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Carbone v. Atlantic Yachting Co.

Decided: September 10, 1952.

JOSEPH CARBONE, SR., AND DEPARTMENT OF LABOR AND INDUSTRY, DIVISION OF EMPLOYMENT SECURITY, DISABILITY INSURANCE SERVICE, PLAINTIFFS-RESPONDENTS,
v.
ATLANTIC YACHTING COMPANY AND AMERICAN CASUALTY COMPANY OF READING, PENNSYLVANIA, DEFENDANTS-APPELLANTS



Jayne, Proctor and Schettino. The opinion of the court was delivered by Jayne, S.j.a.d.

Jayne

Pursuant to Rule 3:81-8 the defendants request us to review the legal and factual propriety of the conclusions embodied in the final determination and resultant order of the hearing officer of the Department of Labor and Industry, Division of Employment Security, Disability Insurance Service, in this proceeding.

The order in effect obliges the American Casualty Company of Reading, Pennsylvania, in its contractual capacity as the carrier under a private insurance plan approved under the provision of the Temporary Disability Benefits Act (R.S. 43:21-25, et seq) to pay disability benefits to the plaintiff Joseph Carbone, Sr.

Most of the basic information relative to the subject matter of the proceedings is imparted in the decision rendered in a former appeal. 14 N.J. Super. 269 (App. Div. 1951). To warm it over again is unnecessary.

There are two questions addressed to us. The first is of a legalistic complexion. Was the plaintiff's claim filed within the prescribed time? The pertinent facts are not in dispute.

The plaintiff terminated the services of his employment on June 27, 1950. He received his first care and treatment thereafter by "a legally licensed physician" on August 2, 1950. He filed his claim on August 30, 1950, pursuant to which he has sought disability benefits for a period beginning August 2, 1950, and including November 24, 1950.

Considerations of the public welfare induced the Legislature to enact the statute entitled "Temporary Disability Benefits Law" and to declare that it should be liberally construed. R.S. 43:21-25. Statutes, such as this, are designed to meet the exigencies of the social and economic conditions of the time. The statute contains, however, the limitational provisions that no benefits shall be payable under the State plan to any person:

"(a) for the first seven consecutive days of each period of disability, or for more than twenty-six weeks with respect to any one period of disability, or for any period of disability which did not commence while the claimant was a covered individual;

(b) for any period during which a claimant is not under the care of a legally licensed physician." (R.S. 43:21-39)

The statute expressly recognizes the privilege of an employer by a contract of insurance to provide a private plan for the payment of disability benefits by a duly authorized insurance company, but the approval of the private plan by the Division of Employment Security is required, and the approval is withheld if the eligibility requirements for benefits under the insurance policy are more restrictive than those prescribed by the State plan. R.S. 43:21-32.

The plaintiff's employer, Atlantic Yachting Company, under a duly approved private plan held a contract of insurance issued to it by the American Casualty Company which ...


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