Shands v. Nationwide Life Insurance

250 F. Supp. 627, 1965 U.S. Dist. LEXIS 6231
CourtDistrict Court, N.D. Georgia
DecidedJanuary 18, 1965
DocketCiv. A. No. 1028
StatusPublished
Cited by2 cases

This text of 250 F. Supp. 627 (Shands v. Nationwide Life Insurance) is published on Counsel Stack Legal Research, covering District Court, N.D. Georgia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Shands v. Nationwide Life Insurance, 250 F. Supp. 627, 1965 U.S. Dist. LEXIS 6231 (N.D. Ga. 1965).

Opinion

SLOAN, District Judge.

On the 15th day of December, 1964, an Order was entered by the Court sustaining defendant’s motion for summary judgment and denying plaintiff’s motion for summary judgment and a judgment in accordance therewith was duly entered on December 17, 1964.

Plaintiff has filed a motion to rehear, vacate, alter or amend said judgment and to enter summary judgment in favor of plaintiff on the following grounds:

1. That allowing said judgment to stand overlooks and violates the provision of the policy providing for “Extension of Death Benefit in Event of Total Disability”. A part of this provision of the policy is set out verbatim in the motion.

2. That the judgment entered in favor of defendant is based on a Tennessee decision involving a policy distinguishable from and without certain provisions contained in the policy here involved.

Plaintiff prays that the judgment heretofore entered be vacated and that the judgment be altered or amended so as to provide recovery for plaintiff as prayed for in her motion for summary judgment.

Briefs have been filed by the respective parties in support of and in opposition to the above motion and an oral hearing on the motion was had before the Court on the 4th day of January, 1965, at which time oral arguments of counsel for the parties were heard by the Court.

Plaintiff’s motion to rehear, vacate, alter or amend the prior judgment of this Court is now properly before the Court for determination under Local Rule 8.

[628]*628The statement of facts- entered by the Court on December 15, 1964, are reaffirmed. In addition, the Court states the following additional facts.

Plaintiff on the 13th day of November, 1963, furnished due proof of the death of Robert E. Shands to defendant through a properly executed Proof of Death Form furnished to her by defendant and thereafter defendant denied liability to plaintiff under the policy on the ground that Robert E. Shands was not an active employee of realty company as defined by the terms and conditions of the policy so as to be eligible for insurance and coverage thereunder.

The plaintiff did not furnish to the insurer notice or proof of the disability of Mr. Shands, the insured.

The ruling of the Court on pages 14 and 15 of the original opinion filed in this case on December 15, 1964, are adhered to but all statements and rulings on pages 16, 17 and 18 of said opinion are vacated, set aside and are withdrawn and the following are substituted in lieu thereof,

2. In view of the above ruling there is no necessity for deciding the second question.

3. The Court in its memorandum opinion and order entered on December 15, 1964, did overlook and fail to deal with the provision of the policy relating to “Extension of Death Benefit in Event of Total Disability”. This provision of the policy is in the following language:

“If an Employee, while insured under the Policy and while less than sixty-five years of age, becomes totally disabled as a result of bodily injury or disease, so as to be wholly prevented from engaging in any business or occupation for compensation or profit, and if the Employee dies within one year after discontinuance of premium payments for his insurance and while remaining continuously so disabled, then upon receipt of due proof of such total disability and death, the Company will pay the amount of the Employee’s insurance as determined by the Schedule of Benefits on the date such disability began unless claim is otherwise established because the Employee died within thirty-one days following termination of insurance.
“If the Employee has become totally disabled while less than sixty-five years of age under the conditions stated above and then furnishes not later than one year after discontinuance of premium payments for his insurance written proof to the Company at its Home Office, Columbus, Ohio, that the disability is total and permanent as herein defined, the Employee’s insurance will be extended without payment of premiums during the further continuance of total and permanent disability until one year from the date such proof was received. For the purpose of this insurance, total and permanent disability shall mean total disability as described above which has existed continuously for a period of not less than six months. The Employee’s insurance under the Policy will again be extended without payment of premiums during the continuance of total and permanent disability for successive periods of one year each, provided written proof of such continuance is submitted to the Home Office of the Company within the respective three months period immediately preceding the beginning of the year.
“The Company shall have the right and opportunity to have such Employee examined by physicians designated by it when and so often as it may reasonably require during disability, but not more frequently than annually after the insurance has been extended for two full years.
“In the event of the death of the Employee, the Company shall be liable under these provisions only if written notice of claim is given at the Home Office within one year from the date of death. Payment hereunder will be made to the Bene[629]*629ficiary, provided, however, that any Beneficiary designation in an individual policy issued under the provisions of the ‘Conversion Privilege’ shall, if different from the designation for the insurance under this Policy, be considered notice of change óf Beneficiary for any claim presented under this section.
“If the Employee has furnished due proof that he is totally and permanently disabled but nevertheless again becomes able to perform some work or engage in some business or occupation for compensation or profit, or if the Employee remains totally and permanently disabled, but refuses to be examined as above or fails to furnish within the time allowed satisfactory proof of continuance of total and permanent disability, all insurance of the Employee under this section shall immediately terminate. The Employee shall thereupon be entitled to rights and benefits under the Conversion Privilege, together with insurance protection during the thirty-one day period allowed for conversion, as if employment had then terminated, unless the Employee returns to work with the Policyholder during such period and is again insured under the Policy. If the Employee returns to active work and is otherwise eligible for life insurance hereunder, the life insurance shall be reinstated for an amount determined in accordance with the schedule of insurance applicable to him on his return to active work and on the basis of his basic hourly rate of earnings at that time.
“If the Policy terminates, an Employee’s life insurance shall be continued in accordance with the foregoing provisions in an amount equal to the amount in force on the date of termination.
“If an individual policy of Life Insurance shall have been issued to the Employee in accordance with the provision of the Policy entitled ‘Conversion Privilege’ the amount payable under the foregoing provisions will be reduced by the amount of such individual policy unless such policy is surrendered to the Company without claim thereunder except for the return of any premium paid on such individual policy.”

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Bluebook (online)
250 F. Supp. 627, 1965 U.S. Dist. LEXIS 6231, Counsel Stack Legal Research, https://law.counselstack.com/opinion/shands-v-nationwide-life-insurance-gand-1965.