Crawford v. Metropolitan Life Ins. Co.

• Decision Date: 05 January 1943
• Docket Number: No. 26136.,26136.
• Parties: CRAWFORD v. METROPOLITAN LIFE INS. CO.
• Court: Missouri Court of Appeals

167 S.W.2d 915

CRAWFORD v. METROPOLITAN LIFE INS. CO.

No. 26136.

St. Louis Court of Appeals. Missouri.

January 5, 1943.

Rehearing Denied February 2, 1943.

Appeal from Circuit Court, St. Francois County; Norwin D. Houser, Judge.

"Not to be reported in State Reports."

Suit by Mary I. Crawford, against the Metropolitan Life Insurance Company to recover total and permanent disability benefits under a group life policy. From a judgment for plaintiff, defendant appeals.

Reversed and remanded.

Oliver & Oliver, of Cape Girardeau, and Fordyce, White, Mayne, Williams & Hartman, of St. Louis (Harry Cole Bates, of New York City, of counsel), for appellant.

Ely & Derrick and Karl E. Holderle, Jr., all of St. Louis, and Robert A. McIlrath, of Flat River, for respondent.

HUGHES, Presiding Judge.

This is a suit for total and permanent disability benefits, such disability alleged to have been sustained by Willis P. Crawford, who was the husband of plaintiff, and is under the terms of Group Policy 368G issued by defendant to the St. Joseph Lead Company for the benefit of its employees, the said Willis P. Crawford having been an employee of the St. Joseph Lead Company for many years preceding November 12, 1927, at which time he ceased such employment.

The provisions of the policy relied upon by the plaintiff are not set out in full in the abstract, but purport to be set out in full in appellant's brief as Section 7 and an amendment thereto.

Section 7 is as follows:

"7. Total and Permanent Disability Benefits. — On receipt by the Company at its Home Office of due proof that any Employee insured hereunder has become wholly and permanently disabled by accidental injury or disease, before attaining the age of sixty years, so that he is and will be permanently, continuously and wholly prevented thereby from performing any work for compensation or profit, the Company will waive the payment of each premium applicable to the insurance on the life of such disabled employee that may become payable thereafter under this Policy during such disability, and, in addition to such waiver, will pay to such Employee during such disability, in full settlement of all obligations hereunder pertaining to such Employee, and in lieu of the payment of insurance as herein provided such monthly or yearly installments as may be selected by such Employee by written notice to the Company at its Home Office on the following basis, to-wit:

                On basis of $1,000 of insurance either
                  Sixty monthly instalments of $ 18.00, or
                  Twenty annual      "      "    69.98, or
                  Fifteen  "         "      "    83.90, or
                  Ten      "         "      "   116.18, or
                  Five     "         "      "   214.00
                

the first installment to be paid six months after receipt of due proof of total and permanent disability. If the Employee dies during the period of total permanent disability, any installments remaining unpaid, shall be payable as they become due to the beneficiary nominated by such Employee, and such beneficiary shall have the right to commute such remaining payments into one sum on the basis of interest compounded at the rate of three and one-half per centum per annum. This provision is granted without additional cost by the Employer."

The Amendment is as follows: "Total and Permanent Disability Benefits. — Upon receipt, at its Home Office in the City of New York, of due proof that any Employee, while insured hereunder, and prior to his sixtieth birthday, has become totally and permanently disabled, as the result of bodily injury or disease, so as to be prevented thereby from engaging in any occupation and performing any work for compensation or profit, the Company will waive the payment of further premiums as to such Employee and six months after receipt of such proof, will commence to pay, in lieu of the payment of insurance at his death, monthly installments as defined below to the said Employee or to a person designated by him for the purpose, or, if such disability is due to, or is accompanied by, mental incapacity, to the beneficiary of record of the said Employee, and will continue such payments for the period provided below, should the insured continue totally and permanently disabled."

Crawford held certificates for insurance in the amount of $3,125 on and before July 2, 1927, on which date his insurance coverage was increased $125, making a total of $3,250. However, on March 21, 1927, at Crawford's written request his insurance was reduced $2,000, which would leave the total amount of his insurance $1,250 if there was a binding reduction, which plaintiff denies for the alleged reason that Crawford was of unsound mind on March 21, 1927, and for that reason the reduction never became effective.

It was plaintiff's claim that on June 11, 1927, Crawford was injured by being struck on the head while in the course of his employment; that prior thereto he was suffering from arteriosclerosis and that said disease was progressive and was accompanied by mental incapacity, and that said injury caused such condition to be aggravated by becoming active and rendered the same worse and caused epilepsy to develop, and that on and prior to the 11th day of June, 1927, and more than a year prior thereto, he was of unsound mind and incapable of managing his affairs. The amended petition on which the case was tried further alleged that on the 12th day of November, 1927, when Crawford's employment was terminated, and for a long time prior thereto, and prior to his 60th birthday, he became permanently and totally disabled as a result of bodily injury and disease.

There was a great deal of testimony adduced by both plaintiff and defendant as to Crawford's physical and mental condition from 1925 until his death on January 26, 1936. As to whether he did become totally and permanently disabled within the terms of the insurance policy and while it was in effect, and while he was an employee of the St. Joseph Lead Company, were questions for the jury to determine, provided there was substantial evidence to prove plaintiff's case, hence we must only look to the evidence to determine whether plaintiff proved a submissible case.

The holder of the insurance certificates, Willis P. Crawford, lived in Flat River, Missouri, with his wife, the plaintiff herein, and who was named as the beneficiary in his insurance certificates, together with his daughter and stepson. Plaintiff's evidence was to the effect that along the first of 1926 he told her he was going to kill her, that she was going to kill him because he had too much insurance; in 1926 or 1927, he got mad and chopped down bearing peach trees and flower bushes; he borrowed money and bought a bill of second hand goods and opened a store in one room of his home, these goods he afterwards gave away to first one and another; he quit work for a while and made candy and sold it on the streets; the children about town called him "Candy" and tormented him, and he would become very angry; he became a religious zealot and claimed to communicate with God; in March, 1927, he began having convulsions; he would refuse to take medicine and would sprinkle it about the house; in February, 1927, while the ground was frozen hard, he tried to make garden; he burned his certificates of insurance; on one occasion he jumped out of the window, saying the devil was after him; he would scratch around the house with a knife and say he was hunting his chickens, and that he heard them cheeping; on November 1, 1929, he was adjudged by the county court to be insane and was sent to the State Hospital, and at that time was under illusions and delusions, and he was suffering from hardening of the arteries or arteriosclerosis; he was released on March 23, 1930, it being thought he was safe to leave the institution as far as his behavior was concerned, but with instructions to his wife to report his condition periodically to the Hospital officials.

A number of witnesses who had worked with Crawford in the lead mines told of his eccentricities and peculiarities and gave as their opinion that he was of unsound mind. Some of the things he said and did as narrated by these witnesses were as follows: He claimed he was going to live to be 104 years old and be a great preacher; on one occasion he was lost and unable to find a neighborhood store where he often traded and which was within two blocks of his home; he couldn't get his work in the lead mine done unless someone helped him; he said his stepson was going to kill him so that he could run the home; he was always having trouble with children, they would tease him and he would swear and throw rocks at them; he would talk to himself as he walked along the street; he belonged to what was known as the Holy Roller Church, and thought he had power to cure human ills; he thought he could stop the toothache by putting his finger on the tooth, or remove warts by touching them; he was very religious and thought he had conversations with God and that God talked to him from Heaven; on one occasion in the mine he went to get a board used in drilling and came back with a railroad rail 7 or 8 feet long which could not be used for the purpose; he couldn't drill the proper amount of rock; he was supposed to drill holes 6 to 10 feet but would quit at 2, 3 or 4 feet; he invariably went to sleep in church, and on one occasion he woke up scared and got up and started out, and as he passed another man who was asleep he shook him and then turned back and hollered at the preacher, "Dead man, dead man; we've got to get him out of here;" he would talk about his head hurting him and cry; on June 11, 1927, in attempting to move an overhead sheet of tin in the mine with a metal bar, he pushed it against an electric wire and "it knocked him cold"; he would jump from one thing to another in his conversations; his condition gradually got worse; on one occasion a pump in the mine was throwing sparks and he threw a bucket of water on it and...