Schneider v. Travelers Insurance
Schneider v. Travelers Insurance
Opinion of the Court
Edwin C. Schneider, the appellant herein, while employed as an industrial insurance salesman and collector with Carolina Life Insurance Company, was insured under a group accident policy, dated October 1, 1957, by Travelers Insurance Company of Hartford, Conn., the respondent herein. This policy provided for a monthly indemnity of $250.00 for total disability resulting from accidental bodily injuries. The policy excluded from coverage the first sixty days of any period of total disability and provided, inter alia, as follows:
“If such injuries shall, within thirty days after the date of accident, result in continuous total disability (hereinafter defined) the Company will pay monthly indemnity at the rate specified in the Schedule (one-thirtieth of the monthly indemnity rate for each day of any period or part thereof less than one month) for the period of such continuous total disability, but indemnity shall not be paid for the waiting period (if any) specified in the Schedule.
“ ‘Total Disability’ as used herein means complete inability of the insured to engage in any and every occupation or employment for wage or profit, but during the first 24 months of any period of disability the Insured shall be deemed totally disabled while he is unable to perform any and every duty pertaining to his occupation and is not engaged in any occupation or employment for wage or profit.
*243 “Periodic payment will be made in case total disability for which indemnity is payable continues more than one month.”
The appellant instituted this action on July 13, 1959, alleging that while the aforesaid policy was in full force and effect he was, on October 12, 1957, struck by an automobile and as a result thereof became totally disabled. The appellant submitted to the respondent proof of his claim for total disability benefits under the aforesaid policy. It appears that the respondent, pursuant to such claim so made, paid to the appellant total disability benefits for the period from December 12, 1957 to May 27, 1958, at the rate of $250.00 per month, or a total of $1,375.00.
The appellant further alleged in his complaint that after receiving the aforesaid payments that he informed the respondent that he would attempt to work on a trial basis to see if he could overcome his disability. It is further alleged that after so informing the respondent, the appellant sought and obtained employment with the United States Government in a clerical capacity for a period of about ten months on a trial basis, but at the end of such trial period he was discharged on account of his inability to perform his work because of the aforesaid disability. It is then alleged that the appellant applied to the respondent for a reinstatement of his disability benefits under the aforesaid policy. He says that he furnished the respondent with medical reports setting forth that he was not capable of doing the type of work that was required of him before his injuries and could perform work only under a protected job situation because of his disability. It is alleged that the respondent refused to páy the appellant total disability benefits under the said policy and that he is entitled to recover the sum of $250.00 per month, as provided for in said policy in the event of total disability, for the period from April 1, 1959 to the date of this action.
The respondent admits that the appellant while insured under a term policy of group accident insurance, as an
This case came on for trial before Honorable Legare Bates, and a jury,- in the Richland County Court. At the close of the testimony in behalf of the appellant, the respondent made a motion for a nonsuit on the grounds (1) that the appellant was not totally disabled within the meaning of the aforesaid policy for the reason that the evidence shows that he was able to and did return to gainful employment; (2) that the appellant released the respondent of all liability, which terminated his right to disability benefits by accepting a final payment from the respondent and returning to work; and (3) that the policy upon which this action is based lapsed for nonpayment of premiums and since January 1, 1958 had been of no force and effect. The motion of the respondent was granted and this appeal followed.
The insured contends that the question of whether he was totally and permanently disabled within the meaning of the aforesaid policy, should have been submitted to the jury. The answer to this question requires a review of the testimony offered in behalf of the appellant.
This physiciañ testified that the appellant was interested in going back to work and he thought that the work attempt would be the best way to really decide whether the appellant was physically able to return to work. At that time his physician said: “I advised him that his type of work would certainly have to be changed and I did not feel that he could actually hold up under work that required him to stand for prolonged hours or walking or doing a reasonable amount of physical activity.” He further testified that he examined the appellant prior to his taking the clerical work with the United States Government and “I agreed with him at that time that I thought he was physically able to attempt work and we decided that if he could obtain the right position that it would probably be wise for him to go ahead and
It appears from the record that the appellant was to be employed in the Quartermaster Corps for the United States Government. He was to do clerical work and such involved a lot of transcribing from shipping documents. When he first went with the government he was under an extensive training program. His immediate supervisor testified that the appellant “would get nervous under the amount of work that we had to do, under the lengths of time we had to turn this work out in.” He further testified that when the
The appellant, in his testimony, described the nature of his duties with his employer and how he was injured on October 12, 1957. He then gave the following testimony:
“Q. Now, what happened in May, 1958?
“A. Well, in May, 1958, I got in touch with the Travelers Insurance Company by letter and advised them that I was going to try out a government job, and even though I realized I had a disability and was not sure that I could hold the job, I wanted to go out and give it a trial anyway, on a trial basis and I wanted to do that because I was fed up with being on the shelf. I had worked since I had got out of school down here way back yonder years and years ago. I have been active every year of my life and every day of my life until this thing happened, and when this thing happened I was laid on the shelf and that is devastating to the mental attitude and all that of any man.
“Q. You told the insurance company this?
“A. Yes.
*248 And did you ask them' to continue .-paying-ypu benefits? •,
i. “A. .No. I .told them that I would like for-them.to hold, up. on.,the-benefits until I could go out and try this job out and see .whether I-could make a go of it-and then — that was what I really.had asked them to do, hold up on the benefits-until-I could .go out and see whether I would.be able to do; the job.” . •
' The appellant testified as to obtaining work with the United States Government and of his' discharge from such-employment because of his -inability• to do -the work- and of making ’ errors which he didn’t' séém to be able to stop': As-'to his-disability, he-said that he had a lot of dizziness arid'tottery feeling in his head, the cause of which, he ascribed-to being struck thereori from about a five foot" angle down :on the pavement. 'He said he had a deadness, aches, andr; pains from the back of his neck down through his-shoulders and arms-, and- to his ankles, and a constant dead-, ness in his hands and... fingers, „a phlebitis in one leg. He testified that he could not stay on his feet all day and had to lie down' at least about two hours. per day, and that his right leg swells and that both legs fee! tottery and insecure, and when he tries to walk he has to hold to' something tó'keép from tottering- around:-He said-he had considerable trouble 'with his memory and his thinking was not as alert as it' was before his injury'.'1 He has trouble" getting' his-, mind- to properly function. ' -' - - - '■ ' :
' The" factual' situation in the case urider consideration is strikingly similar to that found in the case' of Mann v. Travelers Ins. Co., 176 S. C. 198, 179 S. E. 796. .Iri the cited' case’it appears'that the insurance cbrnpany recognized thé- fact of Mann’s disability’,• ás a' result 'of a fall he sus-’ t'ained;'- arid -paid him- "for about three hionths for- a total disability ánd-áboW-six weeks'for partial disability-. About five months- after' the--'accident-,•-the-'insrired’s ¿physician advised him to try.to d.o-.some work to take his.-mind off his condition, and with the cooperation of his employed-'he-'was
On careful consideration of the entire evidence in this casé, and in the light of our decision in the Mann case, we think that the question of whether the appellant was totally and permanently disabled within the meaning of the aforesaid policy should have been submitted to., the jury. It follows that the trial judge was in error in granting a nonsuit.
-We come now -to the question of whether the appellant released the respondent 'of all liability which terminated ..h-is right to disability benefits by accepting a final payment from the-.respondent and returning to-work. , . '
It appéars from the record--' that prior to going to work for the United States Government, the appellant notified-the respondent that -'even thoúgh-he had a disability he “was going'to try out ¿- government job”, and for- it “to hold -up on' the benefits until! can go out' and try-this job:out artd
The draft for $125.00, according to the respondent’s own letter, was to pay disability benefits to the date the appellant returned to work. Admittedly, it covered only a period of one-half month, or for theíperiod May 12, 1958, to May 27, 1958, and such draft represented one-half of the indemnity of $250.00 per month for total disability, resulting from accidental bodily injuries. Due to the fact that at the time of the aforesaid payment there was no disputed claim, there could have been no compromise or settlement of such. Consequently, there was no consideration for the purported release of liability of the respondent to pay disability benefits thereafter. It has been soundly held that where an insurance company pays only what is then due under its policy as an indemnity for disability, and nothing further is then demanded, a release from liability for any future claim under its policy is invalid for want of consideration. Moore v. Maryland Casualty Company, 150 N. C. 153, 63 S. E. 675, 24 L. R. A., N. S., 211; Hill v. Universal Life Insurance Co., La. App., 160 So. 457; Sutton v. Continental Casualty Co., 168 S. C. 372, 167 S. E. 647. It follows that the attempt here to discharge the insureris liability for
The final question for determination is whether the Trial Judge erred in concluding that the appellant’s claim for total disability benefits, resulting from an accidental injury on October 12, 1957, is barred by any subsequent lapse of the policy. Admittedly, the appellant was struck by an automobile on October 12, 1957 and the respondent recognized that he was totally disabled by paying the benefits provided in said policy for such disability during the period of time hereinbefore stated. If the appellant became totally disabled on October 12, 1957, within the meaning of the terms of the policy of insurance, and such disability continued until the bringing of this action, his rights thereunder had accrued, and the obligation of the insurer was fixed to pay the insured according to the terms thereof. Here, the injury to the appellant, which he asserts caused his total disability, took place while the policy in question was in full force and effect, and if such total disability continued beyond January 1, 1958, the date of the alleged lapse of the policy, the insurer would not be relieved by such lapse from the payment of the monthly payments provided in said policy.
We find in Appleman, Insurance Law and Practice, Vol. 1 A, section 644, at page 548, the following: “The rights of the insured, where disability occurs prior to the lapse of the policy, are considered vested or fixed, so that recovery can be had.” In support of the foregoing rule there is cited the case of Prudential Ins. Co. of America v. Calloway, 54 Ga. App. 863, 189 S. E. 545. We quote the syllabus from the cited case, as follows:
“Rights of insured under group policy providing for payment of benefits for total and permanent disability held to have accrued after insured became totally and permanently disabled before policy lapsed, fixing obligation of insurer to pay according to terms of policy.”
Reversed and remanded.
Case-law data current through December 31, 2025. Source: CourtListener bulk data.