Jones v. New York Life Ins. Co.

• Decision Date: 22 July 1930
• Docket Number: 22329.
• Citation: 158 Wash. 12,290 P. 333
• Court: Washington Supreme Court
• Parties: JONES v. NEW YORK LIFE INS. CO.

290 P. 333

158 Wash. 12

JONES v. NEW YORK LIFE INS. CO.

No. 22329.

Supreme Court of Washington

July 22, 1930

Department 1.

Appeal from Superior Court, King County; John A. Frater, Judge.

Action by Sadie L. Jones against the New York Life Insurance Company. From a judgment in favor of plaintiff, defendant appeals.

Reversed and action dismissed.

Wright & Catlett, of Seattle, for appellant.

George F. Hannan, of Seattle, for respondent.

PARKER J.

The plaintiff, Miss Jones, seeks recovery of total permanent disability benefits under a policy of insurance issued to her by the defendant insurance company. The cause proceeded to trial in the superior court for King county, sitting with a jury. At the conclusion of the trial, counsel for the company challenged the sufficiency of the evidence to entitled Miss Jones to any recovery, and moved for judgment of dismissal accordingly. The court denied the motion and submitted to the jury a single question by a special interrogatory, as the only question of fact to be decided in the case, which, with the jury's answer thereto, reads as follows: 'At what time in the years 1926, 1927, if at all, or 1928, did the plaintiff become totally and permanently disabled under the terms of the policy? Answer: March 1926.' Following the rendering of this special finding by the jury, no general verdict being rendered, counsel for the company again moved the court for judgment of dismissal contending that the special finding of the jury did not establish Miss Jones' right to the recovery she seeks, and also that the evidence fails to support any right of recovery, because of her failure to present to the company proof of her total permanent disability until after the time for which she seeks such benefits by this action. This motion was also denied, and final judgment rendered awarding to Miss Jones recovery as prayed for by her, from which the company has appealed to this court.

On February 11, 1921, there became effective a $2,000 life endowment and total permanent disability benefit policy issued by the company to Miss Jones, containing total permanent disability benefit provisions, reading, in so far as we need here notice, as follows:

'Whenever the Company receives due proof, before default in the payment of premium, that the Insured, * * * has become wholly disabled by bodily injury or disease, so that he is and will be presumably, thereby premanently and continuously prevented from engaging in any occupation whatsoever for remuneration or profit, and that such disability has then existed for not less than sixty days--* * * then * * * commencing with the anniversary of the Policy next succeeding the receipt of such proof, the Company will on each anniversary waive payment of the premium for the ensuing insurance year, * * * One year after the anniversary of the Policy next succeeding the receipt of such proof, the Company will pay the Insured a sum equal to one-tenth of the face of the Policy, and a like sum on each anniversary thereafter during the continued disability of the Insured within the endowment period. Such income payments shall terminate on the anniversary of the Policy preceding the maturity of the Endowment or the prior death of the Insured, and shall not reduce the sum payable in any settlement of the Policy.'

The company conceded that Miss Jones became totally permanently disabled in the spring of 1928. It paid to her, before the commencement of this action, the amount of the total permanent disability benefits accruing to her since the spring of 1928; due proof thereof being presented to the company in June, 1928. Miss Jones sued for and was awarded by the judgment recovery for total permanent disability benefits as accruing to her during the period from March, 1926, to June, 1928. In March, 1926, Miss Jones became totally permanently disabled according to the special finding of the jury, which finding is supported by the evidence, and therefore binding upon us in so far as that fact is material in our present inquiry. But the evidence does not support a conclusion that Miss Jones then or thereafter, up until 1928, regarded herself as totally permanently disabled, or that she presented proof thereof to the company.

Miss Jones testified, on direct examination, as to her illness, in 1926 and later to her notifying the company of her illness, as follows:

'Q. Miss Jones, you allege in your complaint that in March, 1926, you became ill? A. Yes, sir.

'Q. Will you just tell the jury what are the facts about that? A. In March I became ill. On the 15th day of March I entered the Laurel Beach Sanitarium.

'Q. What year? A. 1926. March 15, 1926, I entered the Laurel Beach Sanitarium. I was there until around the latter part of May, and then I came out of the Sanitarium, and * * * between the 1st and 10th of June, 1926, I notified the New York Life Insurance Company of my illness, with no response whatsoever. * * *

'Q. Miss Jones, have you a copy of the letter which you wrote to the New York Life Insurance Company in June, 1926, notifying them of your illness? A. No, sir, because the letter was written in longhand and I kept no copy.

'Q. At that time did you know that you were going to be totally and permanently disabled? A. I did not. I was in hopes the physicians would be able to get me back on my feet. * * *

'Q. And was that your situation for a year or more after that time? A. Yes, sir.'

This letter was not produced, and an officer of the company testified that its files failed to show that it ever received such a letter. However, she does not say that her letter contained any claim of total permanent disability. She further testified to calling at the local office in Seattle several times and orally claiming disability benefits, but not to her there claiming to be totally permanently disabled. On January 31, 1927, Miss Jones wrote her next letter to the company in reference to her illness, which, in so far as need be here noticed, reads:

'I have policy No. 6671569 dated February 11, 1921, for $2,000.00 with your Company. This policy also contains a sick benefit clause.

'I was sick and physically unable to do any work whatever for eight months of 1926. Unfortunately, I did not discover how valuable my policy was until about thirty days ago. I happened to be reading it over and a very good friend of mine, and another policy holder in your Company, pointed out to me that I was entitled to six months sick benefit and rebate on premium payments under the terms of my policy. I immediately took the matter up with your local office, but was informed that there was nothing they could do about the matter because I had failed to properly...