Bowler v. Fidelity & Casualty Co. of New York

In Bowler v. Fidelity & Casualty Co. of New York, 53 N.J. 313, 250 A.2d 580 (1969), plaintiff held an accident insurance policy purchased from the defendant insurance company. The terms of the policy dictated that in case the insured was totally disabled by an injury, the insurer would pay $ 50 per week, for up to 200 weeks. If, by the 200th week, the insured was found to be permanently and totally disabled, the insurer would pay $ 50 per week for an additional 600 weeks. In an accidental fall, plaintiff broke his leg, and subsequently developed a chronic infection, which resulted in total disability. The plaintiff submitted a claim to defendant, who paid $ 50 weekly, for 199 weeks. The insurance company then did not pay the 200th week, fearing that a payment for that week would amount to an admission that the insured was now entitled to the 600 additional weeks for permanent disability. According to the Bowler Court, the insurance company, Instead of fulfilling its contractual obligations . . . lapsed into silence, and not only failed to pay the 200th week but ignored the practically conclusive proof of plaintiff's total and permanent disability . . . Payment of benefits was cut off without a word. . . . Plaintiff, a layman obviously not versed in insurance law, took no legal action until . . . he got into the hands of an attorney, and this suit was brought--more than six years after the end of the 200 week total disability period. When this was done, the insurer pleaded the six-year statute of limitations. . . as a bar. We regard such treatment of its policyholder as shocking and unconscionable. Id. at 326, 250 A.2d 580. The Court found that the defendant's actions constituted an "obvious breach of its duty of good faith and fairness in the handling of its contractual undertaking." Id. at 330, 250 A.2d 580. Consequently, the Court found that the defendant was estopped from raising the statute of limitations defense. Id. at 337, 250 A.2d 580.