Zorger v. Prudential Insurance Co. of America

282 Ill. App. 444, 1935 Ill. App. LEXIS 667
CourtAppellate Court of Illinois
DecidedNovember 20, 1935
DocketGen. No. 38,075
StatusPublished
Cited by10 cases

This text of 282 Ill. App. 444 (Zorger v. Prudential Insurance Co. of America) is published on Counsel Stack Legal Research, covering Appellate Court of Illinois primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Zorger v. Prudential Insurance Co. of America, 282 Ill. App. 444, 1935 Ill. App. LEXIS 667 (Ill. Ct. App. 1935).

Opinion

Mb. Justice Hebel

delivered the opinion of the court.

This cause is in this court on appeal by the defendant from a judgment of $10,180 for the plaintiff entered by the court upon a verdict of the jury. The plaintiff brought suit upon two certificates under a group insurance policy, and seeks to recover for a total and permanent disability. The action is based upon the provisions of the policy, which provide that if an employee, while the insurance on his life under the group policy is in full force, shall become totally and permanently disabled or physically or mentally incapacitated to such an extent that by reason of such disability or incapacity he is rendered wholly, continuously and permanently unable to perform any work for any kind of compensation of financial value during the remainder of his lifetime, the amount of insurance will be paid to the employee either in one sum six months after the company has received due proof of such disability or incapacity, or in monthly instalments during five years, in accordance with the provisions of the group policy.

The life insurance policy, also sued upon, provides that if the insured shall become totally and permanently disabled, either physically or mentally, from any cause whatsoever, to such an extent that he is rendered wholly, continuously and permanently unable to engage in any occupation or perform any kind of work for any kind of compensation of financial value during the remainder of his lifetime and such disability shall occur while said policy is in full force and effect and before any nonforfeiture provision shall become operative, the company, upon receipt of due proof of such disability, will waive premiums due after receipt by the company of said proof of such disability and will pay the insured a monthly income of $100 per month.

The facts as they appear from the evidence are that the plaintiff was insured as an employee of the defendant company under the terms of a group policy issued by the defendant. Two certificates for $4,000 each were issued by the defendant company and received by the plaintiff, together with a life insurance policy of $6,000, upon which premiums were paid to the defendant, and which were in force at the time of the instigation of this litigation.

The issues between the parties, from the facts as they appear in the record, are as to whether the plaintiff filed due proof of total and permanent disability, as required by the terms of the policies, and whether the evidence establishes that the company waived further and other proof of the disability suffered by the plaintiff by its action denying liability. Further, did the plaintiff establish by the evidence that he was totally and permanently disabled within the terms of the policies issued by the defendant?

The plaintiff filed his proof of claim alleging permanent and total disability, and upon receipt of plaintiff’s proof of loss the defendant investigated the plaintiff’s claim, and as a result of such investigation denied liability, upon the ground that the plaintiff was not totally or permanently disabled, and upon this ground alone denied liability under the provisions of the policies issued by the defendant.

The fact is that the plaintiff filed his proof of total and permanent disability upon the forms provided for by the defendant, and part of the proof of loss is the attending physician’s statement, which is signed by Dr. Joseph Mizock, and dated June 23,1931. The doctor answered the several questions, and in reply to the question to state, diagnose and describe fully the injury or illness causing the present disability, stated that the plaintiff was so disabled that he would for all time be prevented from engaging in any gainful work as the result of exophthalmic goiter, myocarditis and chronic nephritis. It also appears that the same doctor made a similar statement dated September 18,1931, the difference being* the date when the plaintiff’s health was first affected, March 3, 1931, instead of March 3, 1930, the date given in his former certificate. In the former certificate dated June 23, 1931, signed by the doctor and filed with the defendant company, it appears that he was first consulted on February 10,1931, and that he believes the insured has been continuously disabled from March 3, 1930. It is to be noted that both of these dates are prior to March 3, 1931. It is significant, however, that upon the filing of these certificates by the doctor, the defendant made an investigation and did not make any objection to the physician’s statements, other than to determine from defendant’s investigation that the plaintiff was not permanently disabled.

The defendant does not question that the proofs of loss were submitted by the plaintiff, but the contention is, as we understand from defendant’s brief, that the proofs submitted were not sufficient, and therefore the plaintiff cannot recover in this action. Among the cases cited, the defendant quotes a portion of the opinion of the court in the case of Garvis v. Northwestern Mut. Relief Ass’n, 102 Wis. 546, in which we believe the court stated a rule which is applicable to the case now before us, when it said:

“The contract required due proof of claim. That gave the assurer, necessarily, authority to require reasonable proof of the existence of the conditions upon which the claim against the company under the contract was based. The term ‘due proof’ did not require any particular form of proof which the assurer might arbitrarily demand, but such a statement of facts, reasonably verified, as, if established in court, would prima facie require payment of the claim.”

Applying this rule, the sole question to be determined is: If the evidence in support of the proof of loss establishes a prima facie case, which the defendant rejected, can the plaintiff, under the facts as they appear, recover under the terms of the policies of the defendant?

The question in this case is largely one of fact. From an examination of the record we find that a number of physicians were called as witnesses and testified as to the condition of the plaintiff, which testimony was based not only upon a physical examination, but also upon their answers to hypothetical questions. The evidence of the plaintiff clearly establishes the fact of his illness, and tends to show that he is suffering from exophthalmic goiter and a bad heart condition, and while there is some dispute as to plaintiff’s ability to engage in a gainful occupation, still it appears from all the evidence that the plaintiff is suffering from a physical disability. As to whether he is totally and permanently disabled was a question for the jury, and we are unable to say from this record that the verdict arrived at by the jury is against the manifest weight of the evidence.

In considering the objections, the defendant calls to our attention certain instructions alleged to be erroneous, but upon examination we are unable to find that the defendant for the purpose of the record made specific objection to the giving of the several instructions before the jury retired. The Civil Practice Act provides in sec. 67, ¶ 195, ch. 110, Cahill’s Ill. Rev. Stats. 1933, in part:

“. . . but all suggestions or objections to the instructions must be made before the jury retires from the bar, or within such further time as the trial court may by order allow before the jury retires from the bar, or they will be deemed to have been waived.”

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Bluebook (online)
282 Ill. App. 444, 1935 Ill. App. LEXIS 667, Counsel Stack Legal Research, https://law.counselstack.com/opinion/zorger-v-prudential-insurance-co-of-america-illappct-1935.