National Life & Acc. Ins. Co. v. King

• Decision Date: 21 October 1912
• Docket Number: 15573
• Citation: 59 So. 807,102 Miss. 470
• Parties: NATLONAL LIFE & ACCIDENT INS. CO. v. M. B. KING
• Court: Mississippi Supreme Court

59 So. 807

102 Miss. 470

NATLONAL LIFE & ACCIDENT INS. CO. v. M. B. KING

No. 15573

Supreme Court of Mississippi

October 21, 1912

APPEAL from the circuit court of Alcorn county, HON. JNO. H MITCHELL, Judge.

Suit by M. B. King against the National Life and Accident Insurance Company. From a judgment for plaintiff, defendant appeals.

The facts are fully stated in the opinion of the court.

Affirmed.

W. J Lamb, for appellant.

"Contracts of insurance must have effect like all other written contracts. The intention of the parties must govern and control, and when the language is plain and unambiguous, such intention must be gathered from such language. In such case the court simply ascertains the language the parties themselves have agreed to and written down in their contracts, and enforces it according to its legal effect." Weidert v. State Ins. Co., 20 Am. St Rep. 813.

The appellee in this case can claim no rights which are not expressed in the terms of his contract of insurance. According to the doctrine laid down in the last case, supra the court simply ascertains the language the parties themselves have agreed to and enforces it according to its legal effect. What is the language to which the parties themselves agreed? "Weekly benefits for sickness will only be paid when the insured has been confined to his or her bed for seven consecutive days." Was the insured confined to his bed for seven consecutive days? He was not. Under these facts, where is his right to recover under this policy? By what is the court to measure the rights of the parties? Nothing but the insurance contract can guide and direct the court, and what does the insurance contract say? The insured must be confined strictly to his bed for seven consecutive days.

"The certificate of insurance is to be regarded as a written contract, and, so far as it goes, it measured the rights of all parties." 29 Cyc. 65; Bloch v. Valley Mut. Ins. Assn., 52 Ark. 201; Chartrand v. Brace, 16 Colo. 19.

Another principle which governs the court in the construction of this contract is that the intention of the parties must govern and control, and, when the language is plain and unambiguous, such intention must be gathered from the language of the contract.

No matter what the insured may have thought when he received his policy, the language is plain and susceptible of but one construction, namely: to recover he must be confined strictly to his bed for seven consecutive days, and the certificate of insurance plainly states this to be a conditon necessary before there can be any recovery.

In the last case, supra, the court says:

"In construing this statute, which is plainly declaratory of the common law, we have held that, if the language is plain, it cannot be used for the purpose of making the contract conform to the notions of one of the parties executing it." Peterson v. Modern Brotherhood of Am., 67 L. R. A. 632; Congower v. Equitable Mutual L. & Endowment Ass'n., 94 Iowa 499.

We submit to the court as a correct proposition of law that the appellee is bound by the terms of his policy after the same has been delivered and accepted by him unless there was some mistake or fraud perpetrated on him. In this case there is no contention that there was either.

"After an unqualified acceptance of a policy there is a binding contract, and both the insured and the company are bound by the terms of the policy, in the absence of fraud or mistake, even though the policy varies from the application. The insured is charged with knowledge of statements contained in the policy in the absence of fraud." 25 Cyc. 723; Johnson v. White, 120 Ga. 1010; Rodder v. Tolbert, 115 N.C. 287; Hutson v. Johnson, 110 Wis. 26.

If the insured is charged with knowledge of the statements contained in his policy, then what reason does the appellee give as to why he should recover. He does not claim fraud, or mistake, or that he was ignorant of a single principle which, under the law, he was to know, or that there was any undue advantage taken of him; but he comes into court, standing squarely on his contract, and says that under that contract he is entitled to recover, when he shows by his own testimony and by that of his family physician that he has not complied with the terms of the contract.

We ask the court to apply the principles of law enunciated to the contract contained in policy No. 795771, under which the appellee seeks to recover the sum of thirty dollars. Under section 3 of this policy, the court will find the following:

"Weekly benefits for sickness will only be paid when the insured has been confined strictly to his or her bed for seven consecutive days."

The testimony of Mr. King shows that he was not confined to his bed for seven consecutive days. The testimony of his physician, Dr. Johns, shows also that he was not confined to his bed for seven consecutive days, but, on the contrary, shows that he, on the advice of his physician, stayed out of bed intentionally. Now, under this clause in this contract, what right has the appellee to recover?

"As between general and specific provisions relating to the same subject-matter, the specific provisions will control." 25 Cyc. 741; N.W. Mutual Life Ins. Co. v. Hazlelett, 105 Ind. 212; Moore v. Lichtenberger, 26 Pa. 268.

Here is a specific provision which says that the insured is only entitled to weekly benefits for sickness when the insured has been confined strictly to his or her bed for seven consecutive days. This is a plain, intelligent, unambiguous clause and the appellee cannot recover according to its terms.

Thos. J. Johnston, for appellee.

What was the contention of the parties when these two policies of insurance were taken out, and how are those intentions to be ascertained? By construing the words of a clause in each of the policies, literally as they are written, says the appellant. But the courts say, "that words shall be made subservient to the intent, not the intent subservient to the words." 19 Cyc. 657 (note 17).

Again it is said, "that the intention of the parties is to be gathered from the surrounding clauses and from all parts of the instrument." Yeaton v. Fry, supra.

Reading the surrounding clauses and all parts of the instrument, we find that policy No. 795771 provides that the premiums are paid, a part for life insurance, and a part for insurance against disability form sickness or accident. Policy No. 52254 is called a "special occupation policy," and provides that the premiums are paid for insurance against sickness which shall wholly and continuously disable the insured from performing every duty pertaining to his occupation. Then the object of the two policies was undoubtedly to insure appellee against disabling sickness; the policies say that is what the premiums were paid for; an indemnity against disability caused by sickness was the thing appellee intended to buy, and thought he was buying, when he paid the premiums. These policies were not written to cover confining sickness as counsed contends in his brief on page 7, but sickness which was disabling. That clause of policy 795771 which provides that, "Weekly benefits for sickness will only be paid when the insured had been confined strictly to his or her bed for seven consecutive days, "and the clause in policy No. 25524, similar to the above, except it provided for continuous and necessary confinement to the house, is evidently intended and designed by the insurance company to show that illness sufficiently severe, ordinarily to confine a man to his bed for seven consecutive days, was contemplated and intended by the insurance company to be considered disabling, and as not intended as a condition precedent to appellee's right to recover. If appellee was sick enough to be confined to his bed for the time required, whether he was so confined or not, his sickness falls with the spirit of the policies, and he should be allowed his indemnity. We think the appellant in its brief on page 7 struck the keynote to the meaning and purpose of these clauses, when considered with all the other parts of the policies, when it says, "Before appellee has any right to recover, he must be sick enough to be confined to his bed for seven consecutive days."

A man may be sick enough to be confined to his bed, without being actually so confined. Such was the case of the appellee. The...