Dunn v. Standard Life & Accident Insurance Company

• Decision Date: 06 June 1917
• Citation: 196 S.W. 100,197 Mo.App. 457
• Parties: EMMA P. F. DUNN, Respondent, v. STANDARD LIFE & ACCIDENT INSURANCE COMPANY, Appellant
• Court: Missouri Court of Appeals

196 S.W. 100

197 Mo.App. 457

EMMA P. F. DUNN, Respondent, v. STANDARD LIFE & ACCIDENT INSURANCE COMPANY, Appellant

Court of Appeals of Missouri, St. Louis

June 6, 1917

Argued and Submitted May 3, 1917 [Copyrighted Material Omitted]

Appeal from St. Louis Circuit Court.--Hon. William M. Kinsey, Judge.

REVERSED.

STATEMENT.--This is an action on an insurance policy. It is averred in the petition that on July 2, 1909, the defendant, for the consideration of $ 35 then paid to it, issued and delivered to William E. Dunn its policy or contract, whereby it promised and agreed to insure Dunn for a term of twelve months from July 14, 1909, "against death caused by accidental means or by sickness," in the sum of $ 5,000 the policy being made payable in case of death to plaintiff. It is averred that Dunn died on February 24, 1910, his death "caused by disease, to-wit, by angina pectoris." Averring that defendant had been notified of the death of Dunn immediately after that occurred and that plaintiff made due proof of the death and demanded payment of the sum of $ 5000, but that defendant, denying liability under the policy had refused payment, judgment is demanded for that and interest thereon at six per cent. per annum from April 9 1910, and for costs.

The answer upon which the case was tried admits the incorporation of defendant, averring that it was incorporated and organized under and by virtue of the laws of the State of Michigan, and that it was doing business in the State of Missouri; admits that the policy sued on herein was issued and delivered to Dunn, but denies all the other averments in the petition.

For further answer, it is averred that the policy sued on is known and described as a "standard accident and limited sickness" policy, and that in and by its terms the defendant expressly agreed that if Dunn should suffer any disability as the result of certain diseases mentioned in the policy, including angina pectoris, and any of said diseases should wholly and entirely disable and prevent him from performing any and all of the business of his occupation, the defendant company would pay to him the sum of $ 25 per week during this disability, and that it was expressly provided that if Dunn died as the result of any of said diseases the limit of defendant's liability under the policy should be only the amount of weekly indemnity specified which had accrued at the time of his death. It is expressly averred that the defendant did not agree to pay any sum of money upon the death of Dunn resulting from disease.

The answer further avers that defendant, incorporated under the laws of the State of Michigan, at the time the policy in question was issued, was not authorized or empowered to enter into any contract of life insurance, or any insurance contract, other than accident insurance and for the payment of weekly benefits in certain cases, and that under the certificate of authority issued to it by the insurance department of this State, it was not authorized to enter into any contract of insurance providing for the payment of any sum in the event of death from angina pectoris, or any other disease, but on the contrary was only authorized to do the business of accident, health and employers' liability insurance within this State at the time the policy was issued. Issue was joined on these affirmative defenses by reply.

The cause was tried on an agreed statement of facts admitting the incorporation of the defendant under the laws of the State of Michigan, and that it was doing business in this State in the year 1909, and at the times mentioned in the petition, under authority of a certificate issued by the insurance department of this State. It is further admitted that plaintiff is the widow and beneficiary of the insured and that in July, 1909, defendant issued its policy to plaintiff's husband, plaintiff being the beneficiary, the premium on which was $ 35; that that was duly paid and that the policy was in force for twelve months from the 14th of July, 1909, the insured dying February 24, 1910. By the stipulation it is further provided that defendant's charter, as amended January 20, 1909, might be offered in evidence, as also the certificate of the authority of the company to do business in this State for the twelve months beginning February 1, 1909; that at the date the policy was issued, the insured was fifty years of age, and that the customary premium for a policy of life insurance for the sum of $ 5000, insuring against death however caused for a man of his age was $ 80. It was stipulated that these three last matters might be offered in evidence subject to any objection plaintiff might make, and at the trial, following the reading of the agreed statement of facts, counsel for defendant offered and read in evidence the charter and its amendments and the certificate of authority to do business in this State, plaintiff objecting. It appeared that by amendment to the charter of defendant, made in 1908, its name was changed to that of "Standard Accident Insurance Company, of Detroit, Michigan."

The policy was indorsed on the back in part and as far as material as follows:

Standard Accident and Limited Sickness Contract.

The Standard Life and Accident Insurance Company of Detroit, Michigan.

Incorporated 1884.

Policy No. S. A. & L. S. 247,014.

Name, Wm. E. Dunn.

Date, July 14th, 1909.

Term, 12 months.

Amount Insured

$ 5,000.00

Weekly Indemnity

25.00

Premium

35.00

The first page of the policy sets out that the defendant--in consideration of the truthfulness of the warranties herein and of the premium of thirty-five 00/100 dollars hereby insures William E. Dunn, for the term of twelve calendar months from noon, standard time, of the 14th day of July, 1909, against bodily injuries effected, directly and independently of all other causes, through external, accidental and violent means (suicide, whether sane or insane, not included); and against disability from sickness with the following modifications:

Death, Loss of Limb or Sight.

1. Principal Sum: Five thousand 00/100 ($ 5,000.00). Weekly Indemnity: Twenty-five 00/100 dollars ($ 25.00).

For loss of life

Principal Sum

For loss of both hands by actual sever-

ance at or above wrist

Principal Sum

For loss of both feet by actual sever-

ance at or above ankle

Principal Sum

For loss of one hand and one foot by

actual severance at or above wrist

or ankle

Principal Sum

For the irrecoverable and entire

loss of sight of both eyes

Principal Sum

For the loss of either hand by actual

severance at or above wrist

1/2 Principal Sum

For the loss of either foot by actual

severance at or above ankle

1/2 Principal Sum

For the irrecoverable and entire loss

of sight of one eye

1/2 Principal Sum

2. Additional Amount, if any of above losses result within 200 weeks: If any of the disabilities enumerated above shall result from such injuries alone, within ninety days from the date of accident, the company will pay the sum specified opposite such disability, or, if such injury shall, from the date of the accident and independently of any and all other causes, directly, immediately, wholly and continuously disable and prevent the insured from attending to any and every duty pertaining to any business or occupation, and such injury shall within Two Hundred Weeks from the date of the accident (during which time such disability shall have been total and continuous), result in any one of the losses enumerated in the above schedule, the company will pay the sum specified opposite such loss and in addition thereto the weekly indemnity mentioned above which has accrued at the time he suffers such loss, but not to exceed Two Hundred Weeks.

Weekly Indemnity

3. Total Loss of Time, or if such injury shall not result in any of the disabilities enumerated in part "1," but shall, from the date of the accident, directly and immediately, wholly and continuously disable and prevent the insured from attending to any and every kind of duty pertaining to his occupation, the company will pay him, while so disabled, for a period not to exceed two hundred consecutive weeks, the weekly indemnity mentioned above.

Partial Loss of Time, or, for a period, not exceeding twenty-six consecutive weeks, during which the insured shall, by reason of such injury, and from date of accident be directly and immediately, totally and continuously disabled from attending to one or more important daily duties pertaining to his regular occupation, or for like disability not exceeding twenty-six weeks immediately following total disability, and not extending beyond the limit thereof, the company will pay him one-half of the weekly indemnity mentioned above.

Following this are provisions for double benefits of amounts specified in the foregoing sections or clauses marked on the margin 1 2 and 3, if the insured is injured under circumstances named. Then follows the provision that if the insured should contract a disease which shall not terminate in death but, within one year from the date of the insurance or any renewal thereof, shall result in the total irrecoverable loss of the sight of both eyes, or permanent paralysis, which shall cause the insured to irrecoverably lose the use of both hands or both feet, etc., the insured will, upon proof of the continuation of the described disability for fifty-two consecutive weeks, be paid one-half the principal sum of the policy in lieu of all other indemnities. The sixth clause provides that if the insured shall suffer from angina pectoris, among other diseases and such disease or illness shall wholly and entirely disable or prevent the insured from performing any or all of the business of his occupation, the insurer will pay to him the weekly indemnity...