Sanderson v. New York Life Insurance

194 S.W.2d 221, 239 Mo. App. 688, 1946 Mo. App. LEXIS 295
CourtMissouri Court of Appeals
DecidedApril 22, 1946
StatusPublished
Cited by12 cases

This text of 194 S.W.2d 221 (Sanderson v. New York Life Insurance) is published on Counsel Stack Legal Research, covering Missouri Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Sanderson v. New York Life Insurance, 194 S.W.2d 221, 239 Mo. App. 688, 1946 Mo. App. LEXIS 295 (Mo. Ct. App. 1946).

Opinion

*692 CAVE, J.

This is an action on two insurance policies for disability benefits and for penalties for vexatious refusal to pay. The petition contained three counts; the first two on the policies, and the third for penalties and attorneys’ fees. The ease was tried without a jury. No findings of fact or declarations of law were asked or made. The trial court rendered judgment for plaintiff on the first count for $248; on the second count for $1,242.32, and for the defendant on the third count. Defendant appealed from the judgment on the first and second counts, and plaintiff appealed from the judgment on the third count. By agreement, the appeals have been consolidated and will be disposed of in one opinion.

The facts are stipulated and may be summarized as follows: William E. .Sanderson was the insured under two policies issued by defendant. The first, dated August 22nd, 1918, provided $1,000 life insurance, double indemnity for accidental death, and one-tenth of the face of the^ policy, $100, annually to the insured on the anniversary of the policy, upon receipt of due proof of total and permanent disability. The setiond policy, dated October 9th, 1931, proAddes $4,000 of life insurance, double indemnity for accidental death, and $40 per month upon receipt of due'proof of total and permanent disability. Both policies provide for waiver of premiums during disability. The provisions of the policies directly involved are:

First Policy:

“3. . . .. The Company may at any time and from time to time, *693 but not oftener than once a year, demand due proof of such continued disability, and upon failure to furnish such proof, or if it appears that insured is no longer wholly disabled as aforesaid, no further premiums shall be waived nor income payments made.” (Italics ours)

Second Policy:

"Before making any income payment or waiving any premium, .the Company may demand due proof of the continuance of total disability, but such proof will not be required oftener than once a year after such disability has continued for two full years. If such proof shall not be furnished, or if at any time the Insured shall become able to perform any work, follow any occupation, or engage in any business for remuneration or profit, no further income payments shall be made nor premiums waived. . . .” (Italics ours)

Sanderson was adjudged insane by the Jackson County Probate Court September 4, 1934, and plaintiff and his wife and beneficiary in each policy, was appointed his guardian. He was confined to State Hospital No. 2 for the insane, at St. Joseph, Missouri, from that time until May 13, 1942. On that date he disappeared from the hospital and although plaintiff and State authorities have made a thorough search in an effort to find him, he has not been seen or heard from and his present whereabouts are unknown.

The Company waived the premiums and paid disability benefits to the guardian from 1934 until 1943. On July 16,1943, the Company wrote Mrs. Sanderson concerning the two policies and advised her that under the terms of the disability benefit provisions, benefits were payable during the continuance of total disability, and that continuance of such benefits was subject to the continuance of such disability and that, under the policies, the Company had the right to "demand due proof of such continued disability and upon failure to furnish such proof, or if it appears that insured .is no longer wholly disabled' as aforesaid, no further premiums shall be waived nor income payments made. The Company now has under consideration the question of the continuance of the disability benefits. As you know, it has been some time since we have been furnished with proof of Dr: Sanderson’s continued total disability. Therefore, we are enclosing herewith a form #4 to be completed by the insured’s present attending physician. Upon receipt of the aforementioned report, we shall be pleased to give the claim our further consideration with a view: to continuing benefits.”

Form #4 asked, among others, the following-questions: "3. Where can the insured be called on in person now? 4. How long have you been the medical attendant or adviser of the insured? 5. Is he now under your treatment? 6. For what injury, infirmity or disease causing disability have you treated or advised the insured during the last twelve months? 7. (a) Is the insured wholly disabled at the *694 present time? (b) If he is, bow long, to your knowledge, has be been prevented, by reason of his disability, from engaging in any occupa-' tion whatsoever for remuneration or profit ? 8. "What is your opinion as to whether or not the insured by reason of his disability will be permanently, continuously and wholly prevented thereby from pursuing any and all gainful occupations?”

In reply to the Company’s letter enclosing this form, Mrs. Sander-son wrote, August 2, 1943, advising the company that ‘ ‘ I cannot have this blank filled out — because my husband "Wm. E. Sanderson, who disappeared from State Hospital No. 2, St. Joseph, Missouri, on May 13th, 1942 has not been heard of neither has he been heard from by the Hospital or by his relatives or by me. ... As you know the nature of my husband’s disability was permanent and total with no possibility of recovery.”

On August 31,1943, the Company wrote Mrs. Sanderson as follows:

“Eeplying to your letter of August 2, we do not know that your husband’s’disability was ‘Permanent and total with no possibility of recovery.’ On the contrary, a large proportion of the insane regain their sanity. The fact that your husband has not been heard from suggests that he must now be self-supporting.

“The policies give the Company the right to require due proof once each year of the continuance of disability. Your letter of August 2 does not comply with this provision of the policies, nor with the Company’s letter of July 16.

“Under the circumstances, the Company cannot continue to waive the premiums or pay disability benefits under the policies. . . .”

No benefits have been paid nor premiums waived since August 31, 1943. Mrs.'Sanderson has kept the policies in force by paying the premiums.

It is stipulated that by plaintiff’s letter of August Ji she intended to convey to defendant and defendant understood that plaintiff was able to furnish the opinion of qualified doctors at said hospital based on their knowledge of Sanderson’s condition prior to May 13, 1942, that he was, at the time the letter was written, still insane, but that she was not able to supply a medical opinion based upon an examination of the insured made at the time the letter was written, because insured’s whereabouts was wholly unknown.

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Bluebook (online)
194 S.W.2d 221, 239 Mo. App. 688, 1946 Mo. App. LEXIS 295, Counsel Stack Legal Research, https://law.counselstack.com/opinion/sanderson-v-new-york-life-insurance-moctapp-1946.