Safran v. Mutual Life Insurance

234 A.2d 1, 210 Pa. Super. 408, 24 A.L.R. 3d 1, 1967 Pa. Super. LEXIS 1014
CourtSuperior Court of Pennsylvania
DecidedSeptember 15, 1967
DocketAppeal, No. 210
StatusPublished
Cited by5 cases

This text of 234 A.2d 1 (Safran v. Mutual Life Insurance) is published on Counsel Stack Legal Research, covering Superior Court of Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Safran v. Mutual Life Insurance, 234 A.2d 1, 210 Pa. Super. 408, 24 A.L.R. 3d 1, 1967 Pa. Super. LEXIS 1014 (Pa. Ct. App. 1967).

Opinion

Opinion by

Watkins, J.,

This is an appeal from judgment n.o.v. entered by the County Court of Philadelphia in favor of the plaintiff-appellee, Moses A. Safran, and against the defendant-appellant, Mutual Life Insurance Company of New York, in the amount of $1585.17; and from judgment n.o.v. entered in favor of the appellee-insured on the counterclaim of the appellant insurance company.

The company had paid monthly disability payments to the insured on two life insurance policies from October 1956 until May 17, 1963, when it refused to continue payments. This action sought to recover $1350 with interest for benefits from that date until the institution of the suit. The company counterclaimed to recover benefits paid in the amount of $4600 upon the ground that the insured became ineligible for benefits in June of 1960, since, at that time “plaintiff was following and/or capable of following a gainful occupa[410]*410tion and has so continued to the present date”. The jury brought in a verdict for the company in the amount of $5980, the amount of the benefits claimed in the counterclaim, with interest, and found for the company on the insured’s claim. Post trial motions were filed and the court en banc, with the trial judge dissenting, entered judgment n.o.v. in favor of the appellee on both claim and counterclaim.

At the time of trial, the insured was 67 years of age, spoke with a speech impediment, was hard-of-hearing and had walking difficulties as a result of a stroke and a number of heart attacks. The court below relates his history as follows:

“There is no question that the plaintiff was in good health in 1929 when the policies were issued. At that time he was 31 years of age. He came to the United States at the age of 13 and had little formal education. He made his living as a salesman and, in 1922, started his own jewelry business. He developed a business which had eighteen employees and sold jewelry in about 20 States.

“He had a stroke in 1932 and received disability benefits for about 15 months. In 1937 he was injured in an accident, sustaining a fractured knee. He received disability benefits on that occasion until he was able to resume work. In 1942 he had a heart attack and received benefits for the period of disability. He had several seizures in the years that followed. In 1947 he was hospitalized and received benefits until he was able to resume work. He has been under constant medical attention since 1949. In 1956 he had a severe attack and was hospitálized at the Jefferson Hospital. Plaintiff made claim for total and permanent disability. He submitted proofs of loss and, from time to time, when requested by defendant, furnished statements by his doctors. The defendant never requested a medical examination by its doctors.

[411]*411“There is also no question that the plaintiffs physical condition has remained unchanged since 1956. He is required to lie in bed from about 7 P.M. each day until 9 or 10 the following morning. Upon any exertion he feels pain and is forced to gasp for breath.

“Dr. Joseph Aspel testified that the plaintiff was under his care from 1932 until 1956, when he moved to Florida after his discharge from the Jefferson Hospital. He has since seen the plaintiff on several occasions when the plaintiff came to Philadelphia. He testified that the plaintiff had an arteriosclerotic heart with coronary artery insufficiency.

“Dr. Samuel Bellet, a specialist in cardiovascular diseases testified in behalf of the plaintiff. He testified that the plaintiff has a diffuse vascular disease. He cannot engage in any activity which involves strain or effort.

“The defendant offered no medical testimony. It is undisputed that the plaintiff is totally and permanently disabled from carrying on a business or engaging in any type of employment.”

- The company’s sole objection to the continuance of payments and its insistence upon its claim for restitution rests on the contention that beginning in 1960 the insured was engaged in a gainful occupation because of his purchase and sale of stock market securities.

Under the insurance policies in issue in this case the insured is entitled to benefits if he is totally and permanently disabled. This total disability is defined in the policies as ". . . any impairment of mind or body which continuously renders it impossible for the insured to follow a gainful occupation." Such a clause must receive a reasonable construction as otherwise a man must be a helpless invalid, or physical or mental "basket case" before he would be entitled to benefits. The Supreme Court in Pearlman v. Metropolitan Life Insurance Co., 336 Pa. 444, 448, 9 A. 2d 432 (1939), [412]*412stated that total disability ". . . does not mean that the insured must be a helpless invalid in order to become entitled to benefits under such a policy, . . .". The purpose of such provisions is to provide against loss of earning power that is, if a man is rendered totally unable to carry on the trade, occupation or business for which he is fitted by education and training or experience he is totally disabled within the meaning of the policy. Cobosco v. Life Assurance Company of Pennsylvania, 419 Pa. 158, 213 A. 2d 369 (1965). The insured in this case was an immigrant who had received the equivalent of a sixth grade schooling in Russia and to his attendance at Brown Prep Philadelphia, for five months. The business he knew was the jewelry business. As the court below said:

“It is undisputed that the ordinary lifelong occupation of the plaintiff was either as a salesman or as a merchant, and there is no question that he is totally and permanently disabled from carrying on such occupation. The past history of the plaintiff establishes that, on the occasions when he was disabled prior to 1956, he always returned to work and notified the defendant to discontinue disability benefits. But in 1956 he sold his business and, because of physical disability, retired from the business and occupation which he had followed all his life. This did not mean that he was compelled to give up all activity.

“The fact that he went to the board room every day does not make him ineligible to obtain benefits. Many people go to the board room of the brokerage office to find diversion or entertainment in the same way that others visit courtrooms. To such people the moving ticker tape and the changes appearing in the prices posted on the board furnish an element of drama, suspense and excitement.

“As to the extensive transactions of the plaintiff, they were all conducted on his own behalf. They con[413]*413stituted speculation and do not differ much from the activities of a man who goes to the race track everyday or goes to his club to engage in a game of cards for money stakes.”

It should also be pointed out that his wife accompanied him to the comfort of the board room and cared for him on the way and while there. They both bought and sold securities. What he did in the board room could well be done by this man, by telephone, if he were bedfast, under the care of his wife, or under the care of nurses around the clock. It might just as logically be claimed that benefits must stop because he engaged in poker games or gin rummy at high stakes with friends in his bedroom and that such income represented the following of a gainful occupation.

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Cite This Page — Counsel Stack

Bluebook (online)
234 A.2d 1, 210 Pa. Super. 408, 24 A.L.R. 3d 1, 1967 Pa. Super. LEXIS 1014, Counsel Stack Legal Research, https://law.counselstack.com/opinion/safran-v-mutual-life-insurance-pasuperct-1967.