Bagnall v. Travelers Insurance

California Court of Appeal Feb 13, 1931 No. Docket No. 7741.Published

Before: Spence

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Holding. The court held that under the policy's provisions, an insured is entitled to disability benefits during the period of total disability if that disability lasts at least three months and there is a pending claim that the disability may be permanent, even if the insured later recovers.

Issues

Whether recovery under the insurance policies requires proof that the disability is both total and permanent.
Whether the policy provisions allow for disability benefits when a total disability lasts for more than three months and is potentially permanent, even if the insured eventually recovers.

Disposition. affirmed

Quotations verified verbatim against the opinion

“we construe paragraph (3) to mean that while awaiting adequate and sufficient proof of a claim that an existing total disability lasting for at least three months will be permanent, the company will grant the benefits during the continuance”

“the insured is clearly entitled under paragraph (3) to the disability benefits of the policy during the continuance of the total disability.”

SPENCE, J.

Plaintiff sought to recover the benefits to which he claimed to be entitled under the disability provisions of three life insurance policies. Upon a triál by the court sitting without a jury judgment was entered in favor of plaintiff, from which judgment defendant appeals.

On July 19, 1926, plaintiff became totally disabled as the result of a disease known as hyper-thyroidism and remained so totally disabled from that date until February 14, 1927. Plaintiff returned to work on February 15th and was not totally disabled thereafter. The court found that “plaintiff became wholly disabled by a disease and was prevented thereby from engaging in any occupation or employment for wages or profit for a period of more than three consecutive

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months, to-wit, from July 19, 1926, to February 14, 1927 ... ”; that “said disease was of such a nature that such total disability might have been and was likely to have been permanent and have continued for life”; and that “during said period, due proof of a claim under said policies that such disability would be permanent and continue for life, was pending”. . Thereupon the court awarded plaintiff disability benefits under the policies covering the period from July 19, 1926, to February 14, 1927.

The main question presented on this appeal involves the construction of the disability provisions of the policies. Appellant contends that recovery under the policies depends upon due proof of a disability which is both total and permanent.

The disability provisions of the three policies were the same and the following paragraphs contained in all three of the policies will be numbered to facilitate reference thereto.

(1) “Upon due proof that . . . the insured has become wholly disabled by bodily injuries or disease and will be continuously and wholly prevented thereby for life from engaging in any occupation or employment for wage or profit, the company will waive the payment of any premiums which may fall due on this contract during such disability and will pay from the commencement of such disability and during its continuance the disability income stated on the first page of this contract. ...”

Bagnall v. Travelers Insurance

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SPENCE, J.

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