Gage v. Connecticut General Life Ins. Co.

• Citation: 273 S.W.2d 761,47 A.L.R.2d 1234
• Decision Date: 06 December 1954
• Docket Number: No. 22066,22066
• Parties: Frances GAGE, Appellant, v. CONNECTICUT GENERAL LIFE INSURANCE COMPANY, a Corporation, Respondent.
• Court: Court of Appeal of Missouri (US)

Page 761

273 S.W.2d 761

47 A.L.R.2d 1234

Frances GAGE, Appellant, v. CONNECTICUT GENERAL LIFE INSURANCE COMPANY, a Corporation, Respondent.

No. 22066.

Kansas City Court of Appeals, Missouri.

Dec. 6, 1954.

W. B. Ennis, S. P. Sandler, Gene R. Martin, Kansas City, for appellant.

Henry G. Eager, Henry I. Eager, Blackmar, Newkirk, Eager, Swanson & Midgley, Kansas City, B. F. Holme, Jr., Hartford, Conn., of counsel, for respondent.

BROADDUS, Judge.

This is an insurance case. A jury was waived and the cause tried to the court. Judgment went for defendant and plaintiff appealed. The cause was submitted under the following agreed statement of facts:

'That on July 30, 1951, as well as for some time prior thereto, the plaintiff, Frances Gage, was employed by Trans World Airlines, Inc. (hereinafter called TWA) at its Fairfax, Kansas Overhaul Base; that on said date there was in force and effect between the defendant as insurer, TWA as the employer and the plaintiff as an employee-insured defendant's 'Group Accident and Sickness Policy' numbered 6191 providing for certain payments for disability due to accident or sickness and defendant's 'Group Hospitalization Benefit Policy (Non-Occupational)' numbered 5043 providing for reimbursement for hospitalization, medical and miscellaneous expense incurred by reason of injury or sickness; that on said date the plaintiff was insured under defendant's Group Certificate numbered 30244 which had been issued pursuant to the aforesaid master policies; that the attached copies of the said policies and the certificate (which are respectively marked 'Joint Exhibits 1, 2 and 3') may be considered to be in evidence herein.

'That on July 30, 1951, due to flood conditions, public authorities had previously closed the said Fairfax, Kansas, area to usual and ordinary traffic including private passenger vehicles; that TWA by earlier arrangement with the public authorities was given permission to bring its Fairfax employees, including plaintiff, to work by the use of buses and for such purpose had previously chartered a number of buses from Yellow Cab Company of Missouri; that the cost of such bus transportation for the said TWA employees, including plaintiff, was paid by employer-TWA and no part of such cost was paid or borne by the employees or any of them.

'That on July 30, 1951 at about 7:15 A.M. plaintiff was a passenger in one of said buses and enroute to her said place of employment; that on the Intercity Viaduct while in Missouri a collision occurred between the bus in which plaintiff was so riding and certain other buses, resulting in accidental injuries to plaintiff due to which she became totally disabled and prevented from working for a period of time from and including July 30, 1951, through and including September 17, 1951 (a total period of 7 weeks and 1 day); that on days previous to July 30, 1951, the TWA employees including plaintiff who were transported by said chartered buses were 'timed' in upon reaching their place of employment in Fairfax and thereafter worked eight full hours including 1/2 hour with pay for lunch; that said employees including plaintiff did not receive any remuneration or pay for the time consumed while traveling to work on these chartered buses on this date or carlier thereto but that their remuneration and pay commenced from such time as they 'timed' in upon reaching their respective places of employment in the Fairfax District.

'That the plaintiff returned to work after the flood on July 26, 1951, and worked on that date, on July 27, on July 28 and on July 29, 1951 and that on these said days she was paid for eight full hours as aforesaid; that the plaintiff would have presumably worked on the same hourly basis on said July 30, 1951 but that the said injury prevented her from reporting to or engaging in her work; that plaintiff was transported to work by such buses on these days immediately prior to the accident as well as on the date of said accident, all pursuant to duly promulgated schedule for TWA employees attached hereto as 'Joint Exhibit 4' and which may be considered in evidence.

'That plaintiff made no claim for any Workmen's Compensation award against either TWA or its compensation-insurer arising out of this accident but that on November 26, 1951 she released said Yellow Cab Company of Missouri from all liability arising therefrom.

'That plaintiff was employed in the Upholstery Department of TWA as a Master Mechanic and had been employed and engaged prior to and on said date of July 30, 1951 by what was a Missouri contract of employment.

'That if plaintiff's above accident comes within the coverage of the attached group insurance policies and certificate then she is entitled to recover as follows: For total disability of 7 weeks and 1 day $285.71; for medical visits $18.00; for hospital expense $32.00; for x-ray, laboratory, drugs, dressings, etc. $25.20, totalling $360.91.'

The Group Accident and Sickness Policy issued March 1, 1939, provides weekly indemnities for total and continuous disability by reason of accidental injury or sickness (Joint Exhibit 1, Joint Exhibit 3.) The first page of this policy says:

'The insurance hereunder shall not cover any disability due to injury arising out of, or in the course of, any employment for wage or profit; nor shall it cover any disability due to sickness for which benefits are provided under any workmen's compensation or similar law.'

All of the rest of the benefits here involved are found in the Group Hospitalization Policy (Non-Occupational) together with all endorsements (Joint Exhibit 2). This master policy was issued March 1, 1939, to plaintiff's employer, and within stated limits affords daily indemnity for hospitalization, for necessary services and supplies and under certain conditions for outpatient nursing expense (Joint Exhibit 3). The first page of this policy provides:

'Limitations. No benefit or reimbursement will be paid, * * * (c) for confinement resulting from accidental injury arising out of, or in the course of employment or from sickness for which benefits are provided under any workmen's compensation or similar law.'

On November 1, 1944, a Group Medical Expense Benefits endorsement was added to this policy (Joint Exhibit 2) which within certain limits included payment to physicians or surgeons for hospital, office or home visits necessary for treatment (Joint Exhibit 3.) However, this language also appears:

'Limitations. No benefit shall be paid * * * (2) for fees charged for treatment of accidental injury arising out of, or in the course of employment or from sickness for which benefits are provided under any workmen's compensation or similar law.'

Plaintiff contends that the court erred in that it failed to apply the rule that where the terms of an insurance policy are ambiguous they are to be construed against the insurer and liberally in favor of the insured. Of the correctness of that rule there can be no doubt. On the other hand, it is equally well settled that where the language of an insurance policy is plain and unequivocal, there is no room for construction, and the words employed...