Adkins v. Aetna Life Ins. Co.
| Decision Date | 24 June 1947 |
| Docket Number | 9898. |
| Parties | ADKINS v. AETNA LIFE INS. CO. |
| Court | West Virginia Supreme Court |
Syllabus by the Court.
1. When the evidence which bears upon an issue in the trial of an action is not conflicting and only one inference may be drawn by reasonable minds from undisputed facts the issue becomes a question of law for the court.
2. Clear and unambiguous provisions of a group policy of life insurance, as those of any other contract, will be given the plain meaning and effect of the language used by the parties to the contract.
3. A group policy of life insurance, issued by an insurer to an employer, which contains a clause to the effect that upon the termination of the employment of the insured with the employer, the insurance under the policy shall automatically cease at the end of the policy month in which the employment terminates, except as provided in a paragraph which entitles the beneficiary, upon stated conditions, to the payment of specified extended insurance, is valid and binding upon the parties and upon all other persons whose rights are based upon or exist by virtue of the contract.
4. In a group policy of life insurance under which the insurance automatically ceases at the end of the policy month in which employment of the insured terminates, a clause which provides that upon the termination of such employment the insurer will, within a specified period and upon certain stated conditions, issue to the insured a converted policy of life insurance, confers upon the insured only a right to obtain such policy and does not, during the period in which he may exercise his right, extend or keep effective the insurance which has ceased by virtue of the termination of his employment.
5. In the absence of a provision in a group policy of life insurance requiring notice by the employer or the insurer to the insured of the termination of his employment with his employer, and when it appears from undisputed facts that the insured voluntarily ceased to work for his employer and accepted employment from another, no such notice is necessary to accomplish the actual termination of such employment.
Fitzpatrick Strickling & Marshall, of Huntington, for plaintiff in error.
W W. Smith, of Huntington, for defendant in error.
On this writ of error the defendant, Aetna Life Insurance Company seeks reversal of a judgment against it for $1,000.00 in favor of the plaintiff, Ethel Adkins, rendered by the Circuit Court of Cabell County upon the verdict of a jury in that amount.
The action is based upon a group policy of insurance on the life of Roy E. Adkins, the husband of the plaintiff, in the amount of $1,000.00. This policy, dated January 12, 1942, and in which the plaintiff was the named beneficiary, was issued by the defendant and delivered to Smoot Advertising Company. Roy E. Adkins became an employee of the advertising company in April, 1941. Under the policy a certificate dated December 17, 1941, was issued by the insurance company. The certificate provides that the company has insured the life of Roy E. Adkins, an employee of the advertising company subject to the terms and conditions of the policy; that in the event of his death the sum insured would be paid to Ethel Adkins, the beneficiary; and that the continuance of the insurance is subject to the payment by the employer of the premiums when due. It also refers to certain provisions of the policy which are described on the reverse side of the certificate.
Roy E. Adkins, who was a painter by trade, died from a sudden two day illness on April 26, 1942, while working for Badger and Sons Company, a different concern from Smoot Advertising Company. The defendant insurance company having denied liability on the ground that Roy E. Adkins was not an employee of Smooth Advertising Company at and prior to the time of his death, the plaintiff instituted this action on July 8, 1944. The declaration, following the statutory form, filed a copy of the policy and a copy of the certificate. The defendant filed its plea of the general issue and its specification of defenses. To this specification of defenses the plaintiff filed a replication and an amplified replication. Upon the issues raised by these pleadings the case was tried before a jury. At the conclusion of the evidence the defendant moved the court to direct a verdict in its favor. This the trial court declined to do and, over objection and exception of the defendant, submitted the case to the jury. The jury returned a verdict in favor of the plaintiff for $1,000, upon which the court entered the judgment which the defendant assails in this Court.
The policy issued by the defendant to the Smoot Advertising Company, the employer of Roy E. Adkins at the time it was issued, constitutes the contract of insurance.
Both the policy and the certificate issued to the insured by the company contain certain identical provisions which are material to the decision of the case. One of these provisions is that: 'In the event of the termination of the insured's employment with the employer, the insurance under this policy shall automatically cease, * * * at the end of the policy month in which employment terminates.' This provision, the defendant insists, applies to the undisputed facts in this case. The other of these provisions relates to a privilege for the benefit of the insured to convert the policy into a new contract of insurance. This provision is, in effect, that upon termination of his employment with the employer, the company will, if desired, issue to the insured, without further evidence of insurability, upon his written application to the company and his payment, within thirty-one days after cessation of the insurance, of the first premium applicable to the class of risk to which he belongs and to the form and the amount of the insurance at his then attained age, a new policy of life insurance, in any one of the nonparticipating forms customarily issued by the company, except term insurance, in an amount not to exceed that of the terminated insurance under the original policy.
The policy contains these additional pertinent provisions: That the company will pay the sum insured to the beneficiary upon surrender of the policy and due proof of the death of the insured during the continuance of the insurance; that the agreement is made in consideration of a premium to be paid by the employer for insurance for one month from the date of the policy and of the payment of renewal premiums for subsequent insurance; and that the policy may be continued at the expiration of the first premium period and monthly thereafter, but only while the insured remains in the employ of the employer, upon payment by the employer of the required premium at the beginning of each monthly period. The policy also provides that if any premium is not paid when due, the policy shall cease, except that a grace period of thirty-one days, during which the policy shall remain in force, is allowed for the payment of any premium after the first premium. The plaintiff contends that the foregoing provisions with respect to the conversion privilege given the insured and the period of grace of thirty-one days allowed for the payment of any insurance which has become due kept the insurance under the policy in effect at the time of the death of the insured on April 26, 1942.
The question of controlling importance is whether, under the facts disclosed by the evidence, the employment of the insured by his employer, Smoot Advertising Company, had terminated and, if so, by reason of the termination of his employment, the insurance under the policy had ceased before his death. It is not controverted that the death of the insured occurred on April 26, 1942, after a sudden and short illness, or that the last policy month for which any premium was paid by the employer ended on April 12, 1942.
The testimony introduced on behalf of the plaintiff was that the insured, Roy E. Adkins, worked for Smooth Advertising Company in and about the City of Huntington, where his employer maintained a branch office, from some time in April, 1941 until April 2, 1942. Upon occasions, when weather conditions prevented outside activities in which his employer was engaged, he worked for short intervals of several days for other concerns which used and paid him for his services as a painter. During the times he worked in this manner there was no formal termination of his employment with Smoot Advertising Company, and it continued to pay his insurance premiums and to keep his name on its pay roll lists. After he ceased to do any work for Smoot Advertising Company, on April 2, 1942, he kept the keys to its garage and automobile truck which he had used in connection with his work for that company, and his wife, the plaintiff, had the keys in her possession at the time of the trial of this case. No notice was given the insured of any termination of his employment and he never indicated to the plaintiff by any act, other than his acceptance of employment with Badger and Sons Company, that he considered his employment with Smoot Advertising Company as having been terminated. The work which he performed for Badger and Sons Company, which consisted of painting, was done in Point Pleasant, in Mason County, from which place he returned each day from his work to his home in Huntington. The wages of the insured for the last work performed by him for Smoot Advertising Company were paid by it on April 3, 1942, to his daughter who called for the money which she received for the insured while he was at work for Badger and Sons Company at Point Pleasant. All prior wage payments to the insured had been called for by him and paid to him...
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