Court Opinion

ID: 9636093
Source: CourtListenerOpinion
Date Created: 2023-08-22 14:16:33.902143+00
Date Added: 2024-06-11T18:09:42.388765
License: Public Domain

Sam Robinson, Associate Justice, dissenting. Whether the insured is totally disabled is a question of fact. Likewise, it is a question of fact whether the insured leaves the yard and house on the advice of his physician to improve the condition of his health. And if the jury finds that he leaves the house for such reason, then according to a long line of decisions by this Court and the great weight of authority in general the policyholder is entitled to recover on a policy of sick and accident insurance, notwithstanding there is a house or bed confinement clause in the policy. This Court has held repeatedly that it is a question of fact for the jury as to whether a policyholder has been confined to the house within the meaning of a house or bed confinement clause in a policy of insurance, although the undisputed evidence may show that actually the policyholder has not been confined to the house. If the question of whether there has been confinement within the meaning of an insurance policy is no longer a question of fact for a jury, this Court should say so and expressly overrule the numerous cases to the contrary. Such cases should not be overruled by implication. It is admitted that Dr. Hayes is totally disabled, due to a very serious heart condition. The fact that acting on the advice of his doctor on rare occasions he went fishing and deer hunting and made a trip or two to Prescott to see his mother did not render him any less disabled. Incidentally, as I see it, the majority opinion leaves the impression that Dr. Hayes hunts practically all the time. The record shows that he only goes deer hunting; the deer season is open only two weeks out of the year; and the record clearly shows that the way he hunts entails no physical hardship or exertion, and the undisputed evidence is that he was at all times acting on the advice of his physician. The majority goes to great length in an attempt to distinguish the case at bar from the case of Occidental Life Ins. Co. of California v. Sammons, 224 Ark. 31, 271 S. W. 2d 922, but there is no valid distinction. The provision of the policy in issue in the case at bar is practically identical with the provision of the policy in the Sammons case and other cases decided by this Court, and there is no material distinction between tbe facts in the Sammons case and the case here involved. For convenient comparison, we show the undisputed facts in the Sammons case along with the undisputed facts in the case at bar: • Sammons Case 1. Sammons ’ disability was due to a heart condition. 2. During the entire period for which Sammons sought recovery he followed the practice of leaving his house and the yard frequently for the purpose of taking rides and frequently for walking and recreation. 3. Sammons visited with friends at various places of business. 4. Beginning with the year 1950, about two years before the suit was filed in the Sammons case, he began work on Saturdays as a clothing salesman. During the period from November 11, 1950 to December 30, 1950, Sammons earned $180 working as a clothing salesman, and from that time up to the time of the trial, which was on March 20, 1953, three years later, he worked as an extra salesman. 5. The work that Sammons did was on the advice of his physician. Hayes Case 1. Dr. Hayes’ disability is due to a heart condition. 2. Dr. Hayes left the house and yard frequently for taking rides, but did no walking for recreation purposes. 3. Dr. Hayes visits with friends at various places of business. 4. Since Dr. Hayes became disabled with heart disease he has done no work whatever, and according to the undisputed testimony he is unable to do any kind of work. 5. Dr. Hayes did no work, but he did some hunting and fishing on the advice of his physician. If there- is any distinction between the two cases it is to the effect that Dr. Hayes is more disabled than was Sammons. Dr.- Hayes is unable to do any work, while Sammons worked over a period of years as a clothing salesman, where it was necessary to be on his feet all day. And, moreover, the majority fails to point out wherein Dr. Hayes left the house and yard any more than did Sammons. After all, the'only issue involved in the case at bar is whether Dr: Hayes is- precluded from recovering under the. terms, of the policy because he left the house and yard. There is no question about his' disability; the insurance company admits-he-is totally disabled. The majority mentions directly only the Sammons case, but-we have other cases to the same effect as that case and just as strong. In fact, we have a long line of cases where the issues were whether the insured was confined to the house and yard within the meaning of that kind of provision in a policy of insurance. In all of those cases it was held that the question was one for the jury, and it is not shown in the case at bar that Dr. Hayes left the house and yard any more often than did the policyholdersin the ca.ses heretofore decided by this Court. It must bq borne in mind that there is no question about Dr. Hayes’ total disability. According to all the cases heretofore decided by this Court, without an exception, it was held to be a question of fact to be determined by a jury whether the insured left the yard and house on the advice of his physician to improve the condition of his health. And if the jury finds that he leaves the house for such reason, then according to the long line of decisions by this Court and the great weight of authority in general he is entitled to recover. This Court first dealt with a house confinement clause in an insurance policy in the year 1911, in the case of Great Eastern Casualty Co. v. Robins, 111 Ark. 607, 164 S. W. 750. There it was held that the policyholder could recover although he was not confined to the house. Later, in the case of Interstate Business Men’s Accident Assn. v. Sanderson, 144 Ark. 271, 222 S. W. 51, this Court approved what had been said in the Robins case and further held that it is a question of fact for the jury to determine whether the policyholder is disabled within the meaning of the house confinement clause in a policy of disability insurance. The Court specifically held that whether the policyholder’s disease and his state of health at the time required continuous confinement in the house within the meaning of the policy, notwithstanding his trips out of the house, was a question for the jury. And the Court held it was a question for the jury although there was no dispute as to the facts. Only the insured introduced testimony, the same as in the case at bar. In Massachusetts Protective Assn. v. Oden, 186 Ark. 844, 56 S. W. 2d 425, a clause the same as the one involved here was in issue; the insured had heart disease, the same as Dr. Hayes. Oden, the policyholder, took frequent automobile rides, including a trip to Montieello, and a train trip to Corpus Christi, Texas. The Court cited with approval the Robins and Sanderson cases and said that the activity of the insured did not bar him from recovery as a matter of law. The case of Mutual Benefit Health & Accident Assn. v. Murphy, 209 Ark. 945, 193 S. W. 2d 305, involved a house confinement clause in a disability policy. During the time the insured claimed benefits under the terms of the policy, he became engaged in the insurance business. There the Court said: “It is undisputed that about a year prior to the date of trial, appellee procured a contract with a life insurance company to sell insurance and opened an office in Fort Smith, across the hall from that occupied by Dr. Rose. It also appears in the testimony of H. R. Parker, representative of appellant, that appellee, Murphy, sold insurance for appellant while being paid by appellant $80 per month for total disability. . . . Appellee’s territory with the Life Insurance Company covered thirteen comities and he managed to sell a number of policies, substantially supplementing his income over the monthly payments from appellant. . . . The Supreme Court of Arkansas has consistently given a liberal construction to the provisions of these policies which require that the insured be confined to the house.” A judgment for the insured was affirmed. Bear in mind that in the Murphy case at the time the policyholder was claiming benefits under a policy having a house confinement clause, lie went down town, rented an office, began to ■ sell insurance and did sell insurance over an area embracing-13 counties. The Sammons case, decided by this Court, has been heretofore mentioned. It is the one that the majority attempts to distinguish from the case at bar, but in my opinion the Sammons case is no stronger than the other cases in point decided by this Court in support of the proposition that it is a, question of fact for the jury to say whether a policyholder, conceded to be totally disabled, is confined to the house within the terms of the policy of insurance. In fact, I have not been able to find a single case where the policyholder was totally disabled and the house confinement clause was in issue and this Court has not said such issue was a question of fact for the jury. And the majority has cited none to that effect. In fact, the majority has not cited any authority from any source sustaining the views therein expressed. The case of Colorado Life Co. v. Steele, 101 F. 2d 448, involved a health and accident policy issued in Arkansas. The Arkansas law applied. Judge Gardner of the Eighth Circuit Court of Appeals wrote the opinion. The policy had a house confinement clause and the issue before the court was whether the policyholder had been confined to his home within the meaning of the policy. There the court said: “It appears from the undisputed evidence that plaintiff transacted more or less business during the period for which recovery is sought, and that he traveled by automobile a great deal, and it is claimed that he was not totally disabled, as that term is used in the policy, and that he was not necessarily and continuously confined within the house, nor prevented from engaging in his occupation. ... In considering the question of the sufficiency of the evidence, it is our province to determine whether or not there was substantial evidence to sustain the verdict. ... As the jury has resolved the issues in favor of plaintiff, we must accept the testimony in his favor as true, and he is entitled to such reasonable favorable inferences as may fairly be drawn therefrom. . . . The Supreme Court of Arkansas has consistently given a liberal construction to tbe provisions of these policies which require that the insured be confined to the house and that he be there treated regularly by a physician.” The court sustained a judgment in favor of the insured. In the case at bar a jury was waived; the cause was tried before the court sitting as a jury; and the court’s finding of fact is as conclusive on appeal as a jury verdict. Pate v. Fears, 223 Ark. 365, 265 S. W. 2d 954. In my opinion according to all the law ever announced by this Court on this subject up to this time, it was a question of fact for the trial court, since a jury was waived, to determine whether the policyholder was confined to his house within the terms of the policy as such terms have heretofore been construed by this Court. The finding of fact by the trial court was in favor of the insured, and the judgment should be affirmed. For the reasons set out herein, I respectfully dissent.