PRINCIPAL MUTUAL LIFE INSURANCE COMPANY, FORMERLY BANKERS LIFE COMPANY, A FOREIGN CORPORATION, APPELLANT,
v.
TIM MARTIN, APPELLEE
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Principal Mutual Life Insurance Company appealed a jury verdict awarding disability benefits to Tim Martin after the insurer discontinued payments following the initial 24-month period. The court affirmed, holding that there was sufficient evidence for the jury to find Martin was totally disabled under the policy's definition despite his inability to earn comparable income in alternative occupations.
The court held that there was sufficient evidence for the jury to return a verdict finding Martin totally disabled under the policy's definition. Once Principal continued payments for 14 months beyond the initial 24-month period, it acquiesced in Martin's disability claim and thereafter bore the burden of proving his disability had ended, which was a jury question on conflicting evidence.
[1] An insurance policy's definition of "total disability" may shift from the insured's regular occupation to any occupation for which the insured is reasonably fitted after…
[2] An insurer bears the burden of proving that an insured's total disability has ceased after the insurer has made payments for a period beyond the initial definition of tot…
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Join FLexlaw to unlock all legal intelligence“A defendant is entitled to a directed verdict where, upon considering the evidence in a light most favorable to the plaintiff, 'there is no evidence upon which the jury could lawfully have found a verdict for the plaintiff.'”
Establishes the legal standard for directed verdicts that the trial court must apply
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Join FLexlaw to unlock all legal intelligenceMartin purchased a disability insurance policy from Principal that provided benefits for total disability, defined as the complete inability to perfor…
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PER CURIAM.
Appellant, Principal Mutual Life Insurance Company, (Principal) appeals a jury verdict entered in favor of appellee, Tim Martin (Martin). We affirm.
Martin purchased an insurance policy from Principal. The policy provided benefits for Martin in the event he became totally disabled. The policy defined “total disability” as: [T]he complete inability of the Insured due to Injury or Sickness to perform any and every duty pertaining to an occupation (as defined herein) for remuneration or profit. During the Insured’s Regular Occupation Period defined above [the first twenty-four months of total disability], the word “occupation” as used in this definition of Total Disability means the Insured's regular occupation. Thereafter the word “occupation” means any occupation for which the Insured is reasonably fitted by education, training or experience with due regard to his Earned Monthly Income at the time Total Disability commenced.
Martin suffered injuries, and as a result, was unable to continue working as a police detective. Martin filed a claim and received payments from Principal. After the first twenty-four months, Principal discontinued payments. Martin filed suit and a trial followed.
Principal contends that it was entitled to a directed verdict, because there was insufficient evidence that Martin was totally disabled under the policy’s definition. Martin asserts that the jury had sufficient evidence on which to base its verdict, because any income from employment he could secure would not have been comparable to that of his previous employment. Thus, Martin argues, he was totally disabled under the policy’s definition.
Further, Principal Mutual continued to make payments to Martin fourteen months after the initial twenty-four month period, which amounted to an acquiescence in Martin’s claim of disability. Afterwards it was Principal Mutual’s burden to show, with due regard to income earned at the time of the accident, that Martin’s total disability no longer continued. Aetna Life Insurance Co. v. Fruchter, 283 So. 2d 36 (Fla.1973). It was a jury question, on which the evidence was conflicting, whether Martin would have been able to earn $45,000 per year — his earnings at the time of injury — in any occupation he was reasonably fitted to perform by education, training or experience.
A defendant is entitled to a directed verdict where, upon considering the evidence in a light most favorable to the plaintiff, “there is no evidence upon which the jury could lawfully have found a verdict for the plaintiff.” Jones v. City of Hialeah, 368 So. 2d 398 (Fla. 3d DCA), cert. denied, 378 So. 2d 346 (Fla.1979); see also Guzman v. Faraldo, 373 So. 2d 66 (Fla. 3d DCA 1979), cert. denied 383 So. 2d 1195 (Fla.1980). We find sufficient evidence for the jury to return a verdict finding him totally disabled under the policy’s definition.
Accordingly, we affirm.
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Shaps v. Provident Life & Accident Ins. Co., 826 So. 2d 250 (Fla. 2002)…ted this Court’s opinion in Fruchter. See, e.g., Mizrahi v. Provident Life & Accident Ins. Co., 748 So. 2d 1059, 1060 (Fla. 3d DCA 1999); Derius v. Allstate Indem. Co., 723 So. 2d 271, 273 (Fla. 4th DCA 1998); Principal Mut. Life Ins. Co. v. Martin, 585 So. 2d 474, 475 (Fla. 3d DCA 1991). This does not change the fact that by discharging the writ in Fruchter, this Court effectively refused to rule on the [*254] merits of the case. Therefore, for purposes of the certified question it is irrelevant whether othe…
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Shaps v. Provident Life & Accident Ins. Co., 244 F.3d 876 (11th Cir. 2001)…and Ewing does not in our judgment change the principle applying.” Notably, the policy provision under which Shaps claimed benefits provides: "We will pay the Monthly Benefit for Total Disability....” See also Principal Mut. Life Ins. Co. v. Martin, 585 So. 2d 474, 475 (Fla. App. 3d Dist. 1991) (Fruchter applied in case without mention of permanent disability). There is simply no indication that Fruchter is inapplicable because Shaps did not claim permanent disability. . The substantive law of New York does n…
Authorities Cited
- Jones v. City OF Hialeah, 368 So. 2d 398 (Fla. 3d DCA 1979)
- The AETNA Life Ins. Co., Inc. v. Fruchter, 283 So. 2d 36 (Fla. 1973)
- Ofelia Guzman and Thomas Guzman v. Faraldo, 373 So. 2d 66 (Fla. 3d DCA 1979)