Adamaitis v. Metropolitan Life Ins. Co.
| Decision Date | 08 September 1936 |
| Citation | 295 Mass. 215,3 N.E.2d 833 |
| Parties | ADAMAITIS v. METROPOLITAN LIFE INS. CO. |
| Court | United States State Supreme Judicial Court of Massachusetts Supreme Court |
Action of contract by Charles Adamaitis against the Metropolitan Life Insurance Company. From an order of the Appellate Division for the Southern District, on a report by the trial judge, that a finding for defendant be reversed and finding for the plaintiff in the sum of $625 with interest be entered, the defendant appeals.
Reversed.
Appeal from Appellate Division of District Court Southern District; Murphy, Judge.
B. J Killion, of Boston, for appellant.
L. H Miller, of Brockton, for appellee.
This action of contract was brought in the district court to recover total and permanent disability benefits under a supplementary contract attached to a life insurance policy. See G.L.(Ter.Ed.) c. 175, § 24.
The facts that the plaintiff was insured by the defendant under a policy and supplementary total and permanent disability contract, which were in full force when the alleged disability commenced, and that the plaintiff made due proof of claim were admitted by the defendant. The policy and supplementary contract were introduced in evidence. There was evidence that they were issued on October 29, 1924. It appeared that the supplementary contract was attached to the policy and made a part thereof. This contract as described in the report, sets forth that ‘ in addition to the other benefits of the policy, if the assured, while the policy was in full force, became totally and permanently disabled as the result of bodily injury or disease occurring and originating after the issuance of said policy, so as to be prevented thereby from engaging in any occupation and performing any work for compensation or profit, the company would, during the continuance of such disability, waive the payment of each premium falling due under the said policy and contract and pay to your plaintiff the monthly sum of twenty dollars.’
It stated in print that these were all his occupations and further stated that no change in occupation was contemplated and that those were his only occupations for at least within the last ten years. The application referred to and applied to the supplementary disability contract as well as to the rest of the policy.'
The evidence tended to show that the plaintiff was permanently disabled. Apparently there was no controversy on this issue. The principal, if not the sole, controversy was whether on the evidence the plaintiff was totally disabled within the meaning of the supplementary contract.
Evidence tended to show these facts: The plaintiff, a man about fifty years of age, for about twenty years previous to February 25, 1930, was employed as a machinist at a stove manufacturing plant and ‘ also owned a small farm in which he lived * * * where he did some small amount of planting in the hours he had free from the stove factory.’ In November, 1929, ‘ the plaintiff dislocated his right shoulder tearing several ligaments and paralyzing, to a large extent, the action of the entire right shoulder and arm and forearm.’ After some time ‘ he went back on the same job in that stove factory, having some one help him and using mostly his left arm.’ On February 25, 1930, while drilling a hole, his ‘ left eye was torn out entire,’ and the ‘ right eye was impaired to so great a degree that in his right eye he had left only a partial direct vision and no lateral vision either toward the left or right.’ His ‘ mind became and remained confused and * * * he became subject to dizzy, fainting spells which left him weak and shaken, and the recurrence of which became more and more close as time went on.’ As ‘ time went on his left arm developed less grip than there was in his right arm.’ His ‘ right arm and shoulder were disabled from the accident of November, 1929 to the date of hearing.’ According to the testimony of the plaintiff's physician ‘ the plaintiff's left eye was completely missing, the right eye had only a very slight direct vision, the right arm was practically useless, the left arm had a partial motion left and the plaintiff was extremely nervous and neurotic.’
With respect to the plaintiff's ability to work the evidence was as follows: He testified, The plaintiff's physician testified that the plaintiff could not perform the duties of a machinist or farmer as he had heard them described ‘ except for the doing of occasional acts, temporary in their nature and unimportant with relation to the disability.’ A physician called by the defendant, however, testified that the plaintiff
The trial judge denied certain requests for rulings made by the plaintiff, among them request numbered 5, hereinafter set forth, and found for the defendant. There was a report to the Appellate Division. Thereafter the parties agreed ‘ that an alternative verdict may be rendered,’ and that in the event of a finding for the plaintiff it should be in the amount of $625 with interest from the date of the writ. The Appellate Division by its ‘ Finding, Decision and Order’ decided ‘ that there was prejudicial error in the trial Court in the finding for the defendant and in the refusal to grant the plaintiff's fifth request,’ and ordered the entry in the case, ‘ Finding of the trial court reversed and in accordance with agreement filed by the parties, finding for the plaintiff ro $625.00 with interest from the date of the writ.’ The defendant appealed.
1. The denial of the plaintiff's request numbered 5 was prejudicial error.
The ruling requested was as follows: any occupation and performing any work-'etc. are to be considered with regard to the fact that the Policy insures the claimant as a ‘ Machinist and Farmer."
The trial judge in a case like the present performs a dual function. He must adopt correct rules of law for his guidance and find the facts as guided by these rules. And upon proper requests therefor he must state the rules of law adopted by him for his guidance as a trier of fact in order that the right of review thereof may be preserved. John Hetherington & Sons, Ltd., v. William Firth Co., 210 Mass. 8, 18, 19, 95 N.E. 961; Castano v. Leone, 278 Mass. 429, 431, 180 N.E. 312.
Clearly the policy, the supplementary contract and the plaintiff's application for insurance were to be construed together to determine the rights of the parties. Paquette v. Prudential Ins. Co. of America, 193 Mass. 215, 220, 79 N.E. 250; Larsen v. Metropolitan Life Ins. Co., 289 Mass. 573, 194 N.E. 664. Even if the first two sentences of the requested ruling-which stated the law correctly-involved only principles of law to be applied by the judge in construing the instruments, see Bascom v. Smith, 164 Mass. 61, 76, 41 N.E. 130, the third sentence, that ‘ The words ‘ any occupation and performing any work-’ etc. are to be considered with regard to the fact that the Policy insures the claimant as a ‘ Machinist and Farmer," in effect stated a rule of law for the guidance of the judge as trier of fact. In substance the requested ruling was that the plaintiff's occupations as stated in the application were material for consideration in determining the issue of fact whether the plaintiff was totally and permanently disabled.
The requested ruling was correct. The words ‘ totally * * * disabled,’ as used in the supplementary contract, are expressly limited by the phrase ‘ so as to be prevented thereby from engaging in any occupation and performing any work for compensation or profit.’ Complete physical or mental incapacity of the insured, therefore, is not essential to his total disability within the meaning of the contract of insurance. It is sufficient that his disability is such that it prevents him from performing remunerative work of a substantial and not merely trifling character. Rezendes v. Prudential Ins. Co. of America, 285 Mass. 505, 510, 512, 189 N.E. 826; Treblas v. New York Life Ins. Co. (Mass.) 196 N.E. 908; Metropolitan Life Ins. Co. v. Foster (C.C.A.) 67 F.(2d) 264, 267. See Mutual Benefit Life Ins. Co. v. Commissioner of Insurance, 271 Mass. 365, 171 N.E. 656. And the fact that the application, which contains statements about the plaintiff's occupations,...
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