Conrad v. Midwest Coal Co.

Citation300 N.W. 721,231 Iowa 53
Decision Date18 November 1941
Docket Number45791.
PartiesCONRAD v. MIDWEST COAL CO. et al.
CourtUnited States State Supreme Court of Iowa

Appeal from District Court, Marion County; W. S. Cooper, Judge.

Action for workmen's compensation by reason of injuries received. The industrial commissioner held for the claimant which decision, on appeal to the district court, was affirmed. The insurance carrier has appealed to this court.

Affirmed.

Miller, Huebner & Miller, of Des Moines, for appellant.

Mabry & Pabst, of Albia, for appellee.

WENNERSTRUM, Justice.

This appeal has developed by reason of an action commenced before the industrial commissioner by the claimant-appellee to recover workmen's compensation against his employer and the defendant-appellant insurance company, the Pioneer National Casualty Company. Claimant was injured in an automobile accident on September 9, 1937 while engaged, as he claims, in duties attendant to his employment. As a result of the injuries sustained it became necessary to amputate his left arm. Upon submission of the claim before the deputy industrial commissioner that official made an award in favor of the claimant. This decision was confirmed and approved by the industrial commissioner on review, with the exception that the deputy's ruling was modified on the issue as to who were the interested partners. A further appeal was taken to the district court where the industrial commissioner's holding was confirmed generally and judgment rendered in keeping with the award made. The Pioneer Casualty Company has appealed to this court.

The appellant insurance company has raised numerous questions on this appeal asserting: that there had been a change in the personnel that made up the partnership, termed the Midwest Coal Company, after the policy involved in this action had been written; that the policy was not applicable to the claimant in that he had not taken any affirmative action as is claimed was necessary to come under its terms; and that the premium had not been paid as provided by the contract of insurance, and the policy had therefore lapsed.

The appellant, in its brief and argument, now concedes that the injuries for which award has been made arose out of and in the course of claimant's employment. By reason of this concession no further comment concerning the extent of the injuries or the manner in which they were received is necessary. However, it is the appellant's contention that the claimant-appellee, and his injuries, were not covered by the policy issued by the appellant. By reason of this contention it is necessary that, as briefly as possible, we review the terms and conditions of the insurance agreement, and the facts pertaining to its issuance, and the matter of payment of the premium claimed to be due on the policy at the time of the claimant's injury.

According to the policy issued, the Pioneer National Casualty Company is a legal reserve mutual insurance company. The initial arrangements between the Midwest Coal Company and the insurance company commenced on August 12, 1937, at which time the coal company, by one of its partners, signed an application termed: " Declarations for Workmen's Accident Insurance." This declaration provided that " The term of the policy shall be from Aug. 12, 1937 to Sept. 1, 1937, at twelve and one minute o'clock A. M., Central Standard Time, as to each of said dates." A further provision in the " declarations for workman's accident insurance" which the coal company signed was as follows:

" Permisson is hereby given the Pioneer National Casualty Company to examine the books of this Employer during the term of the policy and any renewal thereof and within one year after its final termination so far as they relate to the remuneration earned by any person working for this Employer while the Policy is in force. The maximum contingent liability of the Employer under the policy shall be an additional amount equal to the premium for the term for which the policy is written. It is agreed and understood that the policy is issued in consideration of the statements made herein, which are represented by the Employer to be true and correct. It is further agreed and understood that the insurance herein applied for shall not be binding until this application has been approved by the Company and the policy issued. The Employer hereby agrees to the terms of the policy when and if issued."

The policy which was issued on August 13, 1937, although designated as " workman's accident insurance", purported to insure " each person named in the attached list of those who have entered into a Compensation Agreement with the employer hereinafter named, in the form hereinafter set out, and such other persons as shall hereafter enter into such Compensation Agreement with said employer, as follows."

Further provisions of the policy are hereafter set forth. An endorsement attached to the policy struck out paragraphs 1, 2, and 3 and substituted in lieu thereof the following:

" As to each person, the insurance hereunder shall begin upon the issuance of this policy, the payment by the employer of the deposit premium specified in the Declarations, and such execution of said Compensation Agreement.

4. The insurance hereunder shall apply only to personal injuries sustained while such person is insured under this policy or a renewal or extension thereof and which arise out of and in the course of such person's employment as an employee of said employer within the meaning of the Iowa Workmen's Compensation Law.

5. For and on account of any and all personal injuries thus sustained, the Company agrees as follows:

(a) To promptly pay to any person who would be entitled thereto under the Iowa Workmen's Compensation Law an amount equal to and in accordance with the terms, conditions and limitations of the Iowa Workmen's Compensation Law as the same appear in Chapters 70, 71, and 72 of the Code of Iowa with Amendments thereto.

(b) To furnish necessary and reasonable surgical, medical and hospital services and supplies therefor in accordance with the terms, conditions and limitations of said Workmen's Compensation Law.

(c) In case of death resulting from such injury, to pay the reasonable expense of burial of such employee in accordance with the terms, conditions and limitations of said Workmen's Compensation Law."

The policy further provides that it shall be subject to certain conditions, a portion of these being hereinafter set out:

" Section I. The Iowa Industrial Commissioner having approved the plan of insurance herein provided, it is agreed that as respects said employer's obligation to carry insurance for and to provide, secure and pay compensation according to the provisions of said Workmen's Compensation Law for personal injuries sustained by such employee arising out of and in the course of the aforesaid employment, the insurance provided in this policy shall be and is a substitute for and in lieu of any other form or plan of insurance provided for in said Workmen's Compensation Law. Otherwise all of the provisions of said Workmen's Compensation Law applicable to employees and employers who have not rejected the same or who have waived such rejection shall be and remain a part of this policy as fully and completely as if written herein. And all of the rights and defenses which such an employer has under said Workmen's Compensation Law are hereby vested in and reserved unto the Company. Nothing herein contained shall operate to so extend this policy as to impose upon the Company liability for any injury or death that would not be compensable under said Workmen's Compensation Law.

Section II. * * *.

Section III. Jurisdiction of Commissioner and Definitions of Terms. It is agreed that the Iowa Industrial Commissioner shall have jurisdiction to hear and determine any and all controversies arising under and within this policy and out of injuries covered thereby in the same manner and to the same extent as in controversies arising out of injuries covered by other forms of policies provided for and permitted by said Workmen's Compensation Law. It is also agreed that whenever and wherever terms are used herein that are defined in said Workmen's Compensation Law, the same are used in this policy in the same sense and with the same meaning as such terms are used and defined in said Workmen's Compensation Law.

Section IV. What Constitutes Policy. * * *.

Section V. Premium Basis. * * *.

Section VI. Cancellation. This policy may be cancelled at any time by the employer upon written notice to the Company stating when thereafter cancellation shall be effective; or by the Company upon written notice to the employer stating when, not less than ten days thereafter, cancellation shall be effective. The effective date of such cancellation shall then be the end of the policy term. In the even(t) of such cancellation, the remuneration to the end of such policy term of all persons working for said employer shall be exhibited to the Company and the earned premium thereon shall be computed, as provided in Section V of this policy. If the earned premium thus computed is greater than the deposit premium paid, the employer shall immediately pay the additional amount to the Company, if less the Company shall return to the employer the unearned portion of such deposit premium. Notice of cancellation mailed by first-class mail to the employer at the address herein given, shall be sufficient notice, and the check of the Company, similarly mailed, shall be sufficient tender of any unearned premium.

Section VII. Said employer agrees that at the effective date of this policy he is bound by and operating under the compensatory provisions of said Workmen's Compensation Law and will not give notice of his...

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