United States v. Golden

34 F.2d 367, 1929 U.S. App. LEXIS 3242
CourtCourt of Appeals for the Tenth Circuit
DecidedAugust 1, 1929
Docket22
StatusPublished
Cited by34 cases

This text of 34 F.2d 367 (United States v. Golden) is published on Counsel Stack Legal Research, covering Court of Appeals for the Tenth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
United States v. Golden, 34 F.2d 367, 1929 U.S. App. LEXIS 3242 (10th Cir. 1929).

Opinion

McDERMOTT, Circuit Judge.

This is an action on a war risk insurance policy. The plaintiff claimed permanent and total disability dating from 1919. The government denied such claim and asserted that even so, the soldier had lost his right by converting his term policy into an ordinary life policy in 1926. The trial court found for the plaintiff, and this appeal results.

The whole ease is clouded by a mistake plaintiff labors under, a confusion of war risk insurance and compensation. It appears at length in his amended complaint, in the testimony, and apparently in the findings of the trial court. In his amended complaint, instead of simply alleging a permanent and total disability while the policy sued on was in force, the plaintiff set out in detail the various “ratings” of the government for purposes of compensation. Counsel for the government promptly detected the error, and moved to strike all the allegations as to “ratings” for compensation, and in support thereof said:

“That the first grammatical paragraph 6 of said amended complaint should he stricken because the said war risk insurance matures either upon the permanent total disability or death of the insured while the said insurance is in force and effect and it is immaterial whether the disability or death is due to the military service of the insured or whether any rating was ever given the said insured and therefore the said allegations in the said paragraph are immaterial and irrelevant, and do not constitute a cause of action against this defendant.”

The government is quite right in this contention. While the laws as to compensation and insurance are administered by separate divisions of the Veterans’ Bureau, and while the beneficent provisions of both laws are confined to war veterans, there the similarity *370 ends. Compensation flows from service, like pensions of old, and the soldier is not- consulted in the matter. Insurance is a contract, and the soldier takes it or leaves it alone; if he takes it, he pays for it, and his benefit is proportional to his payment. White v. U. S. 270 U. S. 180, 46 S. Ct. 274, 70 L. Ed. 530. Compensation benefits are paid to veterans to compensate them for a loss of ability to follow their pre-war occupation. It is only payable when the incapacity is traceable to a service origin and in line of duty. Compensation is “rated” in percentages, from nothing to 200 per cent., and is figuredi on comparative inability to follow a pre-war occupation. When the disability occurs is immaterial, save that it must be traceable to service origin. The amount of benefits paid are the same to all equally disabled.

On the other hand, insurance benefits go only to those who have bought and paid for policies of insurance. The amount paid depends on the amount of insurance bought. There are no degrees of disability recognized by the insurance contract — no “ratings” made. An insured must be totally and permanently disabled, or he recovers nothing; 96 per cent, disability avails him not. Nor does his disability depend upon his ability to follow his pre-war occupation; he must be disabled from following “any substantially gainful occupation.” Service origin is immaterial in insurance. If he is totally and permanently disabled while his insurance is in force, he recovers, regardless of its origin. A total disability directly traceable to service origin will not entitle him to recover,- unless it occurred while his insurance was in force.

Another' striking difference is that Congress has conferred no jurisdiction upon the courts to determine disagreements over compensation, and the Supreme Court has held there is no such jurisdiction, “at least unless his [the Director’s] decision is wholly unsupported by the evidence, or is wholly1 dependent upon a question of law or is seen to be clearly arbitrary or capricious.” Silberschein v. U. S., 266 U. S. 221, 225, 45 S. Ct. 69, 71 (69 L. Ed. 256). On the contrary, Congress expressly placed upon the courts the duty of deciding claims under insurance policies in case of disagreement of the parties. Section 19; World War Veterans Act, as amended by Act March 4, 1925, § 2 (43 Stat. 1302, 38 USCA § 445). Necessarily, therefore, the fact that' thei Bureau does not believe a man is permanently and totally disabled does not conclude the ease where a claim is made on an insurance policy; such belief starts the ease in the courts, for, if the Bureau believed he was totally and permanently disabled, there wopld be no disagreement and no jurisdiction. This is spelled out in McGovern v. U. S. (D. C.) 294 F. 108, where Judge Bo-urquin allowed a recovery, notwithstanding a rating by the Bureau of no disability, and the judgment was affirmed (C. C. A.) 299 F. 302, and writ of error dismissed, 267 U. S. 608, 45 S. Ct. 351, 69 L. Ed. 812. Judge Bourquin said:

“Incidentally, the Bureau’s determinations are not final; the statute (section 1, Act May 20, 1918, 40 Stat. 556, Comp. St. 1918, Comp. St. Ann. Supp-. 1919, § 514kk), providing that, in event of disagreement between the Bureau and insured, action like this at bar may be brought. Therein the whole matter is at large and open to contention, the proceeding in no sense a review of the Bureau’s judgment. The statute prescribing no procedure, the rule as usual is that the action will be assimilated to like actions, here, against the United States, and so in accordance with the Tucker Act (24 Stat. 505).”

This is enough to indicate the immateriality of “ratings” for compensation in an insurance case. The doctors making the “ratings” are of course competent witnesses, just as doctors examining for other purposes are; but it is their testimony that is competent, and not the Bureau’s “rating” predicated thereon. While the motion to-strike should have been sustained, the error has resulted in no prejudice, save the necessity of clearing up the resulting confusion.

Another confusing circumstance is the fact that the amended bill not only sets up the plaintiff’s claim, but also the defense and. the plaintiff’s reply thereto. Upon oral argument, we are advised that originally the action was at law, and there is in the record a stipulation waiving a jury trial. Issue was joined as to the release of the claim by the application and acceptance of the new policy, and the plaintiff’s claim of mutual mistake thereto. An equitable issue was thus presented, which must be tried by the chancellor and disposed of, before the remaining issues can be tried at law. Upon this situation developing, plaintiff’s counsel took leave to file an amended complaint, in which he set up his claim, anticipated the government’s defense, and his reply thereto; the entire case was then transferred to the equity side. However, this unusual situation in the pleadings presents no obstacle to a consideration of the controversy as actually presented by the record.

*371 The controversy may be thus summarized :

(1) The plaintiff alleges the existence of a policy of insurance in 1919 ; that he became permanently and totally disabled at that time. The government admits the policy existed at that time, but denies the disability. That is the first issue, and presents a legal question. (2) The plaintiff alleges a disagreement; the government denies it. That is the second question, a legal one.

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Cite This Page — Counsel Stack

Bluebook (online)
34 F.2d 367, 1929 U.S. App. LEXIS 3242, Counsel Stack Legal Research, https://law.counselstack.com/opinion/united-states-v-golden-ca10-1929.