119 N.Y.S. 955 | N.Y. App. Div. | 1909
Lead Opinion
The plaintiff was a subject of Great Britain and the defendant a - corporation organized and existing under the laws of Great Britain. The plaintiff had been in the employ of the defendant as its agent. The defendant issued to the plaintiff a policy of insurance covering accidents happening in Europe which- was extended by an indorsement on policy so as -to cover risks attendant on journeys by the assured to the United States of America and the south of Canada. -This policy insured the plaintiff against accidents within twelve months beginning at noon on May 9, 1903. One of the conditions to which this policy was subject was that the right to recover payment of any capital sum insured under this policy should be forfeited and extinguished on the expiry of six months from the date of the accident and the right to recover payment of the weekly compensations should be forfeited -and extinguished on the expiry, of fifteen months from the date of the accident or sickness, on the completion of .which periods respectively the liability of the company in respect to such accident or sickness should cease and determine, unless within these periods respectively a settlement with the insured or his representatives has .been agreed upon or referred to arbitration in terms of condition 8. Condition 8 is as follows: “ If any difference or dispute shall arise respecting the liability of the . company or the amount payable to the insured, the matter in difference shall-be referred to the arbitration and decision of a neutral person as single arbitrator, and the decision of the arbitrator shall be final and binding on all parties and this condition shall be deemed and taken to be an agreement to refer as aforesaid within the meaning of the ' Arbitration Act, 1889, the Arbitration (Scotland) Act, 1894,
By the English Arbitration-Act of-1889, referred to in the policy, it is provided that the court or a judge may, on application by the party who. gave the notice,, appoint an arbitrator, umpire or third arbitrator, who shall have the like powers to-act in the reference and / . make an award as if he-had been appointed by consent of all. parties. • As both parties to this transaction are citizens of Great. Britain and there domiciled, it is clear that the contract-must be ' construed according to the laws of Great- Britain. Both parties ' called witnesses to testify as -to the law.. An English barrister testified for;.the plaintiff and was asked a hypothetical question setting out the provisions of the. policy-and-in response to which the witness answered that “ under the laws of -Great Britain and' oii the facts stated, condition 8 above quoted, as to-arbitration is a good and valid condition precedent; ” and that on the facts stated the ' plaintiff would be precluded ,from recovering from the insurance company,, unless the insurance company by some overt, act had expressly notified the plaintiff that.it would not proceed to arbitration at all and excused the. plaintiff from making an application :to any court-or judge to appoint an arbitrator. -
The plaintiff' testified ■ to many, interviews "with the defendant’s-adjuster in April oí'May, 1904; that in one of these conversations , he says they conversed about the 7th.clause of the policy and that the defendant’s-adjuster said that it would be absurd to apply that clause; that it would not apply in the plaintiff’s case because, he. believed that the plaintiff would get the sight of his eye again. He further testified that the adjuster, told him that if the defendant agreed to arbitrate it must be done in England arid that subse- '
On behalf of the defendant this adjuster denied ever having stated to the plaintiff that the defendant would not arbitrate or that the defendant waived any condition of the policy. .There is not the slightest evidence to show that this adjuster had any authority to waive any of the conditions of this policy and the matter had only been referred to him to determine whether or not a settlement could be arrived at. The parts of the deposition of the English barrister who had been called on behalf of the plaintiff which had not been read by the plaintiff w'ere read by the defendant. He there testified that upon the facts stated in the hypothetical question the defendant was not liable to the plaintiff because the insurance company having rejected the plaintiff’s claim a difference or dispute did arise respecting the liability of the company and the amount payable to'the insured, which matter in difference ought, in the first instance, to have- been referred to arbitration and an award obtained. The obtaining Of an award was a condition precedent tó a right on the ..part of the plaintiff to maintain an action on the policy for the insurance moneys and that no right of action vested in the plaintiff until after arbitration held and award obtained. And also because the right to recover the capital sum was forfeited and extinguished before action brought, six months having expired since the date of the accident without, within that period, a settlement being arrived at or a reference made to arbitration in terms of condition 8; that plaintiff is precluded from recovering by condition 7, unless he was excused by the act of the insurance company from taking the proper steps to have the dispute referred to arbitration ; that under the laws of Great Britain, the conditions 7 and 8 are valid and enforcible in accordance with their terms; that under the Arbitration Act of 1889 an insured has, under a policy of accident insurance containing ,.a condition as to arbitration in the language of condition 8, the right, and power to cause a matter in difference as between himself and the insurance company to be referred to the arbitration and decision of a neutral
An English barrister was called by the defendant as a witness. He testified that the defendant was not liable to the plaintiff in any sum whatever upon the facts stated in the hypothetical question ; that the right to recover the capital sum insured by the policy has been forfeited and extinguished, and the liability of the company has ceased and determined by the expiry of six months from the daté of the accident without a settlement having been agreed on or referred to arbitration in terms of condition 8 that a difference has arisen respecting the liability of the company within the meaning of condition 8, and no award of such arbitrator as mentioned in that condition has been obtained, and the obtaining of such .award is by that provision made a condition precedent to enforcing the liability of the company in respect of a claim made under the policy; that this is a valid condition precedent, and ,on the facts stated it precludes the plaintiff from recovering from the company unless waived by the company. .
I do not think that there is any dispute as to the law's of Great ' Britain applicable to this claim as between these parties. It seems to me clear by the law of England these provisions contained in sections Y and 8 and made a part of the policy are conditions precedent" to the maintaining of any action at law based upon the policy. That condition is. that within six months from the time of the accident there shall be a settlement between the insured and the company as to all claims covered by the policy or a reference of the question to an arbitrator, either by agreement of the parties or by obtaining the appointment of an arbitrator under the Arbitration Act of 1889. It is not such a short statute of limitations as has X been before the courts of this State in many reported cases, but a condition precedent upon which the right to mainiain an action depends. A refusal to arbitrate is not a waiver of this condition of the policy. There was, by the "refusal to agree" upon an arbitrator, presented a situation contemplated by the condition which would
I, therefore, think that the judgment should be reversed and a new trial ordered, with costs to the appellant to abide the event.
Laughlin and Scott, JJ., concurred; .Clarke and Houghton, JJ., dissented.
See respectively 52 & 53 Viet. chap. 49; 57 & 58 Viet. .chap. 13.— [Rep.
Dissenting Opinion
The defendant is an English company, and on the 9th day of Hay, 1903, at London, it issued to the plaintiff, a British subject, an accident policy, providing, amongst other things, that it would pay to the insured £500 in case he received, within the life of the policy, an accident to ■ an eye which should cause .total blindness within one calendar month, and in addition would also pay his reasonable physician’s bills.
By its terms the policy covered only accidents happening in Europe, but upon the plaintiff informing the general manager of the defendant that he contemplated a journey to the United States,
On the 26th of February, 1904, within the life of the policy unless it had been forfeited by acts of the assured, at Pittsburg, Penn., the assured received an injury through accident to one of his eyes, which he claimed resulted in total blindness within one calendar month.
On the twenty-ninth of February the plaintiff • wrote to the defendant at London, informing it of the accident and claiming compensation, and asking advice as to what he should do. The defendant thereupon, after some delay, sent to the plaintiff blank forms of proof of loss to be filled up by him and returned to them, which recpiest was complied with and the proofs retained by the defendant. After receiving these proofs of plaintiff’s claim the defendant authorized one Denneen of Pittsburg to make inquiries and adjust the claim.
- The plaintiff ultimately wholly lost the sight of the injured eye¿ and two matters seem to have been under investigation by the defendant with respect tó the accident, the-one whether such total blindness occurred within one. calendar month, and the other whether the assured had established his residence at Pittsburg, instead of continuing a journey throughout the United States as his permit provided. Ultimately the defendant claimed that the whole premium had not been paid and that it had not received notice of the accident within seven days, as the policy provided.
..The plaintiff was able to produce a letter of tlie. defendant, acknowledging payment in full of the premium, and the contention that notice of the accident was not received within the stipulated time was very properly abandoned because the defendant requésted proofs of loss long after such period had expired without questioning the regularity of the notice.-
Amongst the conditions contained in the policy are those numbered “ Seven ” and “ Eight.”. So far as material to the controversy involved, condition numbered seven provided that the defendant should not be liable to pay any sum'until the amount of compensation díte or the defendant’s liability to. pay had been ascertained and proved to the satisfaction of the directors, and, further,
The Arbitration Act referred to was introduced in evidence, and, amongst other things, it provides that where a submission to a single arbitrator by agreement has been made any party may serve the other with a written notice to appoint an arbitrator, and if he shall fail to do so within seven days the court or a judge may, on application by the party giving the notice, appoint an arbitrator who shall have the same powers as one designated upon consent of the parties; and that a submission to arbitration, unless a contrary intention is expressed therein, shall be irrevocable except by leave of the court or a judge, and shall have the same effect in all respects as if it had been made an order of court.
The plaintiff wrote many letters to the defendant and to Denneen containing propositions and urging an adjustment of his claim and making certain inquiries. Some of his inquiries were answered
By his complaint the plaintiff alleged that he had duly complied with all the terms and conditions of the policy on his part, and that he had at all times been ready and willing to refer whatever difference or dispute there may have been under the policy to an arbitrator or arbitrators, but that the defendant had neglected and refused to refer such difference or dispute to such arbitration.
The defendant, amongst other defenses, alleged specially that the plaintiff had not complied with the condition as to arbitration, which was a condition precedent, in that he had not obtained any award or the appointment of an arbitrator in respect, to the claim against the defendant; and further that more than six months had expired from the date of the accident and that no settlement or arbitrator had been agreed upon, and hence that the action was not maintainable.
The defendant contended at the trial and now contends that the plaintiff’s complaint was not sufficient to entitle him to prove waiver of the condition of the policy respecting the bringing of the action within six months after the happening of the accident, or as to the arbitration ; and in effect that the provision with respect to arbitration required the plaintiff before he could bring any action at all, whether the defendant refused to arbitrate or not, to obtain the award of an arbitrator.
The learned trial court held that the allegation of the complaint that the defendant had neglected and refused to arbitrate was sufficient to entitle the. plaintiff to prove waiver of arbitration, and that the provision of the policy respecting the bringing of the action within six months was not a condition precedent but was in the nature of a forfeiture or limitation which it was not necessary for the plaintiff to plead and which he had a right to rebut in contradiction of the defendant’s plea and proof; and that if the plaintiff established waiver of the arbitration or refusal to arbitrate the six months’ clause became operative only on such refusal because the plaintiff had six months after such waiver or refusal within which to bring his action. I think the ruling was right and that the judgment should be affirmed.
The 7th condition of the policy to the effect that the right of
The contract was made in England and, concecledly, is to be governed. by the English law, and testimony of English barristers was introduced on the trial to show what that law was, and it' would seem that their views aré that the six months’ provision applied only in case of refusal to arbitrate and began to run only after such refusal. Their attention was particularly drawn to condition Ho. 8 and their, opinions with respect, to the- six months’ clause are not entirely clear. They'testified that plaintiff would be barred from recovering by the stipulation contained in condition 8,Respect-ing arbitration, and that he must submit to arbitration or procure the appointment of an arbitrator “.unless the insurance company (defendant) by some overt act had expressly, notified * * * W. (plaintiff) that they would not proceed to arbitration at all and excused W. (plaintiff) from making an application to any court or judge to appoint an arbitrator,” and that the plaintiff would be precluded from recovering, under condition Ho. T “ unless lie was
If the six months’ clause be treated as a limitation applying only upon refusal to arbitrate or waiver of arbitration, it was not necessary for the plaintiff to anticipate'that the defendant would plead such limitation and set forth in his complaint matters showing avoidance. It was incumbent upon the defendant to plead limitation, and by way of rebuttal plaintiff could show such facts without plea as proved that the limitation was not applicable to him or that it had been waived. Of course the pleadings in the action are to be governed by our rules of procedure, and there being iio proof on the subject it must be assumed that the English law with respect to contract limitation and waiver are the same as our own.
It is lawful for parties to agree upon a reasonable limitation for the bringing of an action, and the agreement of limitation in a policy of insurance has the same effect as a statute on the subject. (Hamilton v. Royal Ins. Co., 156 N. Y. 327.)
In the above case an agreement for a short limitation was held to have all the effect of a statutory provision, and to have also all the benefits of the Statute of Limitations respecting attempt to bring an action.
Under our law also the condition contained in a policy of insurance that no action shall be brought unless commenced within a specified time may be waived by the act of the parties either through agreement founded on a consideration or through estoppel. (Ripley v. Ætna Ins. Co., 30 N. Y. 136; Trippe v. P. F. Society, 140 id. 23; Bowen v. Preferred Accident Ins. Co., 82 App. Div. 458; Robinson v. Metropolitan Life Ins. Co., 1 id. 269.)
According to the testimony of both plaintiff and defendant negotiations respecting plaintiff’s claim and his policy were continued long after the expiration of six months from the happening of the accident, the defendant making no claim that it was relieved from liability under the provisions of the six months’ clause. By numerous letters the defendant recognized the plaintiff’s claim as subsisting except for the fact that total blindness did not occur within one calendar month, and that plaintiff had become a resident of Pittsburg instead of proceeding on his journey as was stipulated.
■ In Trippe v. P. F. Society (supra) the court says“ It is well settled that such defenses (limitation) are waived when the company with knowledge of all the facts requires the assured by virtue of the contract to do some act or. incur some expense or trouble inconsistent with the claim that the contract had become inoperative in consequence of a breach of some of the conditions.”
In Barnum v. Merchants’ Fire Ins. Co. (97 N. Y. 188) the' court says: “ The defendant may, by objecting to the proofs of loss, impose upon the assured the duty of' making them complete and removing, if possible, the dissatisfaction of the insurer, and if he chooses to do ■ so, the delay is mutual and the time of limitation necessarily- extended.” ■■
Negotiations were continued and hope held out to the plaintiff that the defendant would arbitrate to within a few Weeks of the' bringing of the action. In my opinion the six months’ clause was one of' limitation, and the defendant by its acts was estopppd from pleading it as a defense to the plaintiff’s action.
I fully appreciate the holdings of the learned courts in Allen v. Dutchess County Mutual Ins. Co. (95 App. Div. 86) and in Williams v. Fire Association of Philadelphia (119 id. 573) to the effect that the provision in a policy of insurance that actions shall be brought thereon within twelve months after thé occurrence of
An objection that the action was not commenced within the time limited can only be taken by answer (Code Civ. Proe. § 413), and even though it appear by the complaint that the action was not commenced within the time limited, advantage cannot be taken by demurrer. (Sands v. St. John, 36 Barb. 628.) It is improper, for a complaint to allege matters in avoidance of an anticipated defense of the Statute of Limitations (Butler v. Mason, 5 Abb. Pr. 40); and when the answer sets up the statute as a bar, without reply directed by the court, the plaintiff may prove itiatter in avoidance. (Esselstyn v. Weeks,. 12 N. Y. 635; Arthur v. Homestead Fire Ins. Co., 78 id. 462, 467.) If, therefore, the six months’ clause was an' agreement limiting the time in which to commence the action, plaintiff without plea .could prove matter hi avoidance.
The plaintiff’s' complaint was sufficient to permit him to show that the defendant had waived arbitration through refusal to arbitrate. In Glazer v. Home Ins. Co. (113 App. Div. 235) the plain-, tiff plead performance and that he had served proofs of loss upon the defendant which' it had retained without objection and without requiring any further proof on the subject. . Tlie Appellate Division held such plea insufficient to show waiver, and because the proofs were riot sucli as were required under the conditions of the policy reversed the judgment. On appeal the Court of Appeals (190 N. Y. 6) held such ruling erroneous, and that while the word “ waiver ” was not used in the complaint the facts were sufficiently stated to make a good pleading. In Young v. Phenix Ins. Co. (61 N. Y. 650) the complaint alleged that proofs of loss -were not given within the specified time, and set forth certain facts which tended to show a waiver without, however, stating their effect, and the complaint was held good. By the plaintiff’s complaint the
In my -opinion condition Ho. 8 did not require the plaintiff to obtain the award of an arbitrator at all hazards, whether the defendant wanted an arbitration or not. Even if the defendant had an absolute right to arbitration it could waive that right. When, the plaintiff accepted the defendant’s policy containing the arbitration clause lie may be assumed to have agreed irrevocably on his part that lie would arbitrate and that arbitration should be a .condition precedent to recovery, yet the' defendant could relieve him from that condition and could waive, its right- to an arbitration, The absolute refusal to have anything to do.with an arbitration, either in England or in the United States, was a waiver by the defendant of the arbitration agreement, and the defendant cannot now be heard to say that arbitration should have been had.
If the pleading was sufficient to admit to proof, as I think it was, the plaintiff stands 'uncontradicted in stating that the defendant’s manager told him that-if plaintiff' would write him a letter after his return to England he would submit the matter-finally to the defendant’s directors, and that if he did not hear from him by a certain, time he might consider that'the defendant refused both to pay and to arbitrate, and that he .should go ahead and sue. Plaintiff’s story in this respect was for the jury to believe or' disbelieve, and they chose to believe him. Besides the circumstances corroborate the plaintiff. Denneen himself testifies that there was talk of arbitration, but denies that he ever refused to arbitrate in England. It would seem that the defendant in the beginning of the negotiations was insisting upon that being done, and even as late as the spring of, 1906 .the defendant’s solicitors were corresponding with -the lilaintiff’s solicitor on that subject.
The other questions involved were properly disposed of by the court and jury, and I think the judgment should be - affirmed, with costs.
Clarke, J., concurred.
Judgment reversed, new trial ordered, costs to appellant to abide, event. . .
