Metropolitan Life Ins. Co. v. Wann

• Decision Date: 15 March 1930
• Docket Number: No. 12285.,12285.
• Citation: 28 S.W.2d 196
• Parties: METROPOLITAN LIFE INS. CO. v. WANN.
• Court: Texas Court of Appeals

28 S.W.2d 196

METROPOLITAN LIFE INS. CO. v. WANN.

No. 12285.

Court of Civil Appeals of Texas. Fort Worth.

March 15, 1930.

Rehearings Denied April 19, 1930.

Appeal from District Court, Tarrant County; H. S. Lattimore, Judge.

Action by William Charles Wann against the Metropolitan Life Insurance Company. From a judgment for plaintiff, defendant appeals.

Reversed and rendered.

Fred R. Switzer, of Houston (Vinson, Elkins, Sweeton & Weems, of Houston, of counsel), for appellant.

McLean, Scott & Sayers, of Fort Worth, for appellee.

BUCK, J.

Wm. Charles Wann filed suit in the district court of Tarrant county against the Metropolitan Life Insurance Company, hereinafter styled insurance company, alleging that the insurance company issued to plaintiff two certificates, being No. 79350 and No. 79350A, group policy No. 2000-G and group policy No. 2000. The contract sued on is as follows:

"(1) Issued May 5, 1925, in the sum of $250 on the life or for the total and permanent disability of the insured; (2) an increase of $2250, attached to the face as a rider."

Plaintiff alleged that while the policies were in force and on, to wit, September 28, 1926, he sustained an injury to his left hand while working for the Southern Pacific Railway Company as a brakeman; that while attempting to stop and place a car in motion and using a brakeman's stick therefor, placed in the brake wheel, his left hand was injured so as to become totally and permanently disabled, and so as to render him totally and permanently disabled. That by the terms "totally and permanently disabled," used in said policies of insurance, is meant such disability as totally and permanently prohibits and prevents plaintiff from ever performing any character of work for which plaintiff is fitted and suited; that by reason of a defective brake staff spinning around and striking plaintiff on the wrist and hand of his left arm, the same was thereby broken and the bones and nerves crushed and destroyed. Plaintiff prayed for damages in the aggregate of the two policies, with 12 per cent. penalty.

The record discloses that a group policy was issued to the Southern Pacific Railway Company by the defendant, and delivered to one of the railway representatives in the state of New York. The contention is made that appellant's motion for an instructed verdict should have been given, in the absence of any proof of the contents of such group policy or master policy. That the facts are that a group policy is issued to the railway company and then, upon names of the employees being furnished to the insurance company, the latter issues individual certificates to the individual employees, evidencing the fact that they are insured. Appellant cites a number of cases, mostly from other jurisdictions, on the proposition that where the individual policy refers to and shows to be dependent on the group policy for the terms and conditions expressed therein, no recovery can be sustained without the introduction of such group policy.

In Duval v. Metropolitan Life Ins. Co., 82 N. H. 543, 136 A. 400, 402, 50 A. L. R. 1276, the court said: "A group or master policy is issued to the employer, containing a full recital of the contract stipulations. The employer reports to the insurer the names of employees who have accepted the offer of insurance, and thereupon a certificate for each such employee is sent by the insurer to the employer. The certificates state that they are issued under, and subject to, the terms and conditions of the group policy. The insurance is effective only during the term of employment."

To the same effect is Spande v. Western Life Indemnity Co., 61 Or. 220, 117 P. 973, 122 P. 38; Higman v. Hood, 3 Ind. App. 456, 29 N. E. 1141; Seavers v. Metropolitan Life Ins. Co., 132 Misc. Rep. 719, 230 N. Y. S. 366.

We believe that where the individual policy shows a complete contract between the insurer and the insured to insure the individual employee, stating the amount of such insurance and giving other terms and conditions, a recovery may be had upon proof of the individual policy. This assignment is overruled.

The first policy issued to the appellee was signed by the president of the insurance company on the first page thereof. On the back or reverse side there is some writing, which provides the amount of insurance that the insurance company will pay to the employee when he is shown to have been permanently, continuously, and wholly prevented by injury from performing any work for compensation or profit. That upon receipt of due proof of such disability the insurance company will pay to such employee in lieu of the payment at death of the said insurance on the life of such employee, equal monthly installments based on the amount of insurance in force on such employee at the date of receipt of proof of such disability. Then is stated various amounts of insurance, and the number of indemnity installments payable thereon, and the amount of each monthly installment. Objection is raised to the introduction and consideration of all the writing on the reverse side of the policy, and appellant cites such cases as Burbank v. Pioneer Mutual Insurance Association, 60 Wash. 253, 110 P. 1005, Ann. Cas. 1912B, 762; Wilstach v. Heyd, 122 Ind. 574, 23 N. E. 963; Goddard v. East Texas Fire Ins. Co., 67 Tex. 69, 1 S. W. 906, 60 Am. Rep. 1. In the last-cited case it is said that in order to constitute any statement or promise of the insured a warranty, it must be made part of the policy, either by appearing in the body of the instrument, or by a proper reference in the policy to some other paper in which it is to be found. That where there is doubt as to the intention of the parties to treat any outside papers as a part of the contract, the courts give the benefit of the doubt to the assured, and construe the policy liberally in his favor. In this case the clause which appellee sought to be construed as part of the policy was not written or printed on the same paper with the rest of that instrument, nor was it referred to in the policy as forming a part of the contract between the appellant and the insurance company. The Supreme Court, in an opinion by Chief Justice Willie, properly held that the conditions of the clause...