Opinion ID: 77298
Heading Depth: 3
Heading Rank: 3

Heading: Equitable's Arguments

Text: 66 Equitable argues that Georgia law compels the interpretation that total disability exists only where the insured is unable to perform all of the substantial, material duties of his occupation. Equitable cites several Georgia cases that it claims compel this definition of total disability. See, e.g., Cloer v. Life & Cas. Ins. Co. of Tennessee, 222 Ga. 798, 152 S.E.2d 857 (1966); Mut. Life Ins. Co. of New York v. Barron, 198 Ga. 1, 30 S.E.2d 879 (1944); Metro. Life Ins. Co. v. Johnson, 194 Ga. 138, 20 S.E.2d 761, 762 (1942); Prudential Ins. Co. of Am. v. South, 179 Ga. 653, 177 S.E. 499, 502 (1934); Cato v. Aetna Life Ins. Co., 164 Ga. 392, 138 S.E. 787 (1927). 67 Those cases fail to support Equitable's position because the policy language interpreted in those cases was substantially different from the relevant language in this case. In those cases, the policies defined total disability as the inability to perform any occupation or any work. 12 Here, by contrast, the Policies define total disability as the inability to perform the substantial and material duties of your regular occupation,  without regard to whether the insured could do other kinds of work. 13 More importantly, none of the policies in these Georgia cases contained the language at issue here — the substantial and material duties. 68 If anything, Equitable's cases show how Georgia courts liberally construe disability policies in favor of insureds and strictly against insurers. In the cases Equitable cites, the Georgia courts rejected the insurers' claims that the requirement of inability to perform any occupation or any work meant any gainful employment. See Barron, 30 S.E.2d at 883; Johnson, 20 S.E.2d at 762; South, 177 S.E. at 501. Instead, the Georgia courts construed the language of inability to perform any work or any occupation, in favor of the insured, to mean inability to perform substantial portions of the insured's ordinary employment or any other employment approximating the insured's same livelihood as he might fairly be expected to follow given his personal circumstances, including his experience, education, physical and mental capacities. See Barron, 30 S.E.2d at 883; Johnson, 20 S.E.2d at 762; South, 177 S.E. at 501. In doing so, the Georgia courts stressed that the word occupation must be construed according to the facts and circumstances of the execution of the contract, including the objects to be effectuated thereby. South, 177 S.E. at 501; see also Cato, 138 S.E. at 791 (construing total disability language and stating that [p]olicies of insurance will be liberally construed in favor of the object to be accomplished, and provisions therein will be strictly construed against the insurer). Thus, in these cases the Georgia courts construed any occupation as occupations approximating the insured's livelihood. 14 The object to be accomplished in Giddens's Policies is total disability coverage if he is unable to perform so many substantial and material duties that his regular occupation is reasonably closed to him. That point is clearly reached in Giddens's case. 69 Equitable finally argues that total disability must mean the inability to perform all of the material and substantial duties because to interpret the term otherwise would nullify the Residual Disability clause. The Policies define residual disability as the inability to perform . . . one or more of the substantial and material duties of [the insured's] occupation. This argument is unpersuasive. Quite obviously, there is a continuum of disability. If the insured is unable to perform only one or more of many material occupational duties, then the insured would not be totally disabled. Where the insured, such as Giddens, is unable to perform most or the majority (but not all) of the material duties and thus cannot engage in his regular occupation, the insured nevertheless is totally disabled from his regular occupation, and this interpretation does not nullify the Residual Disability clause. 15 At some point, a line must be drawn where the disability becomes so severe, and affects such a large percentage of the insured's material and substantial duties, that the disability is total rather than residual. The language of the Residual Disability clause does not suggest where that line should be drawn and certainly does not require that it be drawn only where Equitable suggests. If Equitable means all in its Total Disability clause, then Equitable may make that simple change to its policy forms. 16