Franklin Life Ins. Co. v. Fisher

• Court: Oklahoma Supreme Court
• Writing for the Court: CULLISON, J.
• Citation: Franklin Life Ins. Co. v. Fisher, 23 P.2d 151, 164 Okla. 193, 1933 OK 397 (Okla. 1933)
• Decision Date: 20 June 1933
• Docket Number: Case Number: 21269
• Parties: FRANKLIN LIFE INS. CO. v. FISHER

1933 OK 397

23 P.2d 151

164 Okla. 193

FRANKLIN LIFE INS. CO. v. FISHER

Case Number: 21269

Supreme Court of Oklahoma

Decided: June 20, 1933

Syllabus

¶0 1. Insurance--Disability Benefits--Proof of Disability as Condition Precedent.

Where an insurance policy provides in its disability clause that due proof shall be furnished to the company at its home office that the insured is disabled as provided in the policy, then the company upon approval of such proof and upon indorsement of said policy will grant the benefits prescribed by the terms of the policy; the giving of proof by the insured to the insurance company is a condition precedent to the accrual of payments under the policy.

2. Same.

The date of furnishing proof to the insurance company and not the date disability commenced is the determining factor under a policy such as considered in the case at bar.

3. Same--Insured Held not Entitled to Recover Premiums Paid Prior to Submitting Proof of Disability.

Where an insurance company agrees to waive the payment of premiums during the continuance of disability of the policyholder, and that any premium due before the company approves the proof of disability is payable in accordance with the terms of the policy, but if due after receipt of proof, will, if paid, be refunded upon approval of such proof, and plaintiff paid certain premiums before submitting proof of disability, held, that plaintiff could not recover premiums paid before submitting proof of disability.

4. Same--Judgment for Insured not Sustained.

Record examined, and held: The judgment of the district court is reversed.

Appeal from Court of Common Pleas, Tulsa County; Wm. N. Randolph, Judge.

Action by Wilton Morris Fisher against the Franklin Life Insurance Company. Judgment for plaintiff, and defendant appeals. Reversed.

Herbert D. Mason, Harold R. Williams, and Herbert S. French, for plaintiff in error.

Yancey, Spillers & Fist (Silverman, Rosenstein & Fist, on supplemental brief), for defendant in error.

CULLISON, J.

¶1 Wilton Morris Fisher, as plaintiff, instituted suit against the Franklin Life Insurance Company, seeking to recover for amounts alleged to be due plaintiff as a result of certain disabilities. Plaintiff procured the life insurance policy under consideration from defendant in April, 1924. The policy was in amount of $ 2,500, with a supplemental agreement attached providing for certain disability benefits in the nature of a waiver of premiums and the payments of monthly income. The policy provided, in substance, that defendant would waive payment of premiums during disability after the receipt of proof of disability of the policyholder, and that during such disability the company would pay the insured a monthly income of $ 10 for each $ 1,000 worth of insurance carried.

¶2 Plaintiff alleges that he has been disabled from February, 1925, to April, 1929, and that his disability benefits are provided for within the terms of said policy. In February, 1929, plaintiff submitted proof to the insurance company, stating that he had been disabled since 1925, and requested payment from 1925 to 1929 in the sum of $ 25 per month, and for the return of the insurance premiums paid during the said period of disability. Plaintiff recovered judgment in the trial of said cause, and defendant appeals to this court.

¶3 Defendant presents two questions, briefly as follows: That the judgment is not supported by the record; and that the court erred in instructing the jury.

¶4 The decision of this court hinges upon the construction of the supplemental agreement attached to said insurance policy containing the clause relative to waiver of premiums and monthly incomes. Plaintiff's first cause of action as pleaded in his petition pertains to the amount of money alleged to be due under the terms and conditions of his insurance policy, which said clauses are as follows:

"If due proof shall be furnished to the company at its home office that the insured, before the anniversary of said policy on which the insured's age at nearest birthday is 60 years and after the issuance of said policy and the payment of at least one full annual premium thereon and before default in the payment of any subsequent premium, has either (a) become totally and permanently disabled by bodily injury or disease so that he is and will continue to be for life totally and permanently prevented thereby from the performance of any work or the transaction of any business for compensation or profit, or (b) been totally and continuously disabled for a period of not less than three consecutive months and during all of that time has been prevented thereby from the performance of any work or the transaction of any business for compensation or profit, then the company upon approval of such proof and upon indorsement on said policy will grant the following benefits:***

"Monthly income. The company agrees to pay to the insured a monthly income of $ 10 for each $ 1,000 of the principal sum insured under said policy during, the continuance of such disability. The first income payment shall become due on the first day of the calendar month following receipt of due proof of total and permanent disability, as defined in (a) above, or, due proof of continuous total disability for three consecutive months, as defined in (b) above, and succeeding payments shall become due on the first day of each calendar month thereafter during the continuance of such disability. Any income payments accruing before the company approves the proof of disability shall become payable upon such approval and subsequent payments will be made as they become due. Any income payment so made during such disability shall not be deducted from the sum payable in any settlement of said policy. Interest on any indebtedness to the company said policy shall be deducted from the income payments herein provided."

¶5 Plaintiff contends that there was $ 1,250 due as disability payments under the terms of said policy from February, 1925, to and including April, 1929. The record further shows that plaintiff submitted proof of disability to defendant on or about February, 1929, and the gist of the contention between the parties to this suit in the first cause or action is whether plaintiff can recover for said disability payments under the terms of the policy prior to the date plaintiff furnished defendant with proof of disability. If the submitting of proof of disability was a condition precedent to the operation of said clause of insurance entitling plaintiff to receive said disability benefits, then said disability benefits began to accrue upon the date of filing said proof, provided said disability was established.

¶6 In construing the terms of the insurance contract, we must interpret the same in accordance with the language contained in said contract. The terms of that portion of the policy under consideration provide: If due proof shall be furnished to the company at its home office, the insured has either (a) become totally and permanently disabled, or (b) been totally and continuously disabled for a period of not less than three consecutive months then the company upon approval of such proof and upon indorsement on said policy, will grant the following relief: First, waiver of premium, and second, pay a monthly income.

¶7 We observe that under the terms and conditions of the policy, it became necessary for the policyholder to furnish due proof to the company at its home office touching on certain questions as designated by said policy, and upon approval of such proof and indorsing the same on the policy, the company will make the monthly payments as directed by the terms of the policy.

¶8 Plaintiff contends that the case at bar is controlled by Prudential Insurance Company of America v. Singletary, 151 Okla. 301, 3 P.2d 657. We have carefully...