Woods v. Central States Life Insurance

271 N.W. 850, 132 Neb. 261, 1937 Neb. LEXIS 165
CourtNebraska Supreme Court
DecidedFebruary 26, 1937
DocketNo. 29785
StatusPublished
Cited by12 cases

This text of 271 N.W. 850 (Woods v. Central States Life Insurance) is published on Counsel Stack Legal Research, covering Nebraska Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Woods v. Central States Life Insurance, 271 N.W. 850, 132 Neb. 261, 1937 Neb. LEXIS 165 (Neb. 1937).

Opinion

Carter, J.

This is an action on a policy of insurance to recover total permanent disability benefits alleged to have accrued thereunder. The insurance company contended that plaintiff was able to perform work and to follow occupations for compensation, gain and profit, and that liability had therefore ceased under the express provisions of the policy. A jury was waived and a trial had to the court. The trial court [262]*262found for the defendant and dismissed plaintiff’s petition: From the overruling' of his motion for a new trial, plaintiff appeals.

The policy provided for the payment of benefits when proof was made that the insured “has become wholly and permanently disabled by bodily injury or disease, so that he is and will be permanently, continuously and wholly prevented thereby from performing any work for compensation or profit or from following any gainful occupation.” The cessation clause in the policy provided that, “if it shall appear to the company that the insured is able to perform any work or to follow any occupation whatsoever for compensation, gain or profit, the company’s obligations as above set forth shall cease.”

In a suit on a policy containing similar clauses to the ones above quoted, the Missouri court of appeals said: “In other words, the insuring clause gives the right to benefits when insured is disabled so as to prevent the doing of certain things. The last clause but negatives his right to benefits when he is not so prevented, but when he is able so to engage and does so engage. They are correlative clauses. Both are to be given the same construction. It would be anomalous that the language employed when found in the insuring clause in one part of the policy should be given one construction and when found in another part of the policy should be given another. In the insuring clause, such language is construed to mean that insured is totally disabled when he cannot perform the material and substantial acts of his occupation and is thereupon entitled to benefits; in the last (so-called conduct) clause, it is to be construed as meaning that plaintiff is not totally disabled when he is able to and does perform the substantial and material acts of his occupation and is not in such event entitled to benefits. There is then no conflict between the two clauses. The latter has no effect to limit or vary the former. It is but declaratory of the former. It was doubtless, inserted in the policies to enable the defendant to review the condition of plaintiff and his disabilities from time to time and to dis[263]*263charge itself of liability under the policies when it is found that plaintiff’s disabled condition has so far improved that he is again able substantially to carry on his occupation or substantially to engage in others.” Stoner v. New York Life Ins. Co., 90 S. W. (2d) (Mo. App.) 784. It is clear, therefore, that the-addition of the cessation clause in no way changes the liability created in the first-quoted section of the policy.

The plaintiff in the case at bar was a registered pharmacist at the time he became disabled by an attack of infantile paralysis. It is not disputed that he is completely paralyzed below the waist and that his left arm is somewhat impaired. Neither is it disputed that his physical condition has not improved since he was afflicted with this disease and that his means of locomotion is limited to the use of a wheel chair. Total disability benefits were paid by the insurance company until April, 1932, after which further payments were discontinued. The only reason advanced by the insurance company for not continuing to pay the total disability benefits provided by the policy is that the insured was elected county treasurer of Brown county in 1930 and reelected in 1934, and that this is conclusive proof that insured is able to perform work or follow an occupation for compensation, gain or profit as provided in the policy.

The rule applicable is well stated in Missouri State Life Ins. Co. v. Case, 189 Ark. 223, 71 S. W. (2d) 199, as follows : “In construing provisions in policies relating to total and permanent disability sufficient to prevent the insured from engaging in any gainful occupation, the rule has been often stated to the effect that we do not give to these provisions a strict and literal interpretation, on the theory that a fair intention of the parties to the contract of insurance is that the insured shall receive indemnity when he is disabled to the extent that he is unable to carry on any business which, without the disability, he would be able to do or capable of engaging in. Therefore, to come within the meaning of the contract of indemnity, it is not required [264]*264that the insured shall be absolutely helpless, but he is totally disabled when the infirmity from which he suffers renders him unable to perform all the substantial and material acts of his business, or the execution of those acts in the usual and customary way.” See, also, Aetna Life Ins. Co. v. Person, 188 Ark. 864, 67 S. W. (2d) 1007; National Life & Accident Ins. Co. v. O’Brien's Exrx., 155 Ky. 498, 159 S. W. 1134; Atlantic Life Ins. Co. v. Worley, 161 Va. 951, 172 S. E. 168; Metropolitan Life Ins. Co. v. Blue, 222 Ala. 665, 133 So. 707; Cooper v. Metropolitan Life Ins. Co., 317 Pa. St. 405, 177 Atl. 43; Foglesong v. Modern Brotherhood of America, 121 Mo. App. 548, 97 S. W. 240; Nickolopulos v. Equitable Life Assurance Society, 113 N. J. Law, 450, 174 Atl. 759; Hamblin v. Equitable Life Assurance Society, 124 Neb. 841, 248 N. W. 397; Oswald v. Equitable Life Assurance Society, 128 Neb. 173, 258 N. W. 41.

We conclude that a policy of insurance providing for the payment of benefits when the insured has become wholly and permanently disabled by bodily injury or disease, so that he is and will be permanently, continuously and wholly prevented thereby from performing any work for compensation or profit or from following any gainful occupation, does not mean, as its literal construction would require, a state of complete helplessness; but the total disability contemplated means inability to do all the substantial and material acts necessary to the prosecution of the insured’s business or occupation in his customary and usual manner. Under this construction of the policy, plaintiff is totally and permanently disabled and entitled to recover the benefits provided for in the policy.

The defendant contends- that plaintiff, in holding the office of county treasurer, is actually engaged in an occupation for compensation, gain or profit within the meaning of the provisions of the policy and that there is, therefore, no existing liability for the payment of indemnity.

In Mutual Life Ins. Co. v. Marsh, 186 Ark. 861, 56 S. W. (2d) 433, it is disclosed that Marsh was a traveling salesman for a drug company. He was injured in an accident [265]*265and was left partially paralyzed. He was totally and permanently disabled in the ordinary sense, but payment was resisted for the reason that he was no longer disabled within the meaning of the policy and was able to work and engage in a gainful occupation for the reason that he had been elected circuit clerk. The court, in ruling against the insurance company, said:

“We do not agree, however, with the theory held by the appellant, for, if we adopt it, no case of total disability can arise except where not only the body is disabled, but the mind wrecked as well.

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Cite This Page — Counsel Stack

Bluebook (online)
271 N.W. 850, 132 Neb. 261, 1937 Neb. LEXIS 165, Counsel Stack Legal Research, https://law.counselstack.com/opinion/woods-v-central-states-life-insurance-neb-1937.