Claxton v. American Casualty Co. (1916) · DecisionDepot

Claxton v. American Casualty Co.

Name: California Superior Court Tentative Rulings
Creator: DecisionDepot
License: https://creativecommons.org/licenses/by-nc/4.0/

California Court of Appeal May 15, 1916 No. Civ. No. 1816.Published

Before: Richards

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Holding. The court held that the insurance policy provides indemnity for the loss of an eye regardless of whether the injury caused immediate and continuous disability, as the disability clause does not govern the lump-sum payment for the loss of a member.

Issues

Whether the complaint states a cause of action for the loss of an eye under the insurance policy.
Whether the policy's 'immediately and continuously' disability clause limits the insurer's liability for the lump-sum payment for the loss of an eye.

Disposition. Affirmed

Quotations verified verbatim against the opinion

“We cannot give our assent to such a narrow and limited interpretation of this insurance policy.”

“the intended scope of said provision was to define the conditions under which disability benefits would be payable, but not to prescribe the condition under which the lump sum -payable for the loss of the plaintiff’s eye should be due.”

Synopsis

APPEAL from a judgment of the Superior Court of the City and County of Sail Francisco. George A. Sturtevant, Judge.

The facts are stated in the opinion of the court.

RICHARDS, J.

This is an appeal from a judgment in plaintiff's favor in an action for the recovery of an amount alleged to be due upon an accident insurance policy for the loss of an eye. The only question presented is as to whether the complaint states a cause of action.

The complaint set forth the policy of insurance in full, and then proceeded to aver that while it was in effect the plaintiff suffered an accidental injury to one of his eyes which for several days thereafter seemed trivial and did not give him much concern, but which gradually developed into a cataract which destroyed the sight of his eye. The policy of insurance as shown by its heading “provides indemnity for loss of life, limb, sight or time by accidental means, and loss of time by sickness to the extent herein provided.” In the body of the policy there is a provision that for the loss of both eyes the sum of five thousand dollars, and for the loss of one eye the sum of two thousand five hundred dollars shall be payable. The policy also contains the following clause: “Part I. — If such bodily injury alone shall, directly and independently of all other causes, immediately, continuously and totally disable and prevent the insured from performing any and every kind of duty pertaining to his business or occupation, and if during the period of such continuous and total disability shall result in any one of the losses specified in Part I hereof, the company will pay the sum specified for such loss, and

in addition will pay

the weekly indemnity as provided in Part II from the date of the accident to the date of such loss.”'

There are other clauses in the policy providing that for total disability the sum of $25 per week shall be payable during the period of such continuous total disability not resulting in total loss, and that for partial disability a gradual payment shall be made depending upon the extent of the disability for a period not exceeding 52 consecutive weeks.

It is the contention of the appellant that the provision of the policy above quoted

in haec verba

limits the liability of the defendant to cases where the accident “immediately and continuously” disables and prevents the insured from per

[459]

Claxton v. American Casualty Co.

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Synopsis

RICHARDS, J.

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