GRAHAM E. FLEMING, APPELLANT,
v.
PAN AMERICAN WORLD AIRWAYS, INC., APPELLEE

Fla. 3d DCA | 1970-08-04
No. 69-985
Before PEARSON, C. J., and HENDRY and SWANN, JJ.
238 So. 2d 474 Florida District Court of Appeal, Third District (1970)

AI-generated. These summaries, headnotes, and key points are machine-generated and may contain errors or omissions. Always verify against the full opinion text below. Not legal advice.

Synopsis

Former Pan American employee Fleming sought to recover permanent total disability insurance benefits after his employment was terminated, claiming he should be treated as a retired rather than discharged employee. The trial court found Fleming failed to properly apply for disability benefits and that Pan American did not willfully frustrate his claim, and the appellate court affirmed.


Holding

Fleming is not entitled to the disability insurance benefits because he failed to properly apply for them through the established procedure and failed to effectively communicate to Pan American his desire to claim disability benefits. The evidence does not establish that Pan American refused to provide the necessary claim forms or that Pan American willfully frustrated Fleming's claim.


Headnotes

[1] An appellate court will not re-evaluate evidence to support factual conclusions of the trial judge when there is evidence in the record to support those conclusions.

[2] A former employee seeking disability benefits under an insurance policy must follow the prescribed procedure for making proof of disability, including submitting necessar…

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Key Quotes

“Plaintiff's position throughout the grievance proceedings was that he was fit to work, both mentally and physically. After the award of the Board, he told the Pan American employee who filled out his annuity application forms that he was in good health.”

Demonstrates Fleming never claimed disability status to his employer, undermining his later claim for disability benefits

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Facts & Procedural History

Fleming was employed by Pan American until August 16, 1965, when his employment was terminated. An arbitrator for the Field Board of Adjustment determ…

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Opinion of the Court
PER CURIAM.

PER CURIAM.

The appellant, Graham E. Fleming, is a former employee of the appellee, Pan American World Airways, Inc. His employment was terminated on August 16, 1965. Grievances were filed and were finally determined when an arbitrator for the Field Board of Adjustment determined the controversy in favor of the appellee.

On October 2, 1967, Mr. Fleming filed in the circuit court a complaint entitled “complaint for declaratory decree and other relief”. The burden of this complaint was that the appellee Pan American should be directed to provide for Mr. Fleming the benefits of a hospital and surgical benefit policy maintained for employees of Pan American under an employees participating plan.1

After an extensive trial the trial judge entered his judgment for the appellee Pan American and entered findings of fact which are in part as follows:

“Plaintiff’s theory is that, since Pan American discharged him because of disability, Pan American should be required to pay him the benefits of permanent total disability provided by his life insurance policy issued by The Travelers.
“Plaintiff’s position throughout the grievance proceedings was that he was fit to work, both mentally and physically. After the award of the Board, he told the Pan American employee who filled out his annuity application forms that he was in good health. He gives no outward appearance of being disabled. By his own testimony, plaintiff has never claimed to Pan American that he was, or is, disabled.
“The mechanics of ‘making proof’ of disability under the terms of plaintiff’s insurance require plaintiff to go to. Pan American’s personnel office, indicate that he wants to apply for permanent total disability benefits, fill out a form sup*476plied by The Travelers, and submit a statement from his doctor, whereupon Pan American’s duty is to complete certain employment and other data in the form and submit it to The Travelers, which investigates the claim and determines whether it should be allowed.
“Plaintiff has never taken this step. Approximately a year after the Board’s award, plaintiff went to the local office of The Travelers and stated he wanted to collect his life insurance benefits, saying he was retired because Pan American told him he wasn’t able to do the job. The claims man to whom he talked told plaintiff he would have to file his claim through Pan American. Plaintiff reported this, to his attorney, but did not contact Pan American about it.
“Plaintiff contends that he attempted to get disability claim forms from Pan American and was refused them. The evidence relied on in this regard is unconvincing. Pan American’s evidence to the contrary is credible. Additionally, over a period of more than a year and a half following the award of the system adjustment board, neither plaintiff nor either of his attorneys wrote a letter about plaintiff being refused disability claim forms, or indicating that plaintiff desired to claim insurance disability benefits, to either Pan American or The Travelers, although during this time and as late as April, 1967 letters were written seeking to obtain the paid up policy and continued medical insurance of a retired .employee. The Court is convinced, and so finds, that whatever plaintiff may have said to Pan American, he failed to convey the idea that he desired to make a claim for insurance disability benefits, and that Pan American has not refused forms therefor to plaintiff.
“The evidence fails to establish facts that impose any obligation, either contractual or tortious, on Pan American to pay the disability benefits of plaintiff’s life insurance issued by The Travelers.
“Upon all of the evidence the Court finds that plaintiff is not a retired, but is a discharged, former employee of Pan American, and that he is receiving all of the benefits to which he is entitled from Pan American. The Court further finds that plaintiff is not entitled to recover the disability benefits of his life insurance policy from Pan American.”

On this appeal the appellant presents a single point as follows: “Is Fleming entitled to insurance benefits as a retired employee and if so, how much?” Under this point appellant argues that he should be entitled to the insurance benefits because “everything indicated Fleming was a retired employee.” It is pointed out there is in evidence as a part of the recommendation of the arbitrator a statement by the arbitrator:

“ I * * * feel certain that the Company will want to renew its offer of early retirement in light of the conclusion I reach here; Grievant only refused the offer to press this case. Now that the case is over he will probably wish to accept the offer.”

It is also urged that the evidence substantiates appellee’s position that Pan American willfully frustrated appellant’s claim to total and permanent disability under the policy.

Appellant’s argument in effect asks this court to retry the case in which the trial judge has made full and explicit findings of fact against the appellant. Upon our determination that there is evidence in the record to support the factual conclusions of the trial judge, we will not re-evaluate the evidence in support of these conclusions. See the principle of appellate review stated in Board of County Commissioners of Highlands County v. F. A. Sebring Realty Company, Fla.1953, 63 So.2d 256, 258.

Affirmed.


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