOLITAN LIFE INSURANCE COMPANY * * * Hereby Agrees, that upon receipt by the Company at its Home Office * * * of due proof, on forms which will be furnished by the Company, on request, that the insured has, * * * become totally and permanently disabled, as the result of bodily injury or disease *370 * * * so as to be prevented thereby from engaging in any occupation and performing any work for compensation or profit, and that such disability has already continued uninterruptedly for a period of at least three months, it will,, during the continuance of such disability, * * * Pay to the insured, * * * monthly income of $10 for each $1,000 of insurance, or of commuted value of installments, if any, under said Policy;” and further, “if the insured shall be able to perform any work or engage in any business whatsoever for compensation or profit, the monthly income herein provided shall immediately cease, * * (Italics supplied.)

The plaintiff, aged 55 years, lived at Thomas, West Virginia, where he owned a meat and grocery store. He also owned a farm about seven miles from Thomas. About the middle of April, 1935, he developed an inflammatory condition of the gall bladder, which failed to respond to medical treatment. He was taken to a hospital at Cumberland, Maryland, where, on April 19th, he underwent an operation, the purpose of which was to drain the gall bladder. In this action, brought on October 22, 1935, the plaintiff claims that from the time of his operation, his physical condition was such as to bring him within the total and permanent disability clause of the policy.

A good deal of testimony, both medical and lay, was introduced on behalf of both parties bearing upon the plaintiff’s physical condition, both before and after the operation. The witnesses who gave the medical testimony were Dr. Harry Bolton and Dr. John H. Miller, called by both the plaintiff and defendant, Dr. W. E. White-side, a witness for defendant, and Dr. Samuel Weisman, a witness for the plaintiff. Time will not permit a detailed summary of this medical testimony. Dr. Bolton, who attended Rubenstein at his first sickness and took him to the hospital for the operation, testified in part that he would not classify Rubenstein as totally and permanently disabled; that Rubenstein would not be fit *371 for hard manual labor; that he has been improving since the time of his illness; and that he could manage and supervise his farm and store and do the ordinary running around; that it 'would be a rather indefinite time during which the plaintiff’s condition might last; and that he was unable to say if plaintiff will improve. On cross-examination, this witness defined total and permanent disability from a medical standpoint: “If I am to interpret it literally, my understanding of total and permanent disability would mean a man could not do anything for the rest of his life, anything at all. That would be my idea of permanent and total disability, would be my interpretation at that time.” Dr. Miller testified in part that the plaintiff was not totally and permanently disabled; that he was not disabled for any of the lighter duties of managing and overseeing his farm and meat market; that plaintiff was able to get around and look after things as a normal man; that the percentage of disability was thirty, forty or fifty per cent, less than fifty probably. On cross-examination, this witness adopted the medical definition of total and permanent disability as given by Dr. Bolton; and when asked as to probability of improvement, he testified: “It is possible he will continue to improve, and it is possible he may not.” Dr. Whiteside stated, among other things, that at the time he examined Rubenstein, the latter had a partial disability; that such disability should gradually decrease; and that plaintiff was not totally disabled. When asked whether the amount of disability plaintiff had would remain permanently, Dr. Whiteside replied: “It is pretty hard to decide. I have seen men get along under the conditions of .that kind and apparently get back into usual work and do ordinary work, and I have seen cases where subsequently they have had to have an operation.” Dr. Weisman testified that he did not think plaintiff would be able to undertake his usual or former duties of farming or butchering or any form of physical exercise because, of the gangrenous gall bladder; that any undue exercise may cause a new eruption which would cause peritonitis; that plaintiff is totally and per *372 manently disabled and will continue until the gall bladder is removed.

The lay witnesses testified variously as to plaintiff’s physical condition before and after the operation. Testimony was introduced that plaintiff was able to do as much supervising in the butcher shop and on the farm, as he had done prior to the operation; and that he was able to do, and had been doing, a good deal of physical work in connection therewith.

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Related

Cunningham v. Metropolitan Life Insurance
294 F. Supp. 1054 (S.D. West Virginia, 1969)
Maynard v. National Fire Insurance Co. of Hartford
129 S.E.2d 443 (West Virginia Supreme Court, 1963)
Christian v. State Farm Mutual Automobile Insurance
110 S.E.2d 845 (West Virginia Supreme Court, 1959)
Broidy v. Metropolitan Life Insurance
9 S.E.2d 875 (West Virginia Supreme Court, 1940)

Cite This Page — Counsel Stack

Bluebook (online)
190 S.E. 531, 118 W. Va. 367, 1937 W. Va. LEXIS 27, Counsel Stack Legal Research, https://law.counselstack.com/opinion/rubenstein-v-metropolitan-life-insurance-wva-1937.