Gaulden v. Pilot Life Ins. Co., 603
| Decision Date | 07 June 1957 |
| Docket Number | No. 603,603 |
| Court | North Carolina Supreme Court |
| Parties | Mrs. Thomas T. GAULDEN v. PILOT LIFE INSURANCE COMPANY. |
S. Bernard Weinstein and Robert S. Cahoon, Greensboro, for plaintiff-appellant.
Wharton & Wharton, Greensboro, for defendant-appellee.
The sole question posed for decision on this appeal is whether or not the court below committed error in concluding as a matter of law, upon the facts stipulated and the terms and provisions of the policy of insurance involved, that the plaintiff is entitled to recover only $2,000, rather than $4,000 for which she brought her action.
The provisions in the group policy bearing on the question under consideration are as follows:
'All persons directly employed on a full-time bases and compensated for services by the Policyholder may be insured under this policy.
'Eligibility
'Each person described in the preceding provision shall be eligible for insurance hereunder on July 1, 1955, * * *
'Effective Dates
'The insurance hereunder of any person shall become effective on:
provided, in either case, such person is actively at work on that date.
'The insurance on any person not actively at work on the date when his insurance hereunder would otherwise become effective shall become effective on the date such person begins or returns to active work. For the purpose of insurance hereunder, if the effective date of insurance with respect to any person falls on a day which is not a scheduled working day for such person, and if such person was actively at work on the last preceding scheduled working date, the insurance shall become effective as if the person were actively at work on such effective date.
'Endorsement
'Notwithstanding any provision herein to the contrary, if any person eligible for insurance hereunder on July 1, 1955 was not actively at work on that date, the amount of insurance in force on his life, if any, on June 30, 1955 under the Group Policy which this policy replaces shall continue in force under this policy until the earliest of the following dates:
'(c) the first date on which he is both actively at work and enrolled for insurance under this policy, and
'(d) the thirty-first day following his return to active work.
'The insurance on any person insured hereunder shall automatically cease on the date of the termination of employment of such person in the class or classes eligible for insurance hereunder.
'Cessation of active work shall be deemed to constitute termination of employment except as provided in the following paragraphs.
'If any person is absent from active work as a result of injury, sickness or retirement, his employment may be deemed to continue, for the purposes of insurance hereunder, until terminated by the Policyholder.
'If any person is absent from active work on account of leave of absence or temporary lay-off, his employment may be deemed to continue, for the purposes of insurance hereunder, but not for longer than twelve months during such absence, following which, unless he returns to active work with the Policyholder, his insurance hereunder shall terminate automatically.'
With respect to the effective date of the insured's eligibility, the facts disclose that he made written application on 6 June 1955 for coverage under the new policy of insurance, which became effective on 1 July...
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