MARIA PANEPINTO, APPELLANT, v. NEW YORK LIFE INSURANCE COMPANY, RESPONDENT.
90 N.Y.2d 717, 688 N.E.2d 241, 665 N.Y.S.2d 385 (1997).
November 25, 1997
1 No. 210
(97 NY Int. 0202)
Decided November 25, 1997
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This opinion is uncorrected and subject to revision before publication
in the New York Reports.
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Richard M. Duignan, for appellant.
Franklin H. Stone, for respondent.
LEVINE, J.:
This action involves a dispute over the meaning of language found in
two insurance policies that ultimately willdetermine whether
plaintiff's action on the policies is time barred. Each policy
provides for the payment by defendant New York Life Insurance Company
of $1,000 per month in the event of the "total disability" of
plaintiff. "Total disability" is initially defined as "the complete
inability of the insured to perform any and every duty pertaining to
his or her occupation." After five years of such disability, the
definition becomes "the complete inability of the insured to engage
for remuneration or profit in any and every occupation for which the
insured is reasonably qualified, based upon his or her education,
training, experience and prior average annual earnings."
Plaintiff, Maria Panepinto, claims that she continues to suffer from
allergic rhinitis, a severe asthma caused by woolen dust particles
that makes it impossible for her to perform her job as an executive
overseeing the manufacture and sale of garments containing wool. On
January 20, 1984, she filed a notice of claim for total disability and
provided proof of loss to New York Life, including her allergist's
recommendation that she cease working with clothing and fabrics.
Thereafter, pursuant to the terms of the policies, New York Life made
monthly payments of $2,000 to plaintiff for a period of three years,
during which it waived the payment of premiums due on the policies.
Plaintiff was then examined by New York Life's doctor and, relying on
its doctor's report that plaintiff was no longer totally disabled, New
SNIPPETS:
This opinion is uncorrected and subject to revision before publication in the New York
This action involves a dispute over the meaning of language found in two insurance policies
Each policy provides for the payment by defendant New York Life Insurance Company of $1,000
On January 20, 1984, she filed a notice of claim for total disability and provided proof of
Supreme Court granted summary judgment for New York Life and denied plaintiff's cross motion
Resolution of this appeal turns on the interpretation of the provisions of the policies
Paragraph seventeen of the policies unambiguously links the commencement of the limitations
"Written proof of loss must be furnished to the Company at its Home Office.
The policies also include a "Lifetime Maximum Benefit Period" of obligation of New York Life
Thus, relying on the precise language of the policies, she asserts that there has not been a
New York Life proffers two alternative interpretations of the policy provisions regarding the
it urges us to adopt the position of the Appellate Division that the limitations period was
Applying this construction would have required plaintiff to file proof of loss within 90 days
As noted by the United States Court of Appeals for the Third Circuit, this view simply cannot
Paragraph ten of the general provisions of the policies provides that, after submission of
The minority view also is belied by New York Life's practical construction of the policies in
If the insurer is actually prejudiced by a delay in presenting a claim, the claim may be
Accordingly, the order of the Appellate Division should be reversed, with costs, New York
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