Court Opinion

ID: 9642087
Source: CourtListenerOpinion
Date Created: 2023-08-22 17:48:02.901454+00
Date Added: 2024-06-11T18:10:42.890096
License: Public Domain

BARDGETT, Chief Justice,
dissenting.
I respectfully dissent.
The facts as stated in the principal opinion make clear that the insured, Mr. Crim, has had the vision in his right eye reduced to seeing at two feet what is normally recognizable at two hundred feet. It is admitted that that condition satisfies the requirement of the policy which says “With respect to eyes, ‘loss’ means the entire and irrecoverable loss of sight.” It is admittedly a permanent condition. The appellant insurance company seeks to avoid the payment of five thousand dollars as provided in the policy because the insured’s vision .can be and has been improved by the use of glasses (contact lenses).
*78The principal cases from around the nation are cited in the principal opinion, and they certainly support a view that the applicable provision in the policy is at least ambiguous. However, I do not regard it as being ambiguous. The real question presented is: “Was it the intent of the parties to this accidental injury insurance policy for which the plaintiff insured paid a premium, for the insurance company to pay the stipulated sum when the irrecoverable loss of the sight of an eye was sustained by accidental means, or was it the intent of the insured and the insurance company to allow the insurance company to avoid payment where some prosthetic device, but not the eye alone, would enable the insured to see again?”
One sees with his eyes, not with glasses, and the ability to see without glasses is an extremely valuable asset. It allows people to do many things that are difficult, if not impossible, if they are required to wear glasses, whether they be contacts or conventional glasses. There is no doubt in my mind that it was the purpose and intent of this policy that in return for the premium paid, the insurance company agreed to pay the stipulated sum to the insured if he were rendered sightless, in one or both eyes, to an extent which satisfied the provisions of the policy. In this case the provisions were satisfied and, in my opinion, the plaintiff ought to recover the entire sum.
Was the insured entitled to recover the $5,000.00 if he applied after the injury and before securing contact lenses? Whose financial obligation is it to pay for the glasses so as to relieve the insurance company of the obligation to pay? If, next week or next year, the contacts no longer function so as to restore the insured’s vision, or his eyes cannot tolerate the lenses, will he then be allowed to recover?
I realize these issues are not presented in this case, but I regard them as significant factors in deciding the intent of the parties. Is it reasonable to assume that, had the insurance company salesman told the insured that he would not receive payment even though he lost the sight of an eye if glasses, at the insured’s expense, would restore vision, the insured would have bought the policy?
The wording of this policy leads me to the firm conclusion that the insured intended to purchase and the insurance company intended to sell a policy that provided for the recovery by the insured of the stipulated sum on the loss of a human organ or the loss of the function of that organ without the aid of prosthetic devices, whether they be artificial limbs or eyeglasses.
I recognize that there is a reasonable basis for viewing the eye clause as ambiguous and therefore would concur in the dissenting opinion of Rendlen, J.
I therefore dissent and would affirm the circuit court judgment for plaintiff-respondent.