Reserve Life Ins. Co. v. Coke, 43834

• Decision Date: 28 February 1966
• Docket Number: No. 43834,43834
• Parties: RESERVE LIFE INSURANCE COMPANY v. Will Edd COKE.
• Court: Mississippi Supreme Court

Page 490

183 So.2d 490

254 Miss. 936

RESERVE LIFE INSURANCE COMPANY v. Will Edd COKE.

No. 43834.

Supreme Court of Mississippi.

Feb. 28, 1966.

Bacon & Smith, Jackson, for appellant.

Ralph E. Pogue, Aberdeen, for appellee.

SMITH, Justice:

Reserve Life Insurance Company has appealed from a judgment entered against it by the Circuit Court of Monroe County in favor of Will Edd Coke in the amount of $329.50.

Appellant issued its health and accident policy to Will Edd Coke, the appellee, providing indemnities against liability for hospital and surgical expense 'actually incurred,' not to exceed $6 per day. The policy also covered appellee's wife, Mrs. Betty Ann Coke. Mrs. Coke was a patient in the Mississippi State Sanatorium at Magee, Mississippi, during 1963, for 52 days.

After Mrs. Coke was discharged, the State Sanatorium submitted a bill to Mr. Coke for his wife's hospitalization in the amount of $8 per day. When, however, it was discovered that Mr. Coke had a hospitalization policy that paid up to $6 per day, the bill was reduced to $6 per day.

Reserve Life Insurance Company refused to pay the amount of $6 per day, but said that it would pay the maximum of $21 per week, or $3 per day, as provided by Mississippi Code Annotated section 6872 (1952). That section provides that there shall be collected from patients in the State Sanatorium not less than $5 per week, nor more than $21 per week, according to the patient's 'ability to pay.' Appellee declined to accept this offer, and Reserve Life Insurance Company paid into court the sum of $173.50, which included hospitalization expense computed at the statutory maximum rate of $21 per week.

It is the contention of Reserve Life Insurance Company that Section 6872 fixes $21 per week as the maximum which may be charged for hospitalization at the State Sanatorium, and therefore appellee could not legally incur hospital expense in excess of that amount.

At the conclusion of the evidence on behalf of the plaintiff (appellee), and without the defendant ever having rested, the court sustained a motion for a directed verdict for the plaintiff. However, no point is made on this appeal that the defendant was not allowed to present testimony.

The policy insured appellee against certain 'expenses of hospital confinement' incurred while the policy was in force.

These 'hospital expense benefits' are specified on the front page of the policy under Schedule A, Part One. Here the policy provided:

'* * * If the insured * * * shall be necessarily confined within a recognized hospital as a resident patient on account of * * * such sickness, the Company will pay the Insured (or the Hospital if authorized by the Insured to do so) for the following items of hospital expense actually incurred by the Insured or member of the Family Group * * * (Emphasis added.)

'A. HOSPITAL ROOM, including meals and general nursing care, not to exceed Six Dollars ($6.00) per day, for the period that the Insured or member of the Family Group shall be confined therein, * * *.'

The first provision for the State Sanatorium made by the Mississippi Legislature is embodied in Chapter 109, Mississippi Laws 1916. Section One of that Act provides that, 'a sanatorium for the prevention and treatment of tuberculosis shall be established.'

Mississippi Code Annotated section 6872 (1952) is as follows:

'The State Board of Health shall determine the qualifications and conditions for admission of those applying as patients to the institution, and shall make all bylaws and regulations that may be necessary for the government of said sanatorium, provided they shall direct the superintendent to collect from each patient admitted into the institution a sum of not less than five ($5.00) dollars per week nor more than twenty-one ($21.00) dollars per week according to the patient's ability to pay; the said sum of money shall be collected each month and shall constitute a lien on any property owned by said patient which may be subject to execution, or, in case of minor, against the parent or guardian. The said sanatorium shall be conducted so that it may be as nearly self-supporting as shall be consistent with the purpose of its creation, and the Board of Health is empowered and authorized to take such steps as may be necessary for the collection of said sums of money and to do such other things as may appear to them reasonably necessary and incident to the proper management of the institution.'

Several grounds are assigned by appellant as requiring the reversal of this case. We consider it necessary to notice only one. Were hospitalization expenses 'actually incurred' by appellee within the meaning of the policy, in the amount of $6 per day, or were the expenses incurred limited to the maximum permitted to be charged under Section 6872, supra?

It is contended by appellee that, notwithstanding the provisions of the above statute, the administrative authority of the sanatorium was authorized within its discretion to exceed the maximum charge fixed in the statute, if a patient was able to pay more. The patient here was able to pay.

The Mississippi State Board of Health is an administrative board created by the legislature, and its powers are defined and limited by statute. In Tepper Bros. v. Buttross, 178 Miss. 659, 664, 174 So. 556 (1937), this Court said:

'* * * The statutory rule of construing laws is that where a statute enumerates the powers given, it must be held that it names all the powers dealt with therein, and that there is nothing implied. State ex rel. Greaves v. Henry, 87 Miss. 125, 40 So. 152, 5 L.R.A. (N.S.) 340 * * *.'

In 73 C.J.S. Public Administrative Bodies and Procedure Sec. 94 at 414-415 (1951), it is stated:

'A public administrative body may make only such rules and regulations as are within the limits of the powers granted to it and within the boundaries established by the standards, limitations, and policies of the statute giving it such power, and it may go no further than to make administrative rules and regulations which fill in the interstices of the dominant enactment. It may make only rules and regulations which effectuate a law already enacted, and it may not make rules and regulations which are inconsistent with the provisions of a statute, particularly the statute it is administering or which created it, or which are in derogation of, or defeat, the purpose of a statute, and it...