285 Mass. 505 | Mass. | 1934
The plaintiff has brought suit to recover disability benefits of $100 per month from November, 1930, alleged to be due under a policy of insurance issued to the plaintiff by the defendant company on April 1, 1927.
The policy recites that the company “hereby insures the person herein designated as the Insured, for the series of monthly instalments hereinafter provided.” It contains a provision for the payment of sixty monthly instalments of $100 each “upon receipt of due proof of the death of the Insured during the continuance of this Policy” and a further provision for the payment of the same number of additional monthly instalments of the same amount in the event of the death of the insured by accident. Under the caption “Total and Permanent Disability Benefits” it provides for the payment to the insured of a “monthly income” of $100 “in event of total and permanent disability before age 60, subject to the provisions as to Total and Permanent Disability contained in the Policy.” Under the heading “Provisions as to Total and Permanent Disability” the policy states: “If the Insured shall become totally and permanently disabled, either physically or mentally, from any cause whatsoever, to such an extent that he . . . is rendered wholly, continuously and permanently unable to engage in any occupation or perform any work for any kind of compensation of financial value during the remainder of his . . . lifetime, and if such disability shall occur at any time after the payment of the first premium on this Policy, while this Policy is in full force and effect and the Insured is less than sixty years of age, and before any non-forfeiture provision shall become operative, the Company, upon
The case was tried in the Third District Court of Bristol. The judge found for the plaintiff. He stated in his finding among other things that no question of pleading was raised and that “the only issue involved at the trial was whether or not the plaintiff was totally and permanently disabled as provided in the policy. ... I find as a fact that the plaintiff is not in a physical and mental condition to do any
The plaintiff became disabled after the payment of the first premium while the policy was in full force and effect and the plaintiff was under the age of sixty and before any nonforfeiture provisions of the policy became operative. It does not seem to have been in dispute that his disability began about December 1, 1930, and continued for more than ninety days prior to the bringing of the suit. The question mainly in controversy is whether or not he was disabled to the extent required by the policy in order to entitle him to monthly payments.
The policy in referring to disability of the insured repeatedly employs the absolute words “total” and “permanent” and their derivatives and synonyms but from a reading of the policy as á whole it is manifest that it was not intended that those words should be taken in a literal sense or given an absolute effect. So far as concerns totality of disability complete physical or mental incapacity is not necessary; the policy in terms makes the obligation of the insurer rest upon a lesser disability than “total.” He is entitled to the stated monthly income if he is “totally disabled ... to such an extent that he was rendered wholly and continuously unable” to do any remunerative work. Something less than absolute permanency of disability is contemplated. An obligation of the insurer to pay the stated monthly income arises if disability of the character described in the policy exists for a period of ninety consecutive days. In such case the “disability shall be' presumed to be permanent.”
As in the case of any other contract (Oakes v. Manufacturers’ Fire & Marine Ins. Co. 131 Mass. 164, 165), if there is no ambiguity in the words of an insurance policy they must be given their natural and ordinary meaning. Farber v. Mutual Life Ins. Co. of New York, 250 Mass. 250, 253. If for any reason there is ambiguity in the language employed consideration must be given to the document as a whole, Perry v. Provident Life Ins. & Investment Co. 103 Mass. 242, and to its principal apparent purpose. Cutting v. Atlas Mutual Ins. Co. 199 Mass. 380, 382. Where the language permits two rational interpretations, that more favorable to the interests of the insured is to be taken. The insurer chose the words to express the contract of indemnity and whichever of two warranted interpretations of language best effectuates the main manifested design of the parties is to be favored. Koshland v. Columbia Ins. Co. 237 Mass. 467, 471, and cases cited.
The provisions of the policy with reference to disability benefits manifest a purpose to furnish to the insured as indemnity for loss through physical or mental working incapacity a stated monthly income if he becomes disabled for a period of ninety consecutive days to the extent defined in the policy. The disability of an insured who still retains the power to do some work may be within the policy definition if he is “wholly and continuously unable” to do any work of such character that he can receive therefor any
We are of the opinion that the language of the policy defining disability in terms of the insured’s capacity to do any work for financial compensation should not be given such a narrow and literal construction as to ignore serious or fatal consequences which would be likely to result if he undertook to perform such work. As words are understood by reasonably intelligent men, one is wholly unable to work if he can do no work without seriously endangering his health or risking his life. In Genest v. L’Union St. Joseph, 141 Mass. 417, 420, this court in construing a by-law of a benevolent association providing for sick benefits has said that “A man recovering from an illness of about three weeks’ duration may justly be deemed to be 'incapable of working,’ although by- unreasonable, excessive, and harmful effort and exertion he succeeds in doing light work for two consecutive days, and then by reason thereof suffers a relapse.” Under the workmen’s compensation act (G. L. [Ter. Ed.] c. 152, § 34) which provides that an injured employee is entitled to compensation''While the incapacity for work . . . is total,” it has been held that such an employee is totally incapacitated for work although he has a limited physical capacity to work and earn money. Duprey’s Case, 219 Mass. 189. Sullivan’s Case, 218 Mass. 141. (See also Meley’s Case, 219 Mass. 136; Floccher’s Case, 221 Mass. 54.) It has frequently been held in other jurisdictions that there is ''total disability” within the rational meaning of those words if an insured’s condition is such that reasonable care and prudence require that he refrain from doing work which would aggravate that condition or prevent its improvement. Travelers’ Ins. Co. v. Plaster, 210 Ala. 607. Cato v. Aetna Life Ins. Co. 164 Ga. 392. National Life & Accident Ins. Co. v.
The defendant contends that the evidence did not warrant the finding of the trial judge with respect to the plaintiff’s condition of disability. The summary of the medical testimony in the report occupies more than twenty-five pages. No useful purpose would be served by reviewing it in detail or discussing its contradictions. It is enough to say that there was medical testimony to the effect that the plaintiff’s heart and nervous condition was serious, that working was likely to increase his trouble, that while he would be able to do some work, the amount of which could not be definitely stated by a physician, he ought not to work, that any work light or heavy requiring attention or exertion would eventually impair his health, and that if he worked continuously he would impair his health and shorten his fife.
The plaintiff and his wife in their testimony described various effects injurious to the plaintiff which followed numerous slight physical and mental efforts attempted by the plaintiff from time to time since December 1, 1930.
The trial judge did not give the defendant’s requests numbered 3, 5 and 6, stating that they were covered by the giving of the first and second requests. In this we find no reversible error. The judge, without objection so far as appears from the plaintiff, adopted as governing the trial the theory of law expressed in the first and second requests of the defendant. In substance he thereby ruled that total disability within the meaning of the policy was not merely an incapacity to perform the duties of the occupation in which the plaintiff had been engaged up to December, 1930, or of similar occupations, but must amount to an inability to do any kind of work for any financial compensation in any occupation whatsoever. The judge in effect found as a fact that the plaintiff could not without detriment to himself do such work. The first and second requests included the substance of the third and sixth requests and more. The defendant concedes in its brief that the fourth request which was given included the substance of the fifth which was not, and that no harm was done the defendant by the refusal.
The defendant contends that judgment should be entered for the defendant on the ground that proof of total and permanent disability within the meaning of the policy was not given to the defendant. The policy contains no other specification as to the character of such proof than that it shall be "due.” The defendant filed in the trial court no request for a ruling that the proof in fact furnished was not "due” or adequate.
We find no error in the refusal of the seventh request which asked for a ruling in substance that the plaintiff could not
Order dismissing report affirmed.