Wood v. American Security Life Ins. Co.

304 S.W.2d 559, 1957 Tex. App. LEXIS 1989
CourtCourt of Appeals of Texas
DecidedMay 24, 1957
Docket15233
StatusPublished
Cited by14 cases

This text of 304 S.W.2d 559 (Wood v. American Security Life Ins. Co.) is published on Counsel Stack Legal Research, covering Court of Appeals of Texas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Wood v. American Security Life Ins. Co., 304 S.W.2d 559, 1957 Tex. App. LEXIS 1989 (Tex. Ct. App. 1957).

Opinions

YOUNG, Justice.

Suit in-trial court was by Mrs. Wood on a Hospital and Surgical Expense Policy issued by defendant Company, wherein she sought to be indemnified for detailed items of expense incident to hospital confinement and surgery. Upon trial and after plaintiff had rested her case, the court discharged the jury and entered a -take, nothing judgment on motion of defendant, which ruling be-r comes the subject of this appeal.

' Effective date of the policy was May 1, 1952, premium $64.30 annually. The items sued for as being within coverage of same, were incurred in February 1955, and consisted of the following:

“Surgeon fees for operation $100.00
Six days in Baylor. Hospital 60.00
Laboratory Service Fees 10.00-
Operating Room 36.00
Anesthetics 25.00
Drugs 12.50
Ambulance Service 5.00
A total of $248.50”

Defendant had denied liability, pleading certain conditions of the policy, plaintiff also suing for statutory penalty and attorney’s fee; it having been stipulated during the trial that in event of liability, above items were reasonable and customary charges as per policy schedule.

Material here, the policy provisions were as follows: “American Security Life Insurance Company, * * * a Legal Reserve Stock Company * * * hereby insures the applicant, first named in the following Schedule A, hereinafter called the Insured, and will pay, subject to all provisions and limitations herein contained, the indemnity provided herein for loss of life, limb or sight resulting from accidental bodily injury sustained while this Policy is in force, and the benefits provided herein for expense of hospital confinement commencing while this Policy is in force and other specified expenses incurred while this Policy is in force on account of the Insured and the dependent members of the Insured’s family, if any, named in said Schedule (all of whom, including the Insured, are hereinafter called the Family Group), (a) Resulting from accidental bodily injury sustained while this Policy is in force, hereinafter referred to as such injury; and (b) resulting from sickness the cause of which originates while this Policy is in force and more than fifteen days after the date hereof, hereinafter referred to as such sickness; * * Then follows Schedule A (Part One) “Hospital Expense Benefits. If the insured or any member of the Family Group shall be necessarily confined within a recognized hospital as a resident patient on account of such injury or such sickness, the Company will pay the Insured (or the Hospital if authorized by the Insured to do so) for the following items of hospital expense actually incurred by the Insured or member [561]*561of the Family Group, or incurred in behalf of the Insured or member of the Family Group by any Workmen’s Compensation insurance company, but not to exceed the amounts stated below: * * * (Part Two) Schedule of Operations * * * Abdomen, appendectomy, or other cutting through abdominal wall for diagnosis, treatment or removal of organs in abdominal cavity (unless otherwise specified herein) $100.00.”

Appellant’s points are lengthy and somewhat repetitious; being generally presented in the following statement from her brief: “that she established her cause of action when she introduced the insurance policy in question and proved up her hospitalization expenses and surgical expenses * * * and the demand for payment thereof and the insurer’s denial of all liability, and then the burden was upon the insurance company to prove that the plaintiff’s disability was caused from a sickness or a condition which originated before the date of the policy; that the burden was not upon her to prove good health”; arguing further that although the burden was upon defendant to show a lack of good health on date of policy, the fact of good health up to January 1955 was proven by all witnesses, both lay and medical; and the trial court erred in discharging the jury and rendering a'defendant’s judgment. Defendant on the other hand challenges the general position taken by plaintiff; asserting with equal vigor that “the proof offered by appellant falls short of making a jury question.” In such connection we must view the evidence in a light most favorable to the losing party; in other words, that where the verdict is instructed in favor of defendant at the close of plaintiff’s evidence, the court will assume that the facts shown by plaintiff’s evidence are true. Hoover v. General Crude Oil Co., 147 Tex. 89, 212 S.W.2d 140.

Lois Wood, a nurse by profession, was fifty years of age on date of policy; testifying to the following, in substance, in support of claim: That in January 1955, while lifting a patient, she had suffered a strain, with pain and soreness in lower abdomen which persisted, with symptoms of hernia; going to Dr. Marcus Seely, a licensed practicing physician, in February, for treatment, that her condition becoming more painful Dr. Seely advised hospitalization and surgery, committing her to Baylor Hospital where she remained from February 20 to February 26, 1955. The operation was exploratory in character; a cutting through the abdominal wall, and removal of excess tissues, liberating adhesions, excising of fatty tissues and removal of fatty tumor, left thigh. This hospitalization, surgery, etc., is reflected in the items sued for ($248.-50), though plaintiff testified that the actual expense therefor was more.

In 1942 Mrs. Wood had undergone a hysterectomy while living in Pine Bluff, Arkansas; testifying to a recovery after six or seven weeks; continuing to work while there and during her Dallas residence until the January episode of injury and sickness; that she was in sound health before issuance of policy, May 1, 1952, and after-wards for more than two years and eight months; having lost no time from duties of nursing except in May 1954, at Baylor Hospital, when she was hospitalized for 48 hours, “brought on by sheer exhaustion.” Two other witnesses attested to the good health of plaintiff and that she had worked daily before and after the date of policy.

Dr. Marcus Seely testified in substance that he had known Mrs. Wood for fifteen years, she appearing to be a healthy woman during the past four or five years;, that he had examined her in February 1955, she giving a history of unusual strain -from lifting a patient the previous January. At the time of examination she had lost considerable weight through dieting — 230 to 203 lbs.; advising hospitalization and surgery for a probable rupture “through a previous incisional scar.” He had operated on February 22; on direct examination stating the result to be: “The hernia was repaired and a section of- the pendulous fatty tissue of the abdominal walls was removed. Also, a lipoma was removed from the left thigh. [562]*562That was the extent of the operation.” Dr. Seely also said that the condition of Mrs. Wood pursuant to which the operation was performed “came about in January, 1955.”

On cross-examination of Dr. Seely, defense counsel placed in evidence his written report made at Baylor Hospital at time of the operation, disclosing no condition of hernia or its repair; the witness admitting that he had erroneously made such statement in direct testimony. Dr.

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Wood v. American Security Life Ins. Co.
304 S.W.2d 559 (Court of Appeals of Texas, 1957)

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Bluebook (online)
304 S.W.2d 559, 1957 Tex. App. LEXIS 1989, Counsel Stack Legal Research, https://law.counselstack.com/opinion/wood-v-american-security-life-ins-co-texapp-1957.