UNITED SECURITY LIFE INSURANCE COMPANY v. St. Clair

130 So. 2d 213, 41 Ala. App. 243, 1961 Ala. App. LEXIS 397
CourtAlabama Court of Appeals
DecidedFebruary 21, 1961
Docket6 Div. 783
StatusPublished
Cited by13 cases

This text of 130 So. 2d 213 (UNITED SECURITY LIFE INSURANCE COMPANY v. St. Clair) is published on Counsel Stack Legal Research, covering Alabama Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
UNITED SECURITY LIFE INSURANCE COMPANY v. St. Clair, 130 So. 2d 213, 41 Ala. App. 243, 1961 Ala. App. LEXIS 397 (Ala. Ct. App. 1961).

Opinion

*246 HARWOOD, Presiding Judge.

This is an appeal from a judgment in favor of Belle St. Clair, as Administratrix of the estate of Sam C. St. Clair, resulting from her action seeking damages under a hospital insurance policy issued by the appellant, the United Security Life Insurance Company.

The evidence presented below is in many aspects without material contradictions, and as to this portion of the evidence we think it tends to show that on 1 December 1954, Mr.. Sam C. St. Clair took out a policy with the Home Security Life Insurance Association, a precursor of this appellant, by which the company promised to pay indemnity for loss due to hospital' expenses resulting from accidental injury or sickness. In his application for the original policy Mr. St. Clair disclosed that he had suffered from an arterial condition of the right leg, and this original policy contained a waiver of liability by insured for expenses resulting from “treatment for recurrence of arterial disease of either leg.” Thereafter Mr. St. Clair paid all the premiums due upon the original policy and kept the same in full effect down through April 1957. At about this time the appellant, United Security Life Insurance Company, took over the Home Security Life Insurance Association, and assumed the policies of the said Home Security Life Insurance Association, and premiums thereon were regularly paid.

Thereafter on 4 May 1957, Mrs. Sara Rodgers, an employee and agent of the appellant went to the home of Mr. and Mrs. St. Clair and took an application for a hospital expense policy to be issued in lieu of the policy in the Home Security Life Insurance Association. The only parts or questions of this application that were filled out show only that the name of the applicant and member of the family group were Sam C. St. Clair and Belle R. St. Clair, together with their address in Birmingham, Alabama. This application bears the signature of Sam C. St. Clair, though Mrs. Rodgers testified that she signed Mr. St. Clair’s name to the application stating she did not have Mr. St. Clair sign it because, “I didn’t have to.” The application also acknowledges the payment of the first month’s premium.

In this connection it might be well to interpolate that Mrs. Rodgers testified in substance that she told Mr. St. Clair that the policy to be issued by the appellant was to be in lieu of the original policy issued from the Home Security Life Insurance Association, and was to contain, all the provisions and any waiver or limitation of liability contained in. the original policy.

On the other hand Mrs. St. Clair testified that she was present during parts of the conversation between Mrs. Rodgers and Mr. St. Clair, but was not present during the entire conversation as she was in and out of the room. Mrs. St. Clair testified that at none of the times that she was present during the conversation was anything said by either Mrs. Rodgers or Mr. St. Clair relative to any limitation of liability provision to appear in the new policy to be issued by the , appellant. ’. ’

Thereafter a policy was issued by the appellant by which it, promised to pay indemnity for loss resulting from accidental injury or sickness. The effective date of this policy is 1 December 1954, the same date of the original policy issued by the Home Security Life Insurance Association.

Mrs. St. Clair testified that there was no rider attached to this second policy imposing any limitation of liability resulting from any particular disease or sickness.

*247 In the policy issued by the appellant, sickness is defined as :

“ ‘Sickness’ as used in this policy means sickness or disease contracted and commencing after this policy has been maintained in force for not less than thirty days after its date and causing loss commencing while this policy is in force, subject to the exceptions, reductions and limitations hereinafter expressed.”

Dr. James B. Shelton was called as a witness for the plaintiff in the proceedings below. Dr. Shelton’s direct examination was concerned principally with the reasonableness of the hospital, surgical and medical bills incurred by Mr. St. Clair.

On cross-examination Dr. Shelton testified that he saw Mr. Sam C. St. Clair in January of 1954, and that at that time he had an arterial disease of his right leg; that in August of 1958, Mr. St. Clair was hospitalized for Burger’s disease, or arterial disease of his right leg, and that he was hospitalized again in October of 1958 for this same condition.

During this last hospitalization it was necessary to amputate Mr. St. Clair’s right leg.

This is all of the testimony relative to Mr. St. Clair’s medical history, or diseases other than Mrs. St. Clair’s testimony to the effect that Mr. St. Clair’s first hospitalization in August of 1958 was for the treatment of an infected callus on his foot.

The record shows that the suit on the policy issued by the appellant was originally filed in the Intermediate Civil Court of Jefferson County and the judgment was there rendered in favor of the plaintiff in the sum of $907.32; and that from this judgment the defendant, appellant here, perfected its appeal to the Circuit Court of Jefferson County, where the proceedings were de novo.

In the Circuit Court the appellant filed what it termed a plea in abatement setting up in substance that the plaintiff had failed’ to furnish the defendant company with proof of loss within 90 days after the time in which the defendant might be liable for damages under the policy, and in fact had never furnished proof of loss. The plaintiff filed a motion to strike said plea in abatement on the grounds, among others, that the defendant had waived its right to file such plea in that it affirmatively appeared that the defendant did not file any plea in abatement when the case was tried before the Intermediate Civil Court of Jefferson County, Alabama, but rather joined issue and said case was tried on the merits, and judgment was rendered for the plaintiff, and said judgment was appealed.

The court granted the plaintiff’s motion to strike the plea in abatement and this action by the court is the basis of appellant’s assignment of error No. 2.

This assignment is without merit, in' that by joining issue in the Intermediate Civil Court, the appellant abandoned its right to plead any matter then existing, in abatement, and this right having- once been abandoned in that court, it-cannot be revived by an appeal to the Circuit Court. Noles v. Marable, 50 Ala. 366.

Furthermore, Mrs. St. Clair testified that after the first hospitalization her husband, in her presence, filled out a form for a claim for medical expenses and sent it to the United Security Life Insurance Company office, and in return Mr. St. Clair received a letter from the Claims Department of the company which stated .in substance that the company refused payment because of the special agreement stipulating that no amount would be payable for any loss resulting from arterial disease of either of Mr. St. Clair’s legs. This letter was received in evidence.

Where an insurer refuses to pay an insured on some grounds other than failure to furnish proof of loss, .it waives the requirement of such proof, Byrd v. Aetna Life Insurance Company, 25 Ala. App. 318, 146 So.

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Bluebook (online)
130 So. 2d 213, 41 Ala. App. 243, 1961 Ala. App. LEXIS 397, Counsel Stack Legal Research, https://law.counselstack.com/opinion/united-security-life-insurance-company-v-st-clair-alactapp-1961.