Sapaw v. Metropolitan Life Ins. Co.
| Decision Date | 02 June 1936 |
| Docket Number | No. 23168.,23168. |
| Citation | 94 S.W.2d 1082 |
| Parties | SAPAW v. METROPOLITAN LIFE INS. CO. |
| Court | Missouri Court of Appeals |
Appeal from Circuit Court, St. Francois County; Taylor Smith, Judge.
"Not to be published in State Reports."
Action by Alfred Sapaw against the Metropolitan Life Insurance Company. Judgment for plaintiff, and defendant appeals.
Reversed and remanded with directions.
Edgar & Banta, of Ironton, and Fordyce, White, Mayne & Williams, of St. Louis (Leroy A. Lincoln, of New York City, of counsel), for appellant.
W. A. Brookshire, of Farmington, for respondent.
BENNICK, Commissioner.
This is an action by plaintiff, Alfred Sapaw, to recover the total and permanent disability benefits provided by a policy of group insurance issued by defendant, Metropolitan Life Insurance Company, to St. Joseph Lead Company for the benefit and protection of the latter's employees of whom plaintiff was one until he was laid off at the time of a reduction in the company's force on May 6, 1931.
The total and permanent disability clause in question provides that upon receipt at its home office in the city of New York of due proof that any employee, while insured under the policy, 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, and in lieu of the payment of insurance at his death, will commence to pay monthly installments of benefits computed as to number and amount upon the basis of the amount of insurance in force on the life of the employee, such payments to continue within the limits fixed by the policy so long as the insured continues to be totally and permanently disabled.
It was conceded that plaintiff was insured in the sum of $4,000, at which figure he was entitled, in the event of disability, to a maximum of one hundred monthly installments of benefits of $45.67 each.
As the case is presently submitted, the pleadings are no longer of consequence other than to say that issue was joined between the parties upon the question of whether plaintiff had become totally and permanently disabled during the course of his employment by the lead company and while the policy was in force as to him.
Upon a trial to a jury a verdict was returned in favor of plaintiff, and against defendant, in the sum of $959.07 (representing the aggregate of twenty-one installments of benefits); and from the judgment rendered in conformity with the verdict, defendant's appeal to this court has followed in the usual course.
In the submission of his case, plaintiff asked and received his instructions Nos. 1 and 2, the one upon his case in chief, and the other purporting to define the expression "total and permanent disability" as used in the policy in question.
The one instruction directed a verdict for plaintiff upon a finding by the jury that during the time that plaintiff was employed by the lead company, and while the insurance was in full force and effect as to him, he had become totally and permanently disabled by disease so as to be prevented thereby from engaging in any occupation and performing any work for compensation or profit "without endangering his life or health."
The other instruction told the jury that in determining the question of whether plaintiff was totally disabled on May 6, 1931, the date of the termination of his employment by the lead company, and whether he had been totally disabled continuously from that date, it was not necessary that the jury should find that he was absolutely physically disabled to such an extent as to render him unable to perform any act or kind of business pertaining to any occupation, business, or profession, but that "it is sufficient to find that his ailments and diseases, if any, are such that common care and prudence would require him, in order to preserve his life and health, to desist in the pursuit of his occupation, business, or profession."
Thus both instructions were drawn upon the theory that even though plaintiff concededly worked for the lead company up to the very moment of his discharge, he was nevertheless entitled to claim that he had become totally and permanently disabled prior to the termination of his employment so as to bring himself within the coverage of the policy, provided only that his work for the lead company was done with danger to his life or health.
Defendant complains of both instructions in such respect, contending that in a case such as this where the employee actually worked at his employment until the time of his discharge, the rule that he can recover where work would endanger his life or health is inapplicable, and that in any event in this particular case there was no evidence upon the issue of whether plaintiff's work did endanger his life or health so as to have warranted the submission of such issue in the two instructions in question.
As to the first of defendant's contentions, suffice it to say that however different the rule may be in certain other jurisdictions, it is now definitely agreed in this state, where a liberal interpretation of insurance policies obtains, that even though the plaintiff who sues on the disability clause of an insurance policy may have worked for a time for remuneration notwithstanding the great physical effort required, the pain suffered, and the danger to life and health incurred, and though common care and prudence would have required a person in his physical condition to cease from work, yet the mere fact that he did so work does not of itself serve to show as a matter of law that he was not in fact totally disabled at the time within the meaning of his policy. Moss v. Metropolitan Life Ins. Co. (Mo.App.) 84 S.W.(2d) 395, certiorari quashed State ex rel. Metropolitan Life Ins. Co. v. Hostetter (Mo. Sup.) 92 S.W.(2d) 122; Farmer v. Metropolitan Life Ins. Co. (Mo.App.) 85 S.W. (2d) 235, certiorari quashed State ex rel. Metropolitan Life Ins. Co. v. Hostetter (Mo.Sup.) 92 S.W.(2d) 126; Young v. Metropolitan Life Ins. Co. (Mo.App.) 84 S.W.(2d) 1065; Stoner v. New York Life Ins. Co. (Mo.App.) 90 S.W.(2d) 784; Rickey v. New York Life Ins. Co. (Mo. App.) 71 S.W.(2d) 88; Wall v. Continental Casualty Co., 111 Mo.App. 504, 86 S.W. 491.
So the question decisive of the propriety of the giving of the two instructions for plaintiff is not that of whether he is now in all events barred from claiming a case of total and permanent disability inasmuch as he actually worked for his employer though at the risk of endangering his life or health, but whether there was evidence to show that his work was done with danger to his life or health.
Plaintiff was...
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