Ragsdale v. Brotherhood of R.R. Trainmen

• Decision Date: 03 December 1934
• Parties: EDWARD RAGSDALE, RESPONDENT, v. BROTHERHOOD OF RAILROAD TRAINMEN, APPELLANT
• Court: Kansas Court of Appeals

80 S.W.2d 272

229 Mo.App. 545

EDWARD RAGSDALE, RESPONDENT, v. BROTHERHOOD OF RAILROAD TRAINMEN, APPELLANT

Court of Appeals of Missouri, Kansas City

December 3, 1934

Appeal from the Circuit Court of Randolph County.--Hon. A. W Walker, Judge.

AFFIRMED.

Judgment affirmed.

Thos J. Tydings and W. M. Stringer for respondent.

Hunter & Chamier for appellant.

OPINION

TRIMBLE, J.

The suit herein was instituted May 7, 1933, on a Benefit Certificate or policy of insurance dated April 1, 1900, issued to plaintiff, a Member of Magic City Lodge No. 57 of Moberly, Missouri, of which city and State he was, at all times, a resident and citizen. The second amended petition, on which the case was tried, charged that defendant is and was at all times "a voluntary unincorporated association" . . . "doing business as an insurance company in the State of Missouri," and issued the policy whereby it promised to pay plaintiff the sum of eighteen hundred seventy-five dollars, in the event of plaintiff becoming totally and permanently disabled;" that on or about July , 1931, and while said policy was in full force, plaintiff became totally and permanently disabled, made proof thereof, and fully complied with all the terms and conditions of said policy, and on or about September 1, 1931, demanded said $ 1875, but defendant denied any and all liability and refused to pay anything.

The said second amended petition further alleged that at, prior to, and ever since the issuance of said policy to plaintiff, the defendant, through its Grand Secretary and Treasurer, "stated and represented that every member of defendant association was insured against total and permanent disability and death," that such statement and representation was circulated by defendant, and plaintiff accepted his policy, relying upon said statement and representation, and by reason thereof defendant is estopped from denying liability or "from claiming that plaintiff's total and permanent disability had to be occasioned by any certain cause, in order to render defendant liable upon said certificate or policy of insurance. (Defendant's contention was, and is, that under defendant's Constitution and By-laws the plaintiff's "total and permanent disability" had to be caused either by the loss of a hand or foot, or the loss of the sight of both eyes; while plaintiff's claim is that the "total and permanent disability" is not to be so limited but is as broad as the words indicate.)

Other allegations were made setting up vexatious refusal to pay and asking for penalty and attorney fees; but as the court denied recovery upon these issues no attention need be given to them.

Defendant's answer, after a general denial, set up that it is, and was, at all times mentioned--

"A fraternal beneficiary association, without capital stock, organized and carried on solely for the mutual benefit of its members and their beneficiaries, and not for pecuniary reward or profit, and that such is and was at said times its sole object and purpose; that it now has, and at said times always has had, a lodge system with ritualistic form of work and representative form of government, and is and was at said times engaged in the business of insuring its members, making provisions for the payment of death benefits, and benefits in certain cases of temporary and permanent physical disability, as the result of accident and old age; that as an incident to membership in said association, it issues and has issued to its members a benefit certificate, payable from the proceeds of its regular dues and special assessments of all members of the association; that it is and was at said times a labor organization, consisting of one Grand Lodge and a large number of subordinate lodges, and that membership in said lodges is and was confined to persons of one hazardous occupation, to-wit railroad trainmen engaged in the hazardous occupation of managing and operating railroad trains; that neither said Grand Lodge nor said subordinate lodge is, or ever was incorporated, and defendant is a voluntary unincorporated association; that said Grand Lodge is and was the supreme legislative and governing body; that said brotherhood has adopted a constitution, by-laws, rules and regulations for governing said Grand Lodge and such subordinate lodges, and all the members of the organization, and which have to do with the relationship between its members, between themselves, and their employers; and which obligate and bind each member to pay his dues and assessments promptly, and to yield cheerful compliance to such constitution, by-laws, rules and regulations, which reserve such Grand Lodge full power and authority to alter, amend and repeal such constitution, by-laws, rules and regulations; and which make each beneficiary certificate issued, subject to, governed and controlled by, such constitution, by-laws, rules and regulations, as may be in force at the time such certificate is issued, and such as may be thereafter adopted; and that defendant makes provision for contracts of insurance and that each contract, according to its scheme of organization and rules governing it, consists of the application, the certificate, and such existing and after enacted constitution, by-laws, rules and regulations. That defendant makes provisions for total and permanent disability claims, and benevolent claims, subject to the exceptions, limitations and conditions set out in the contract, and subject to compliance therewith by the members; that the funds from which the expenses of said association are defrayed and payment of benefits made, are derived from dues and assessments collected from the members; that the main aims, purposes and objects of said association and reason for its organization are the following: To unite the Railroad Trainmen; to promote their general welfare and advance their interests, social, moral and intellectual; to protect their families by the exercise of benevolence, very needful in a calling so hazardous as that of railroad trainmen;"

That plaintiff made application to become a member of defendant and was accepted as such, and thereafter on April 1, 1900, was issued a beneficiary certificate Class C by the Grand Lodge, by which he became entitled to all the rights and benefits of membership, "and to participate in the beneficiary department Class C, of said brotherhood."

That in the certificate it was provided that--

1. "Application, said certificate, the constitution, by-laws, rules and regulations of the association, and all amendments made to said constitution, by-laws, rules and regulations, should constitute the contract between plaintiff and defendant, and should govern the payment of benefits thereunder; that plaintiff by said contract did covenant and agree with defendant that said instruments should constitute the contract between him and the defendant and should determine and control the payment of any benefit; that said contract made up as aforesaid is the only contract ever entered into between plaintiff and defendant; that said instruments expressly provided and provide that under no circumstances should plaintiff be entitled to any benefits, except such, and only such, as might be provided for a Class C member in and by the said contract so made up, subject to the conditions, limitations and provisions set out in said instruments, and subject to compliance therewith by plaintiff;"

That said certificate and said constitution and by-laws, rules and regulations provided that--

2. "No member should be considered totally and permanently disabled unless he should suffer the amputation or severance of an entire hand at or above the wrist joint, or should suffer the amputation or severance of an entire foot at or above the ankle joint, or should suffer the complete and permanent loss of sight of both eyes, or should become 70 years of age; that said instruments and contract provided and provide that plaintiff should be a Class C member and should receive the full amount of such class upon his becoming totally and permanently disabled, but that he should not be considered totally and permanently disabled, unless disabled as in this paragraph hereinbefore set out, and that if he sustains such disability he should make and present to defendant proofs of such disability. Defendant says that plaintiff never did present to defendant any proofs of such disability, as provided by said contract, and that he has never suffered the amputation or severance of any part of either hand or either foot and has not suffered loss of sight of either eye and has not reached the age of 70 years, and therefore is not entitled to recover for a total and permanent disability claim;"

That the certificate, constitution, by-laws, rules and regulations required certain proofs to be made, which plaintiff strictly followed, and they were properly executed and forwarded to the general secretary and treasurer and considered by the beneficiary board, which refused said claim and gave due notice of such refusal to plaintiff, and that the action of the beneficiary board would be reported to the Insurance Board and this last named Board would meet on the second Monday in January thereafter for the purpose of considering such disapproved claim; that thereafter said board of insurance at its next meeting considered said claim and refused and disapproved the same, of which due notice was given plaintiff and said local lodge;

That Sections 70 and 71 of the Constitution, the sections under which plaintiff made his claim, provide that all claims for disability, not considered total and permanent disability claims, should be--

"Held to be addressed to the benevolence of the brotherhood, and should in no case be made the basis of any...