Peterson v. Modern Bhd. of Am.

• Decision Date: 16 November 1904
• Citation: 125 Iowa 562,101 N.W. 289
• Parties: PETERSON v. MODERN BROTHERHOOD OF AMERICA.
• Court: Iowa Supreme Court

125 Iowa 562

101 N.W. 289

PETERSON

v.MODERN BROTHERHOOD OF AMERICA.

Supreme Court of Iowa.

Nov. 16, 1904.

Appeal from District Court, Calhoun County; F. M. Powers, Judge.

Action on a certificate of membership in a fraternal insurance company to recover a specific indemnity for the breaking of a leg. Trial to the court without a jury. Judgment for plaintiff, and defendant appeals. Reversed.

Weaver and Bishop, JJ., dissenting.

Blythe, Markley & Rule, for appellant.

C. O. Longley, for appellee.

DEEMER, C. J.

As the case involves less than $100, a certificate of appeal was allowed by the trial judge, and the case comes to us in virtue of this certificate. The certificate or policy issued by the defendant company provides that, should the member, while in good standing, accidentally break his leg or arm, he should receive one-tenth of the amount his beneficiary would be entitled to recover in case of the death of such member. It also provided, “The breaking of a leg is defined to be the breaking of the shaft of the thigh bone between the hip and knee joints, or the breaking of the shafts of both bones between the knee and ankle joints.” The plaintiff sustained what is known to the medical profession as a “Pott's fracture” of the right leg, which, as usually defined, is the breaking of one bone between the knee and ankle joints, and the dislocation of the other, or, as described in this particular case by the physicians who gave testimony, as the breaking of the fibula 1 1/2 to 2 inches above the joint, and of what is known as the “malleolus process.” The physicians further said that there was “complete solution of the continuity of both bones.” The contention of appellant is that the language of the certificate limits the breaking of a leg, for which an indemnity is to be paid, to such breaking as is described in the language of the certificate, and that there was not in this case a breaking of the shafts of both bones, within the definition set forth in the contract, because the term “shaft” or “shafts” excludes the extremities of the bones and the malleolus process, which is in reality a protuberance from the head of the bone. That there is a manifest distinction between the shaft of a bone and its extremities is too clear for argument. But appellee insists that the language used in the certificate should be so construed as to cover the injury above described; relying upon the proposition that it is the duty of the court to construe the terms of every policy of insurance or benefit certificate most strongly against the insurer, and to resolve every doubt or ambiguity in favor of the insured. There is no doubt about the rule for which he contends, but the difficulty is in its application. If the language used in the certificate is ambiguous or is reasonably capable of two or more constructions, that construction should be given which will afford the insured protection under his certificate. But the parties have the right to make contracts for themselves, and there is no authority for the court to change such contracts. To take away from parties or from persons or corpo rations this undeniable right of contract, or to make contracts for parties, is not within the province of courts of justice. In the instant case, had there been no attempt at definition of what was meant by the breaking of a leg, there would be no doubt that plaintiff's injury was covered by his certificate; but here there is a definition given which is clear and unambiguous, and there is no reason why the parties may not define any term they see fit to use in their engagements one with the other. The certificate plainly says that the breaking of the shaft of both bones between the knee and ankle joint is what is meant by the term “breaking of a leg.” We have no means of knowing what the insured thought when he received this certificate, and it matters little what his thoughts were in this connection, if it be found that the language used is plain and susceptible of but one construction. True, when the terms of an instrument have been intended in a different sense by the parties to it, that sense is to prevail against either party in which he had reason to suppose that the other understood it. Code, § 4617. But in construing this statute, which is simply declaratory of the common law, we have held that, if the language is plain, it cannotbe used for the purpose of making the contract conform to the notions of one of the parties executing it. Congower v. Equitable, etc., Ass'n, 94 Iowa, 499, 63 N. W. 192. In another case we said that the provision is applicable only where the writing involved is fairly susceptible of different meanings. Rouss v. Creglow, 103 Iowa, 60, 72 N. W. 429. See, also, Field v. Association (Iowa) 90 N. W. 717.

The pivotal question in the case, then, is, is the definition of the “breaking of a leg,” used in the certificate in suit, fairly susceptible of different meanings? This all depends upon what effect shall be given the use of the words “shaft” and “shafts.” Looking to the derivation of these words, we find that they mean “handle or haft; a shaven or smoothed rod.” In the definition as given in the contract it is the shafts of both bones between the ankle and knee joint. This clearly excludes the heads of the bones, the joints themselves, or the process attached to these heads, which have distinct and definite names. Treating the words as technical, as they no doubt are, the plaintiff is in no better position. Technical words are to be interpreted as usually understood by persons in the profession or business to which they relate. Gauch v. Insurance Co., 88 Ill. 251, 30 Am. Rep. 554;Dana v. Feidler, 12 N. Y. 40, 62 Am. Dec. 130. The medical profession are agreed that the shaft of a bone is something entirely distinct from the malleolus process. There is no room for any doubt as to what these words mean to the medical profession, and nothing in the record suggests that the parties did not use them in a technical sense. Even if there be a popular meaning of the term “shaft,” it has not been disclosed to us; and, taking the full definition as given in the certificate itself, there are, as it seems to us, no two constructions to be put upon the language used. There was, it is conceded, no breaking of the shafts of both bones, unless we say the protuberance from the head of one of the bones known as the “malleolus process” is a part of the shaft of the bone between the knee and ankle joint. Manifestly this protuberance is not so located. It projects from the end of the head of the bone downward toward the heel. Doubtless the accident is more serious than if both shafts had been broken, and plaintiff needs his insurance just as badly as if they had been, but this is no reason for changing the terms of his certificate. The defendant company had the right to narrow its liability, to define the terms used in its certificates, to remove from the field of debate the character of a particular injury, or, in other words, to make its own contract. Having made its contract, it is not within the province of a court of justice to change its terms to meet the equities of a particular case. Our views find support in the following cases: Stevers v. People's Ass'n, 150 Pa. 132, 24 Atl. 662, 16 L. R. A. 446;Gentry v. Standard Co., 6 Ohio Dec. 114;Id., 5 Ohio N. P. 331;Maryland Casualty Co. v. Hudgins (Tex. Sup.) 76 S. W. 745, 64 L. R. A. 349.

The injury does not come within the terms of the certificate issued by the defendant association, and the court was in error in rendering judgment against it. For the reasons pointed out, the judgment must be, and it is, reversed.

WEAVER, J. (dissenting).

Among the most familiar rules of the law of insurance is that which requires the courts to construe every ambiguous and doubtful provision of the policy most strongly against the insurer. The company itself frames the instrument in language of its own choosing, and it brings to that effort the skill born of experience and the aid of learned and astute counsel. The average man to whom that contract is tendered is unlearned in such matters, and he accepts it for what it seems to say; relying upon the company, or upon the agent, who is usually his neighbor, to act in good faith and furnish him the indemnity for which he pays. It is to the credit of the great majority of the companies engaged in this most necessary and useful line of business that the confidence of the insured person is not often abused, and when he suffers loss within the apparent terms of the contract his claim is promptly adjusted and paid. Unfortunately, however, this rule is not universal, and not infrequently the courts are required to deal with policies which appear to have been designed with a deliberate purpose to deceive and mislead the holders. Buried in verbiage, ambushed in small type, obscured in technical terminology, are conditions, warranties, forfeiture clauses, and restrictive definitions without limit, which no one ever reads, nor are they intended to be read or understood, until a loss occurs, when they are summoned forth from their native darkness to defeat a recovery by the assured, or to serve as a menace by which to force him to a compromise of his claim. Ordinarily the courts, when called upon, are prompt to thwart such injustice, though sometimes, as in the case at bar, they reach the conclusion that the arm of the law is too short to arrest the accomplishment of an admitted wrong. The principle stated at the outset of this dissent has been often and effectively applied, and, in my judgment, should be invoked in the present controversy.

In Meyer v. Fidelity & Casualty Co., 96 Iowa, 378, 65 N. W. 328, 59 Am. St. Rep. 374, the accident policy sued upon excepted from its operation injuries caused by “disease or bodily infirmity,” and the company defended upon the theory that the cause of Meyer's death was within the exception. There was evidence...