Supreme Council of Order of Chosen Friends v. Forsinger

• Citation: 25 N.E. 129, 125 Ind. 52
• Case Date: September 16, 1890
• Court: Supreme Court of Indiana

125 Ind. 52
25 N.E. 129

Supreme Council of Order of Chosen Friends
v.
Forsinger.

Supreme Court of Indiana.

Sept. 16, 1890.

Appeal from superior court, Marion county; N. B. Taylor, Judge.

Finch & Finch, for appellant. Carter & Binford, for appellee.

Elliott, J.

The appellee's complaint is founded upon a certificate of membership issued to him by the appellant. The bylaws of the corporation contain, among others, this provision: “Should a member become totally and permanently disabled from following his or her usual or other vocation, by reason of disease or accident, such member, upon the receipt and approval of satisfactory proofs, as hereinafter provided, shall be entitled to a benefit not exceeding one-half of the relief-fund certificate held by him or her.” The certificate issued to the appellee is a contract of insurance, and his right to recover upon it does not depend upon the action of the officers of the society, for if he has performed his part of the contract, and is totally disabled by disease or accident, he has a complete cause of action. A refusal by the officers of the society to allow the claim will not defeat a recovery. The appellee was of course bound to comply with the terms of his contract, and with the lawful by-laws of the society. The valid provisions of the by-laws do indeed form part of his contract, and are of controlling force. Supreme Lodge v. Knight, 117 Ind. 489-496, 20 N. E. Rep. 479; Pfister v. Gerwig, 122 Ind. 567, 23 N. E. Rep. 1041. But while it was necessary for the appellee to comply with the requirements of the valid by-laws of the association, it was not in the power of the officers to defeat his claim by arbitrarily rejecting his proofs as unsatisfactory, or by wrongfully declaring that he had not done what his contract and the by-laws of the association required of him. It was not necessary, therefore, for the appellee to do more than appropriately show, by his complaint, the contract with the corporation, performance of the conditions on his part, that he was totally disabled, and that he had made proper proof of his disability. He was not bound to go further and allege that his proofs were such as satisfied the corporate officers. It was enough for him to show that they were such as his contract and the laws of the land require. He was not bound to anticipate and avoid defenses. It was sufficient for him to make a prima facie case.

The appellant, by way of answer in abatement, sets forth the following bylaw: “Sec. 6. On receipt of the proper notice of disease or accident disability under section 4 of this article, the supreme councilor shall proceed to investigate the same. If at any time he deems the facts to warrant it he may appoint one or more physicians, whose duty it shall be to make a careful examination of the member's condition, and report as to the character and permanence of the disability. If such report shows a disability of an unquestionably total and permanently disabling character, the supreme councilor, supreme recorder, and supreme medical director may approve the same, and order the benefit paid. If, however, in the opinion of said officers, there is any doubt concerning the permanence of the disability, they shall postpone the matter for any period they may determine upon, not exceeding one year, and shall then order a new examination, either by the same or other physicians. If the result of the second examination be also uncertain, said officers

[25 N.E. 130]

may, in like manner, provide for a third, upon the result of which they shall either pay or refuse to pay the benefit claimed. This decision shall be final and conclusive upon the parties affected thereby, unless reversed upon appeal by the supreme council in regular session. Any claimant feeling aggrieved may take such an appeal by serving notice thereof upon the supreme recorder within thirty days after receipt of notice of the decision by the claimant, his or her personal representatives. The supreme council shall accord the appellant a hearing at its next regular session, and dispose of the matter.” The answer sets out other provisions concerning appeals, and regulating the mode of procedure. Both the complaint and the answer show that the claim was presented to the officers named in the by-laws, that action upon it was postponed, as the by-laws provide, and that it was finally rejected. The trial court held the answer bad, and that ruling is questioned by the assignment of errors.

Our decisions declare that it is not competent for parties, in advance of any dispute, to oust the jurisdiction of the courts by providing that the decision of persons named in the contract shall be final and conclusive. Railroad Co. v. Donnegan, 111 Ind. 179, 12 N. E. Rep. 153; Supreme Council, etc., v. Garrigus, 104 Ind....