Seufert v. Commercial Travelers' Mut. Acc. Ass'n of America

Decision Date27 February 1934
Citation189 N.E. 563,263 N.Y. 496
PartiesSEUFERT v. COMMERCIAL TRAVELERS' MUT. ACC. ASS'N OF AMERICA.
CourtNew York Court of Appeals Court of Appeals

OPINION TEXT STARTS HERE

Action by Fred L. Seufert against the Commercial Travelers' Mutual Accident Association of America. From a judgment of the Appellate Division (240 App. Div. 786, 266 N. Y. S. 5) reversing on the law a judgment of the Supreme Court, Trial Term, in favor of the plaintiff, and granting a new trial, the plaintiff appeals. In the Appellate Division, the defendant stipulated for judgment absolute in case of affirmance.

Judgment of the Appellate Division reversed, and judgment of the Trial Term affirmed.

Appeal from Supreme Court, Appellate Division, Second department.

Winfred C. Allen, of New York City, for appellant.

Charles J. Nehrbas and Henry C. Moses, both of New York City, for respondent.

HUBBS, Judge.

Appellant was the holder of a membership certificate in the respondent membership corporation, which insured him against accidental injury. On June [263 N.Y. 498]22, 1931, he suffered an injury covered by the certificate of membership. He filed a claim as provided in the certificate. The respondent refused to pay the claim upon the ground that he had ceased to be a member prior to the date of his injury. The certificate provides for the levying of assessments against members for the purpose of paying losses and expenses. It provides that the mailing of a notice of assessment shall constitute notice thereof, and that, upon failure to pay an assessment within forty-five days from the date of the notice, the membership shall terminate and the certificate be canceled without further notice.

In this action to recover upon the certificate, the complaint is in the usual form. The respondent, as a defense, alleged that an assessment was duly levied and was payable upon or before June 18, 1931, four days before the accident, that the assessment was not paid prior to the accident, and that the certificate was terminated and canceled before appellant's injury was received.

Appellant established a prima facie case by introducing the certificate in evidence and with testimony showing the accident, the furnishing of notice, and the failure to pay. The respondent concedes that appellant established a prima facie case. Respondent's evidence tends to establish that a notice of assessment was duly mailed to appellant, and that by failure to pay it the certificate by its terms terminated on June 18th, before the accident. Appellant introduced evidence that the notice was never received. The only issue litigated was whether the notice was mailed.

The learned trial court charged the jury in effect that the defense upon that issue was an affirmative one and that the burden of proof on that defense rested upon the defendant, and, if the evidence which it believes was evenly balanced, the plaintiff was entitled to recover. Whether that charge constitutes reversible error is the only question for our determination.

Proof of payment of an assessment was not a part of the plaintiff's case. Payment was not due until after notice of assessment. Nonpayment becomes a defense only after forty-five days from the date of mailing of the notice of assessment. The certificate was valid and in force until duly terminated according to its terms. It could not be terminated until a notice of assessment had been properly mailed and forty-five days had elapsed without payment of the assessment.

The defense was an affirmative one which arose after the certificate was issued, and constituted no part of the plaintiff's complaint. Fischer v. Metropolitan Life Ins. Co., 167 N. Y. 178, 60 N. E. 431. ‘The general rule of pleading, which also accords with reason, is that defenses which assume or admit the original cause of action alleged, but are based upon subsequent facts or transactions which go to...

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5 cases
  • Borman v. Borman
    • United States
    • United States State Supreme Judicial Court of Massachusetts Supreme Court
    • 16 Agosto 1979
  • Sachs v. American Central Ins. Co.
    • United States
    • New York Supreme Court
    • 15 Junio 1962
    ...the particular issue involved, the plaintiff is entitled to recover if the evidence is evenly balanced. In Seufert v. Commercial Travelers' Mut. Acc. Ass'n, 263 N.Y. 496, 189 N.E. 563, an action was brought to recover upon a certificate of accident insurance. A defense was interposed that t......
  • Northwestern Mutual Life Insurance Co. v. Linard, 614
    • United States
    • U.S. Court of Appeals — Second Circuit
    • 6 Junio 1974
    ...exclusionary provision; burden on insurer to establish violation of regulations); Seufert v. Commercial Travelers Mutual Accident Insurance Association of America, 263 N.Y. 496, 189 N.E. 563 (1934) (defense of non-payment not based on express exclusion; burden of persuasion on insurer). Thi......
  • Liberty Lumber Co. v. Pye
    • United States
    • New York District Court
    • 15 Enero 1965
    ... ... 94, 123 N.E. 146; Seufert v. Commercial Travelers' Mut. Accident Ass'n, 263 ... ...
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