Bravato v. Mutual Life Insurance Company of New York, 73 N.Y.2d 945 (1989)

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When conflicting inferences can be drawn from evidence regarding an insured’s occupation at the time of injury, the issue is a question of fact that must be resolved by the jury, not by the court as a matter of law.

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Summary

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A chiropractor, who transitioned to working in real estate after losing Medicaid payments and facing fraud charges, sustained injuries in a boiler explosion while working in real estate. He claimed total disability as a chiropractor under a disability insurance policy. The central issue was whether his occupation at the time of the injury was as a chiropractor or a real estate manager. The trial court ruled as a matter of law that he was a chiropractor. The Court of Appeals reversed, holding that the issue of the plaintiff’s occupation at the time of injury was a question of fact for the jury because conflicting inferences could reasonably be drawn from the evidence.

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Facts

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• Plaintiff, a chiropractor, had a disability policy issued by the defendant insurer.

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• He discontinued his chiropractic practice in 1977 after Medicaid stopped covering chiropractic services and he faced Medicaid fraud charges.

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• He served time in prison and sporadically practiced chiropractic after his release.

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• His primary income shifted to his father-in-law’s real estate business.

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• In 1980, he was injured in a boiler explosion while performing real estate duties.

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• He claimed the injury caused total disability from his “occupation” as a chiropractor, despite working in real estate at the time.

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Procedural History

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• Plaintiff sued the insurer to recover disability benefits.

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• The jury found that plaintiff suffered total disability as a chiropractor.

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• The Appellate Division affirmed the trial court’s decision.

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• The Court of Appeals reversed, ordering a new trial.

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Issue(s)

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Whether the trial court erred in determining, as a matter of law, that the plaintiff’s occupation at the time of the accident was that of a chiropractor, rather than submitting the question to the jury.

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Holding

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No, because conflicting inferences could reasonably be drawn from the evidence presented, making it a question of fact for the jury to determine.

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Court’s Reasoning

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The Court of Appeals emphasized that the critical inquiry was the insured’s occupation at the time of injury. The court found that the evidence presented at trial allowed for conflicting inferences regarding the plaintiff’s occupation.r

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The plaintiff argued that his occupation remained chiropractic because he:r

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• Maintained his professional license.

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• Kept his chiropractic equipment.

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• Maintained malpractice insurance.

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• Sought work as a chiropractor.

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• Continued his telephone listings as a chiropractor.

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• Occasionally treated friends at home.

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The defendant argued that the plaintiff abandoned chiropractic practice because he:r

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• Derived no income from chiropractic after February 1979.

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• Continued in the real estate business after his license was restored.

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• Designated his occupation as