Schajer v. Northwestern Mutual Life Insurance

701 A.2d 132, 304 N.J. Super. 394, 1997 N.J. Super. LEXIS 419
CourtNew Jersey Superior Court Appellate Division
DecidedApril 23, 1997
StatusPublished
Cited by3 cases

This text of 701 A.2d 132 (Schajer v. Northwestern Mutual Life Insurance) is published on Counsel Stack Legal Research, covering New Jersey Superior Court Appellate Division primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Schajer v. Northwestern Mutual Life Insurance, 701 A.2d 132, 304 N.J. Super. 394, 1997 N.J. Super. LEXIS 419 (N.J. Ct. App. 1997).

Opinion

KOLE, J.A.D.,

Retired and Temporarily Assigned on Recall.

Julia Schajer (Julia or plaintiff) sues to recover total disability benefits under a disability policy issued by Northwestern Mutual Life Insurance Company (NML or defendant). NML defends, claiming that there is in fact no total disability; that plaintiffs claim is fraudulent; that she made fraudulent misstatements, material omissions of fact or concealments which bar her claim; and that the policy’s incontestability and exclusionary provisions bar the claim. NML also counterclaims for benefits paid under a reservation of rights, as well as other sums claimed to be due it from plaintiff. Plaintiff further seeks compensatory and punitive damages from defendant for the latter’s breach of duty of good faith and fair dealing, as well as its wanton, reckless and malicious wrongful acts.

This case is governed by New York law. On matters relating to the credibility of witnesses and other trial matters, New Jersey law may also apply.

After considering the credible proofs and reasonable inferences therefrom, including the demeanor of the witnesses, as well as the extensive arguments of counsel, I make the findings of fact and conclusions of law that follow.

I. Total Disability Under the Policy

Plaintiff has the burden of establishing her claim for disability benefits by a preponderance of the credible evidence. She [398]*398must show that her claim is more likely true than not. See Flexmir, Inc. v. Lindeman & Company, 4 N.J. 509, 514, 73 A.2d 243 (1950); Dalton v. Gesser, 72 N.J.Super. 100, 111-112, 178 A.2d 64 (App.Div.1962); see also Daniel v. Allstate Life Insurance Co., 71 A.D.2d 872, 419 N.Y.S.2d 662 (1979).

Despite defendant’s argument that plaintiffs proofs are rife with contradiction, I am satisfied that plaintiff presented essentially trustworthy proofs in support of her claim. The claimed contradictions as to dates, including the date the total disability commenced, are understandable in light of an endeavor to recall events that occurred some eight years before trial. I do not find any intent to deceive as to such dates or as to any material matter testified to by Julia or her husband, Morris Schajer, or any of plaintiffs other witnesses, including Dr. Rafii. At best, the differences are the result of confusion and a reasonable failure of recollection. Indeed, Julia’s testimony is corroborated in significant respects by the evidence of others, including defendant’s witnesses.

In short, I find that the claimed discrepancies in testimony in no wise impugn the essential credibility of the evidence presented by plaintiff. See De Rienzo v. Morristown Airport Corp., 28 N.J. 231, 239-240, 146 A.2d 127 (1958). Cf. County of Middlesex v. Clearwater Village, Inc., 163 N.J.Super. 166, 174, 394 A.2d 390 (App.Div.1978); State v. Fleckenstein, 60 N.J.Super. 399, 408, 159 A.2d 411 (App.Div.), certif. denied, 33 N.J. 109, 162 A.2d 338 (1960).

In early 1987, Julia was a highly successful preferred stock trader-broker, earning in excess of $500,000 a year. In 1980, she was hired by Mabon Nugent to create a preferred stock department. By 1987, she was the head of her desk and a partner of the firm, with four or five people under her. Julia’s business was extremely hectic and high pressured. She kept up with the fast pace, barely having enough time to use the restroom during the work day.

[399]*399In early 1987, during a busy work day at Mabon Nugent, Julia was approached by Stephen Meszkat, an agent of defendant, NML. He had already sold several life insurance policies to Julia. He suggested that she buy a disability benefits insurance policy to insure her substantial income in case she should become disabled. She did so.

While Julia was in Vietnam visiting her soldier husband, in 1972, she contracted genital herpes (herpes simplex) from him, and had a single severe outbreak. She was treated at an Army hospital, and as far as she knew, she had been cured. Since then she had had no indication that she had genital herpes or any other venereal disease.

The NML disability income benefits insurance policy (the policy, which she acquired), was issued on March 4, 1987. The benefits for total disability were $15,000 per month. The premiums payable were substantial.

Sometime in April 1989, Julia began having recurrent genital herpes outbreaks. The pain of these outbreaks was excrutiatingly severe. It significantly interfered with her concentration and memory, two essential requirements of her position. The pain stemming from herpetic episodes made it impossible for her to function at her desk. It was totally debilitating. She had extreme difficulty sitting and concentrating on her business.

Upon experiencing these problems in April 1989, Julia sought medical treatment from her gynecologist, Dr. Joseph Finkelstein. Dr. Finkelstein prescribed a medication called zovirax, the generic name of which is acyclovir. Julia suffered unfortunate side effects from this medication: dizziness, drowsiness, irritability, muscle aches in her lower back and shoulder, persistent sore throat and severe nausea. Dr. Finkelstein finally advised her not to take it.

In July, 1989, Julia left work, crying, and made an unannounced visit to Dr. Finkelstein in order to secure relief from her pain. Nothing that she tried could make the pain stop. Finally, in an effort to reheve her pain and after consultation with Dr. Finkel[400]*400stein, she saw a plastic surgeon, Dr. Robert Jetter, who removed a portion of her labia in August 1989.

The surgery succeeded in alleviating the pain for six months. Julia continued to work at her job. Unfortunately, by early 1990, she again began to experience recurring and unrelenting episodes of herpes simplex. These same episodes continue to date. For the remainder of 1990, until October 14, 1990, Julia functioned as best she could at her high stress job.

Hoping that a short leave of absence would help her condition, she left her job at Mabon Nugent on October 14, 1990. Unfortunately, her condition never improved. At the insistence of Mabon Nugent, since she gave no indication of returning, she finally resigned from her position in April 1991, and never returned. She cannot perform in the profession that she loved and in which she was so well compensated, because she cannot think, cannot concentrate and cannot work steadily as is required of a successful preferred stock broker. Despite her disability, Julia did attempt to earn a living after she left Mabon Nugent. However, her condition prevented her from working.

Her claim under the policy was filed with NML in December 1990.

Julia suffers from chronic genital herpes simplex resulting from a virus infection. It is a permanent and incurable condition, although it may go into remission for periods of time.

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701 A.2d 132, 304 N.J. Super. 394, 1997 N.J. Super. LEXIS 419, Counsel Stack Legal Research, https://law.counselstack.com/opinion/schajer-v-northwestern-mutual-life-insurance-njsuperctappdiv-1997.