176 S.E. 702 (Ga.App. 1934), 23399, Aetna Life Ins. Co. v. Padgett

Docket Nº:23399.
Citation:176 S.E. 702, 49 Ga.App. 666
Attorney:Bryan, Middlebrooks & Carter, of Atlanta, and Beck, Goodrich & Beck, of Griffin, for plaintiff in error. Chester A. Byars, of Griffin, for defendant in error.
Judge Panel:BROYLES, C.J., and GUERRY, J., concur.
Case Date:September 27, 1934
Court:Court of Appeals of Georgia

Page 702

176 S.E. 702 (Ga.App. 1934)

49 Ga.App. 666




No. 23399.

Court of Appeals of Georgia, First Division

September 27, 1934

Syllabus by the Court.

It is plain from a construction of the group policy and the certificate issued thereunder, taken as a whole, that it was the intention of the parties that the insured was not covered by the disability benefits contained therein, unless he was eligible for insurance at the date of the group policy and had been continuously insured from a date not more than three months thereafter to the commencement of the disability, or, if not so eligible at the date of the issuance of the policy, that he must have been continuously insured under the policy for at least one year immediately preceding the commencement of disability. The plaintiff not coming within either of these provisions, the trial court erred in rendering judgment against the insurance company.

Error from City Court of Griffin; A. K. Maddox, Judge.

Action by Zonie Padgett, as next friend of Pauline Padgett, against the Ætna Life Insurance Company. Judgment for plaintiff, and defendant brings error.

Judgment reversed.

Bryan, Middlebrooks & Carter, of Atlanta, and Beck, Goodrich & Beck, of Griffin, for plaintiff in error.

Chester A. Byars, of Griffin, for defendant in error.

MacINTYRE, Judge.

Mrs. Zonie Padgett, as next friend of Pauline Padgett, brought suit against the Ætna Life Insurance Company to recover $1,000 as principal by reason of a certificate issued to her under a group policy issued by the defendant to her employer. By agreement, the case was tried before the judge without a jury upon an agreed statement of facts. The judge rendered judgment against the insurance company, and the case is brought to this court on exceptions thereto.

It appears that on May 11, 1931, the defendant company issued to the Georgia Kincaid Mills a group policy of insurance, upon the lives of certain employees of said mills, which contained permanent total disability benefits; that Pauline Padgett became an employee in said mill on April 7, 1931, and a certificate was issued to her, under the group policy, on July 7, 1931, three months after the commencement of her employment; that on November 6, 1931, she became totally disabled and was forced to quit work on that date; that no premiums were paid on her insurance after this date and the insurance on her life was canceled as of December 10, 1931; that on December 7, 1931, she filed claim for disability benefits and thereafter proof of the same; and that the company denied all liability thereunder.

The determination of whether the insured should be allowed to recover disability benefits under the certificate issued to her under the group policy depends upon the construction of the provisions contained in the policy and certificate, taken together. Carruth v. Ætna Life Insurance Co., 157 Ga. 608, 122 S.E. 226; Metropolitan Life Ins. Co. v. Harrod, 46 Ga.App. 127, 166 S.E. 870. In the construction of insurance contracts, as well as all other contracts, we are to be guided by certain well-settled rules. Among these is that "policies of insurance will be liberally construed in favor of the object to be accomplished, and provisions therein will be strictly construed against the insurer." New York Life Ins. Co. v. Thompson, 45 Ga.App. 638, 165 S.E. 847, 848;

Page 703

Johnson v. Mutual Life Ins. Co., 154 Ga. 653, 115 S.E. 14; Arnold v. Empire Mut. & Annuity & Life Ins. Co., 3 Ga.App. 685, 60 S.E. 470. The meaning of this rule has been stated in various ways, thus: "If a policy or contract of insurance is fairly susceptible of more than one construction, the interpretation most favorable to the insured will be given effect" ( Mandeville Mills v. Milam, 39 Ga.App. 768, 148 S.E. 418, 419; Bankers' Health and Life Ins. Co. v. Knott, 41 Ga.App. 639, 154 S.E. 194; Life Ins. Co. of Va. v. Williams, 48 Ga.App. 10, 172 S.E. 101; Niagara Fire Ins. Co. of N.Y. v. James, 48 Ga.App. 276, 172 S.E. 725; Mass. Benefit Life Ass'n v. Robinson, 104 Ga. 256, 30 S.E. 918, 42 L.R.A. 261; Kesler v. Commercial Casualty Ins. Co., 39 Ga.App. 197, 146 S.E. 506; Johnson v. Mut. Life Ins. Co., 154 Ga. 653, 115 S.E. 14; Warwick v. Supreme Conclave Knights of Damon, 107 Ga. 120, 32 S.E. 951; Insurance Co. of North America v. Samuels, 31 Ga.App. 258, 120 S.E. 444; Columbia Casualty Co. v. L. W. Rogers Co., 157 Ga. 158, 121 S.E. 224; Penn Mut. Life Ins. Co. v. Milton, 160 Ga. 168, 127 S.E. 140, 40 A.L.R. 1382; Eisenberg v. Hebrah Gemiluth Hesed Soc., 33 Ga.App. 350, 126 S.E. 265; Macon County Ass'n v. Slappey, 35 Ga.App. 737, 134 S.E. 834; Ætna Ins. Co. v. Johnson, 127 Ga. 491, 56 S.E. 643, 9 L.R.A. (N. S.) 667, 9 Ann.Cas. 461; New Jersey Ins. Co. v. Rowell, 157 Ga. 360, 121 S.E. 414; Ætna Life Ins. Co. v. Palmer, 159 Ga. 371, 125 S.E. 829; State Mut. Life Ins. Co. v. Forrest, 19 Ga.App. 296, 91 S.E. 428; Winder Nat. Bank v. Ætna Life Ins. Co., 36 Ga.App. 703, 137 S.E. 848; Mut. Life Ins. Co. v. Durden, 9 Ga.App. 797, 72 S.E. 295), and, "of two inconsistent clauses appearing in the body of an insurance policy, the one more favorable to the insured will be adopted" ( Hodges v. Planters' & Peoples' Mut. Fire Ass'n of Ga., 37 Ga.App. 203, 139 S.E. 362; Hall v. Royal Fraternal Union, 130 Ga. 820, 61 S.E. 977; Perkins v. Empire Life Ins. Co., 17 Ga.App. 658, 87 S.E. 1094). If words or provisions of an ambiguous meaning are employed in a contract of insurance, it is only fair and in accordance with law that the doubt should be resolved against the insurer, who is the author of the instrument, and in the preparation of which the...

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