Stearns v. Prudential Ins. Co. of America

• Decision Date: 06 June 1940
• Citation: 140 S.W.2d 766,235 Mo.App. 135
• Parties: LYNNE H. STEARNS, RESPONDENT, v. THE PRUDENTIAL INSURANCE COMPANY OF AMERICA, A CORPORATION, APPELLANT
• Court: Missouri Court of Appeals

140 S.W.2d 766

235 Mo.App. 135

LYNNE H. STEARNS, RESPONDENT, v. THE PRUDENTIAL INSURANCE COMPANY OF AMERICA, A CORPORATION, APPELLANT

Court of Appeals of Missouri, Springfield

June 6, 1940

235 Mo.App. 135 at 147.

Original Opinion of May 21, 1940, Reported at: 235 Mo.App. 135.

Motion overruled.

Smith and Fulbright, JJ., concur.

OPINION

ON MOTION FOR REHEARING.

The appellant has filed a motion for a rehearing in the above entitled case, the first, and apparently the principal ground alleged therefor being:

"The first statement in the opinion handed down in this cause is erroneous. It says:

"'This is a suit on a health insurance policy.'

"This is a fundamental error. An examination of the policy sued upon discloses that it is a regular life insurance policy which contains a total and permanent disability clause ."

The opinion, following the statement complained of, sets forth, in quotations, the provision contained in the policy relating to the disability clause. The fact that it is contained in a life insurance policy is certainly immaterial, as is the designation of the character of the policy. All that is involved in this case is the disability clause, and the statement in the opinion designating it as a health insurance policy, whether an accurate or an inaccurate designation, is entirely beside the question involved, is in no way prejudicial to the appellant, and is clearly no ground for a rehearing.

The next point assigned is with reference to the following recital on page 6 of the opinion:

"Respondent started paying regular premiums, and in 1938, filed suit, which suit was compromised."

The recital is wholly immaterial and unimportant and should be, and is, stricken out, as the suit was actually filed on the 26th day of August, 1939. The abstract, with reference to this matter, shows:

". . . When they discontinued paying me the Prudential had me submit myself, I believe, to Dr. Kneibert for an examination. After they discontinued paying me in April, 1932, I started paying my regular premiums to the insurance company and continued to pay them.

. . . .

". . . Dr. Aitken examined me some time in the fall of 1935, and the company started paying me again in January, 1936, and continued paying me until December 16, 1938. My last payment was received December 16, 1938.

. . . .

". . . The company discontinued payments on January 16, 1939; that was when my next payment was due."

The inaccurate statement supra in no way affects the conclusion reached in the case, and constitutes no ground for a rehearing.

The third ground assigned is:

"This opinion holds, in effect, we might say directly holds, on page 11 of the opinion, that if a man thinks he is totally and permanently disabled, that that makes him totally and permanently disabled and entitled to the benefits of the total and permanent disability clause in the policy."

The opinion does directly hold that, under the express terms of the policy in the instant case, it is immaterial what caused the insured's total disability; that is, whether it was caused by his mental condition, as testified to by the insurance company's expert, or whether it was caused by the diseases his physicians testified he had. The fact still remains that, under the unambiguous provision of the policy and the undisputed evidence in the case, whether you adopt the theory of the insured or that of the insurance company, you come out at the same place; that the insured was totally and permanently disabled within the express provisions of the policy.

There is no possible escape from this inevitable conclusion, for under the express provision of the policy, the cause of the disability is entirely immaterial. The policy says: "If the Insured shall become totally and permanently disabled, either physically or mentally, from any cause whatsoever, . . . while this Policy is in full force and effect and the Insured is less than sixty years of age," etc., then insured...