American Ins. Co. of Tex. v. Neal, 5-2630

• Decision Date: 05 March 1962
• Docket Number: No. 5-2630,5-2630
• Citation: 234 Ark. 784,354 S.W.2d 741
• Parties: AMERICAN INSURANCE CO. OF TEXAS, Appellant, v. Myrtle E. NEAL, Appellee.
• Court: Arkansas Supreme Court

Page 741

354 S.W.2d 741

234 Ark. 784

AMERICAN INSURANCE CO. OF TEXAS, Appellant, v. Myrtle E. NEAL, Appellee.

No. 5-2630.

Supreme Court of Arkansas.

March 5, 1962.

Rehearing Denied April 2, 1962.

Paul K. Roberts, Warren, Percy C. Fewell, Dallas, Tex., for appellant.

Clint Huey, Warren, for appellee.

BOHLINGER, Justice.

The appellee brought this action to recover from the appellant a sum of money which she alleged was due under a 1955 insurance policy for expenses incurred by her in connection with hospital confinement and surgery in October, 1960.

The appellant, insurer, answered and denied liability on the grounds that the physical conditions which required hospitalization and surgery did not originate after October 20, 1955, which was six months after the effective date of its policy. The clauses under which this defense is interposed are as follows:

'PART A HOSPITAL EXPENSE BENEFITS

'(c) Sickness, the cause of which originates more than six months after the effective date of this policy and which requires surgery;

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'EXCEPTIONS REDUCTIONS WAITING PERIODS

'WAITING PERIODS. 3. Loss, fatal or otherwise, resulting directly or indirectly from, or by, Tuberculosis, High or Low Blood Pressure, Heart Trouble, Cancer, Hernia or Rupture however caused, Rheumatism, Appendicitis, Rectal or Colon Trouble however caused, Adenoids or Tonsilitis, shall be covered only if the cause of the disease originates after this Policy shall have been in continuous force and effect for a period of six months from effective date. Loss due to any surgical operation, except in connection with accidental injury, shall be covered only if the cause of the disease necessitating such surgery originates after this Policy shall have been in continuous force and effective for a period of six months from effective date.'

The proof in this case discloses that an operation was performed on the appellee for anterior and posterior perineal repair; that appellee filed a claim for hospitalization; and that appellee signed two forms in regard to her claim which were her Claimant's Statements--Hospital Coverage, and Individual Hospital Insurance Form, in which she designated the date of her first symptoms as July, 1947. It is evident that in 1947 the appellee underwent some treatment for the relief of certain complications. We are indebted to the appellant for an enlightening dissertation on the ills of women instant to childbirth, but whatever the 1947 treatment was designed to relieve seems to have been effective for the appellee states that she had not been troubled with the condition for which an operation was required until 'the tomato season of 1960', which we interpret as July, 1960, at which date the policy was in force.

We think the facts in this case bring it squarely within the rule announced in State National Life Insurance Company v. Stamper, 228 Ark. 1128, 312 S.W.2d 441, wherein we had the following facts:

'In July, 1955, a little over a year after Mrs. Stamper purchased the policy of insurance, she began to suffer pain in her neck and shoulders. At first she thought it was caused by her teeth,...