Case Name: The American Assurance Company v. Jesse H. Dickson
Court: Hamilton County Circuit Court
Jurisdiction: Ohio
Decision Date: 1912-11-23
Citations: 15 Ohio C.C. (n.s.) 228
Docket Number: 
Parties: The American Assurance Company v. Jesse H. Dickson.
Judges: Smith, P. J.; Swing, J., and Jones, J., concur.
Reporter: Ohio Circuit Court Reports (new series)
Volume: 15
Pages: 228–230

Head Matter:
LIABILITY FOR SICK BENEFITS.
Circuit Court of Hamilton County.
The American Assurance Company v. Jesse H. Dickson.
Decided, November 23, 1912.
Insurance — Offer to Pay Only a Part of © Claim Amounts to a Rejection of the Whole Claim — Construction of 'Provision as to Total Disability Under a Policy Providing for Sick Benefits.
1. Acceptance of proof of disability on tbe part of a policy bolder and treatment of such proof as final, with an offer to pay a certain amount thereon but less than tbe amount claimed, constitutes a rejection of tbe claim by tbe company, and suit instituted thereon after such rejection is not prematurely brought.
2. In a policy providing for sick benefits, a clause reading that to constitute total disability the insured must be “strictly, necessarily and continuously within the house and there regularly and personally attended by a legally qualified physician,” does not bar recovery by an insured who, under .the advice of his physician, went out for air and to his physician’s office for treatment.
Benton S. Oppenheimer, for plaintiff in error.
Millard Tyree, contra.
The plaintiff sued for $126 sick benefits, and was given judgment.
Smith, P. J.; Swing, J., and Jones, J., concur.

Opinion:
Notwithstanding condition No. 11 of the policy of insurance sued upon in this ease providing that "Legal proceedings upon this policy shall not be brought until after three months from the date of filing final proofs at the home office of the. company, nor brought at all unless commenced within twelve months from the time when the right of action shall arise" the court is of the opinion that this action was not prematurely instituted.
The evidence discloses that the company accepted proof of loss from defendant in error, treated the same as final and offered to pay a certain amount thereon, but not the full amount claimed. This amounted to a rejection of the claim, and having thus determined, defendant in error was not called upon to delay his action further.
The construction placed by the trial court, in its charge to the jury, upon the clause in the policy relating to sickness indemnity (house confinement) we think was correct.
This clause provides as to total disability, that the insured shall be "strictly, necessarily and continuously confined within the house and there regularly and personally attended by a legally qualified physician, not to exceed a period of twenty-six consecutive weeks."
The fact that the insured under the advice of his physician went out for air, and to his physician's office for treatment, could not, we think, defeat his right of recovery within the meaning of this provision.
Any other construction would be unreasonable. The conduct of the insured in this respect in obeying his physician was essential to his recovery, and acting in good faith he is entitled to his indemnity.
Hoffman v. Home and Hospital Association, 128 Mich., 329; Scales v. Masonic Protection Association, 70 N. H., 490; Mutual Benefit Association v. Naucarrow, 18 Col. App., 274.
There being no error in the record the judgment is affirmed.