Opinion ID: 1799090
Heading Depth: 1
Heading Rank: 2

Heading: Is Plaintiff Totally Disabled Within Meaning of Policy?

Text: It is defendant's position that, in spite of the jury's finding that plaintiff has been continuously and completely unable to engage in gainful occupations for which he is reasonably fitted by education, training, and experience since his accident of October 23, 1959, the evidence does not sustain this finding. In interpreting the total-disability provisions and definitions in insurance policies the tendency of many courts has been toward a liberal rather than a strict interpretation. The annotation entitled, When insured deemed to be totally and continuously disabled or unable to transact all business duties, 98 A. L. R. 788, 789, states: The liberal rule, as shown in the earlier annotations, is that the `total disability' contemplated by an accident policy, or the disability clause of a life policy, does not mean, as its literal construction would require, a state of absolute helplessness; rather, that the disability contemplated means inability to do all the substantial and material acts necessary to the prosecution of the insured's, or, in many instances, any, business or occupation, in a customary and usual manner. [10] Total disability is a relative concept. What may totally disable a manual laborer may not totally disable a business executive, physician, or lawyer within the scope of a total-disability clause of an insurance policy. This is particularly true where the policy employs qualifying language equivalent to that of the instant policy which limits the occupations the insured is disabled from engaging in to those for which he is reasonable fitted by education, training and experience. Plaintiff was born and raised on a dairy farm and was forty-one at the time of the accident. He is a high-school graduate who has never attended a college, university, or trade school. After graduation from high school he remained on the farm for six years, then, except for one year in the army, worked at a filling station for nine years. He then obtained a union permit to do ironwork and was engaged in that work until the time of his accident. His employment as an ironworker required him to do welding, cutting and burning of iron, setting and connecting steel columns, setting riggings, climbing ladders and doing much work above ground level which demanded the full use of both hands and arms. Defendant claims that plaintiff's employment for ten months after the accident at his former job clearly demonstrates that he could perform the duties of such employment. But the evidence refutes defendant's argument. Important testimony was given by Ellsworth Swenson, plaintiff's supervisor at the Tomaro Construction Company, both before the accident, and for the ten months of plaintiff's employment following the accident. Mr. Swenson testified that plaintiff was a good worker before the accident, but that after the accident he was unable to perform the necessary duties of his job. The following is an excerpt from Mr. Swenson's testimony: A. Well there was many phases of the work that he couldn't do after the accident. He couldn't climb columns. It was almost impossible actually to crawl ladders and hang on and weld any type of work. He almost had to work on the ground itself or do errands, which we needed done on the ground at the time; other than that there wasn't much he could do. Q. Is it a substantial part of the performance of an iron worker's job that he should be able to work above ground level? A. You have to work all phases of it because at different times of the day or hour, in fact you have to either climb columns, ladders, and in order to weld or connect iron you have to be able to do everything at all times or you're of no value to the company that you work for . . . . Q. In your opinion as an iron worker for many years and from your observation of Mr. Harker after his accident, was he able to substantially perform the duties of an iron worker on the job under your supervision after his accident? A. No. Defendant also claims that plaintiff's three months of employment as a plant mechanic for St. Mary's Hospital indicates he was not totally disabled. Again there is evidence that refutes defendant's argument. The testimony of Marvin Statz, plant superintendent at the hospital, indicates that plaintiff was totally disabled. Statz testified that plaintiff's duties were general repair and maintenance, which could include everything from changing a light bulb to repairing a radiator or steam plumbing. Mr. Statz testified as follows: Q. Did you have an opportunity to observe Mr. Harker from time to time in the scope of his employment? A. Yes. Q. Was he able to substantially perform the duties of his job? A. No. Plaintiff's employment as a salesman was clearly a failure as indicated by his minute income and being fired because he was unable to sell. Plaintiff's background indicates that before the accident his life's work had been one form or another of manual labor. He had never known any other type of work. There is ample evidence that the injury he has sustained now prevents him from engaging in manual-labor occupations for which he is reasonably fitted by education, training, and experience. The foregoing resumé of evidence, together with that set forth in the initial statement-of-facts portion of this opinion, provides support for the jury's finding of total disability. [11]