Thompson v. New York Life Ins. Co.

164 So. 491
CourtLouisiana Court of Appeal
DecidedDecember 13, 1935
DocketNo. 5073.
StatusPublished
Cited by1 cases

This text of 164 So. 491 (Thompson v. New York Life Ins. Co.) is published on Counsel Stack Legal Research, covering Louisiana Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Thompson v. New York Life Ins. Co., 164 So. 491 (La. Ct. App. 1935).

Opinion

DREW, Judge.

Plaintiff is insured under two life insurance policies issued by the defendant in 1920, one for the sum of $1,000 and one for $2,000. Each policy provides for disability benefits in the amount of one-tenth of the face value of the policies annually after the disability should arise, and for waiver of premiums.

Plaintiff sued for a refund of premiums paid by him, amounting to $264.04, and for disability benefits for one year, amounting to $300, and claimed, under Act No. 310 of 1910, a penalty of double the amount due for failure of the defendant to pay the disability benefits. Pie also claimed reasonable attorney’s fees.

Plaintiff’s contention is that he became totally and permanently disabled, within the meaning of each of said policies, on or about January 8, 1931, at which time he was suffering with chronic myocarditis and chronic bronchitis, which wholly disabled him permanently and continuously from engaging in any occupation for remuneration or profit, and that his condition from that date on had continuously grown worse and, since January 17, 1932, he had been confined to his bed most of the time. That, notwithstanding his condition and against the advice of his physician, he endeavored to continue to work and to perform some of his duties as superintendent of W. K. Henderson Iron Works & Supply Company,, until November 10, 1931.

The clause in said policies, under which plaintiff makes his claim, is as follows:

“Whenever the Company receives due proof, before default in the payment of premium, that the insured, before the anniversary of the policy on which the insured’s age at nearest birthday is 60 years and subsequent to the delivery hereof, has become wholly disabled by bodily injury or disease so that he is and will be presumably, thereby permanently and continuously prevented from engaging in any occupation whatsoever for remuneration or profit, and that such disability has then existed for not less than 60 days — the permanent loss of the sight of both eyes, or the severance of both hands or of both feet, or of one entire hand and one entire foot, to be considered a total and permanent disability without prejudice to other causes of disability, then—
“1. Waiver of Premium.. — Commencing with the anniversary of the policy next succeeding the receipt of such proof, the Company will on each anniversary waive payment of the premium for the ensuing insurance year, and, in any settlement of the policy, the Company will not deduct the premiums so waived. The loan and surrender values provided for under Sections 3 and 4 shall be calculated on the basis employed in said sections, the same as if the waived premiums had been paid as they became due.
*492 “2. Life Income to Insured.- — One year after the anniversary of the policy next succeeding the receipt of such proof, the Company will pay the insured a sum equal to one-tenth of the face of the policy and a like sum on each anniversary thereafter during the lifetime and continued disability of the insured. Such income payments shall not reduce the sum payable in any settlement of the policy. The policy must be returned to the Company for endorsement thereon of each income payment. If there be any indebtedness on the policy, the interest thereon may be deducted from each income payment.
“3. Recovery from Disability. — The Company may at any time and from time to time, 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 the insured is no longer wholly disabled as aforesaid, no further premiums shall be waived nor income payments made.
“The Quar. annual premium for the total and permanent disability benefits is $1.36, and is included in the premium stated on the first page of the policy. Any premium due on or after the anniversary of the policy on which the age of the insured at nearest birthday is 60, shall be reduced by the amount of premium charged for the disability benefits.”

Plaintiff further alleged that he made due proof of disability before default in the payment of premiums, and paid premiums thereafter in the amount of $264.-04.

Defendant admits the contract of insurance and payment of premiums as alleged, but denies that plaintiff was disabled, within the intendment of the policies, before the anniversary of the policy on which the insured’s age at his nearest birthday was sixty years. It further avers that the proof made by plaintiff does not bring him under the provisions of the policies sued on.

The lower court rendered judgment for plaintiff as prayed for, and fixed the attorney’s fees at $250; from this judgment, defendant has prosecuted this appeal.

Plaintiff was born June 25, 1871, therefore, he reached his sixtieth birthday on June 25, 1931. Both policies sued on were issued on August 19, 1920. The anniversary of the policies on which the insured’s age at his nearest birthday was sixty. years was August 19, 1931. The proof of disability made by plaintiff was of date February 15, 1932. The questions and. answers on the- proof sheet made by plaintiff and which are pertinent to the question here are as follows:

“8. (a) Are you wholly disabled at the present time?
“A. See doctor’s report.
“(b) State cause of disability — •
“See doctor’s report.
“9. (a) On what date did the illness begin that led up to the present disability and what was the nature of the illness?
“A, See Dr. Gowen’s report.
“(b) Give name and address of the first physician consulted at the beginning of that illness.
“A. Dr. Chas. A. Gowen, Shreveport, La.
“(c) State date on which you first consulted that physician.
“A. January 15, 1931.
“(d) Give names of all other physicians consulted and dates of such consultations.
“A. Dr. Heard. See report.
“10. From what date has your disability prevented you from engaging in any occupation whatsoever for remuneration or profit?
“A. 11 — 10.— 31.
mo. day yr.”

Accompanying this proof sheet filled out by plaintiff was a proof sheet filled out by Dr. Heard, plaintiff’s physician, in which the following questions were answered by Dr. Heard, as follows:

“7. Diagnosis and symptoms of disease, infirmity, or injury, causing disability?
“A. Chronic myocarditis; chronic bronchitis — severe marked dyspnoea.
“8. (a) Is the insured in your opinion wholly disabled and prevented from engaging in any occupation whatsoever for remuneration or profit?
“A. Yes.
“(b) If he is, from what date, to your knowledge, has he been so prevented?
“A. Jan. 17, 1932.

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Related

Thompson v. New York Life Ins. Co.
166 So. 863 (Louisiana Court of Appeal, 1936)

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Bluebook (online)
164 So. 491, Counsel Stack Legal Research, https://law.counselstack.com/opinion/thompson-v-new-york-life-ins-co-lactapp-1935.