Wiener v. Mutual Life Ins. Co. of New York

61 F. Supp. 430, 1945 U.S. Dist. LEXIS 2208
District Court, E.D. Missouri·Decided July 20, 1945·No. No. 3496·Published

Opinion

HULEN, District Judge.

Plaintiff instituted this action against the defendant to recover disability benefits under a policy of insurance issued by defendant. The petition is in four counts, for yearly benefits. The first count covers the period July 3, 1940, to July 3, 1941. Counts two, three, and four are for successive yearly periods. The answer put in issue the total and permanent disability of the plaintiff within the meaning of the term as used the policy during the period in question. The case was submitted to the jury on interrogatories. The jury answered the interrogatories in favor of the plaintiff, and also returned a verdict finding defendant’s refusal to pay the plaintiff was vexatious, arbitrary, and without reasonable cause, and allowed plaintiff $1500 attorneys’ fee, but no damages. The principal complaint now presented by motion for new trial of the defendant is that the Court erred in submitting to the jury the issue of vexatious refusal to pay plaintiff’s claim.

This is the second trial of this case. The first trial was in the state court. There plaintiff suffered an adverse verdict. On appeal to the St. Louis Court of Appeals, that Court, 170 S.W.2d 174, certified the case to the Supreme Court because of division in opinion. The Supreme Court reversed and remanded the case for new trial, 179 S.W.2d 39, on account of error in admission of evidence and instructions given. The record on the second trial is not substantially different than that of the first trial as summarized in the opinions of the Supreme Court.

By brief, the plaintiff submits the following circumstances in support of his position that the issue of vexatious refusal to pay was properly submitted to the jury:

“1. The fact that the defendant company had recognized the claim and paid the benefits thereunder for four years, but in 1941 ceased its payments without any apparent reason or justification.
“2. The undisputed testimony that plaintiff’s condition had not improved by 1941, but, if anything, was worse.
“3. The report by Dr. O’Neal, the defendant’s own doctor, in May, 1941, that plaintiff was still disabled and should not return to work.
“4. The inexplicable, arbitrary failure of defendant to produce any testimony on the ultimate issue, especially its failure to have the inr red examined before trial by its doctors or by a doctor appointed by the court.
“5. The ‘maneuverings’ by defendant in its pleadings in an unjustified, reprehensible effort to get immaterial, prejudicial evidence before the jury.
“6. The attitude of the company, exemplified by the statements of its adjuster, that it would only make a lump sum settlement, to get the claim off of its books, despite its contract to continue annual payments during the period of disability.”

[432]*432In examining the authorities cited by learned counsel for the plaintiff and defendant, it appears that while the opinions handed down by the appellate courts construing the statute on vexatious refusal to pay, R.S. No. 1939, Section 6040, Mo. R.S.A., are uniform as to principles of law announced, the application of the law to the fact situations in the particular cases does not present a uniform construction of the law. The authorities are agreed that a penalty for vexatious refusal to pay is not lightly to be assessed and its imposition will, with rare exceptions, be found to be based upon evidence of conduct on the part of the insurer which clearly reflects delaying tactics, bad faith, or a wilful and recalcitrant attitude toward the claimant on the policy. The cases make it clear that absent such conduct, if there is any reasonable doubt on the part of the insurer as to its liability, it is justified in refusing to pay the claim, and where' such liability is doubtful, it is error to submit to the jury the question of whether the insured’s refusal to pay was vexatious. Clower v. Fidelity-Phenix Fire Ins. Co., St. Louis Ct.App. 1921, 220 Mo.App. 1112, 296 S.W. 257; Paetz v. London Guarantee & Accident Co., Ltd. of London, England, K.C.Ct.App. 1934, 228 Mo.App. 564, 71 S.W.2d 826. The penalty should not be permitted unless the evidence and the circumstances show that the refusal to pay was wilful and without reasonable cause, as the facts would appear to a reasonably prudent man before the trial. Volz v. Travelers Insurance Co., K.C.Ct.App. 1942, 161 S.W.2d 985.

The defense urged at both trials of this cause was one of fact. Such being the case, the question of vexatious refusal to pay will not be one for the jury to pass upon unless there is “something of a substantial nature” in the case to indicate that the insurer has acted in bad faith and without reasonable cause. St. Clair v. Washington Fidelity National Insurance Co., St. Louis Court of Appeals, 89 S.W.2d 85. We review some of the cases as illustrations of what the courts have in mind when they refer to “something of a substantial nature” in the case to indicate that the insurer has acted in bad faith and without reasonable cause. In Clair v. American Bankers Ins. Co., K.C.Ct.App. 1940, 137 S.W.2d 969, it was denial of liability without making any investigation and assertion that the policy was reinsured with another company, a claim later shown to have no basis in law or fact. In Thomas v. Metropolitan Life Ins. Co., K.C.Ct.App. 1935, 230 Mo.App. 206, 89 S.W.2d 590, it was the writing of letters by the insurer which misconstrued the terms of the contract sued on, and which set up an arbitrary and false basis as the grounds for refusing to pay. In Lux v. Milwaukee Mechanics’ Ins. Co., K.C.Ct.App. 1930, 30 S.W.2d 1090, it was the raising of the issue of plaintiff’s insurable interest without a tender back of premiums. In White v. American Life & Accident Ins. Co., St. Louis Ct.App. 1936, 90 S.W.2d 118, it was defendant’s action in taking the position that at the time the policy was issued, assured was suffering from duodenal ulcers, which it claimed had contributed to his death, while assured stated in his application he was in good health. The insurance company did not have any evidence to the effect that the insured was suffering from duodenal ulcers at the time'the policy was issued. The court held that the defendant could not reasonably have expected the return of a verdict in its favor upon the issue of breach of the sound health provision of the policy. In Florea v. Iowa State Ins. Co., St.L.Ct.App. 1930, 225 Mo.App. 49, 32 S.W.2d 111, it appeared that three days after p fire loss, plaintiff notified the company’s agent; that an investigator came to the scene of the first a month later; that neither agent nor investigator would inform plaintiff as to the company’s position on paying the loss. A letter to the company got no reply. Mortgage of the premises had like experience. The local agent could get no response from the company. Such facts were held to sustain recovery of penalty for vexatious refusal to pay the loss. In Novosel v. Mid West Life Ins. Co. of Mo., K.C.Ct.App. 1925, 276 S.W.

Free access — add to your briefcase to read the full text and ask questions with AI

Wiener v. Mutual Life Ins. Co. of New York, 61 F. Supp. 430, 1945 U.S. Dist. LEXIS 2208 (E.D. Mo. 1945).

61 F. Supp. 430 (Wiener v. Mutual Life Ins. Co. of New York) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

Related

Streeter v. Washington Fidelity National Insurance
68 S.W.2d 889 (Missouri Court of Appeals, 1934)
Florea v. Iowa State Insurance
32 S.W.2d 111 (Missouri Court of Appeals, 1930)
Wiener v. Mutual Life Insurance Co. of New York
179 S.W.2d 39 (Supreme Court of Missouri, 1944)
Stearns v. Prudential Insurance Co. of America
140 S.W.2d 766 (Missouri Court of Appeals, 1940)
Clower v. Fidelity-Phenix Fire Insurance
296 S.W. 257 (Missouri Court of Appeals, 1927)
Thomas v. Metropolitan Life Insurance
89 S.W.2d 590 (Missouri Court of Appeals, 1935)
Paetz v. London Guarantee & Accident Co.
71 S.W.2d 826 (Missouri Court of Appeals, 1934)
Groves v. Great Eastern Casualty Co.
246 S.W. 1002 (Missouri Court of Appeals, 1922)
Occidental Life Ins. v. Eiler
125 F.2d 229 (Eighth Circuit, 1942)
Columbian Nat. Life Ins. Co. v. Keyes
138 F.2d 382 (Eighth Circuit, 1943)