The Supreme Lodge of The Order of Select Friends v. Dey

• Decision Date: 05 June 1897
• Docket Number: 9820
• Parties: THE SUPREME LODGE OF THE ORDER OF SELECT FRIENDS v. DANIEL T. DEY
• Court: Kansas Supreme Court

49 P. 74

58 Kan. 283

THE SUPREME LODGE OF THE ORDER OF SELECT FRIENDS v. DANIEL T. DEY

No. 9820

Supreme Court of Kansas

June 5, 1897

Decided January, 1897.

Error from Crawford District Court. Hon. J. S. West, Judge.

Judgment affirmed.

J. L Denison, for plaintiff in error.

Fuller & Randolph, for defendant in error.

OPINION

DOSTER C. J.

In the case of Order of Select Friends v. Raymond, 57 Kan 647, we had under consideration the question of the right of a holder of a benefit certificate in the plaintiff organization to resort to the courts to compel satisfaction of his claim. It was there held:

"It is competent for a fraternal organization, which provides for the payment of benefits, to make reasonable rules or laws requiring those claiming benefits to submit their claims to designated officers or tribunals of the organization for investigation and allowance before the claims are made the subject of litigation in the courts; but a requirement of this kind does not abridge the right of members to resort to the courts when their claims have been submitted to, and finally rejected by, such officers and tribunals. The right of resort to the courts will not be deemed to have been taken away by mere inference, and, if it can be done at all, it will only be where the restriction is stated in the clearest and most explicit terms."

We are now called upon to determine whether the claimant under a benefit certificate issued by the society in question, is compelled to exhaust all the remedies provided by its laws, by way of appeal from one tribunal to another, before resorting to the courts for the collection of his claim.

The general laws of the Order, after declaring the circumstances under which a member may become entitled to apply for the fulfillment of its contract or policy of insurance, provide as follows:

"Any member claiming the disability benefit under section 8 or 9 of this law, shall make application therefor to his lodge upon the blank form furnished by the Supreme Lodge, accompanied by a certificate of a reputable physician, setting forth in full the nature and extent of the disability; thereupon such certificate and application shall be forwarded to the Supreme Medical Director, and a certified copy thereof sent to the. Supreme Recorder, to remain on file as part of the papers in such case.

"Upon receipt of proper notice of disease or accident disability, the Supreme Medical Director shall immediately proceed to investigate the same, and for that purpose shall appoint one physician who shall be paid by the Supreme Lodge, the subordinate lodge to which the member belongs shall appoint one to be paid by such subordinate lodge, and the member shall appoint one to be paid by said member, neither of whom shall be the member's attending physician or a Subordinate Medical Examiner of this order, whose duty it shall be to make a careful examination of the member's condition, and report to the Supreme Medical Director as to the character and permanency of such disability. If it shall appear from such examination that the member is totally and permanently disabled from following his usual business, occupation, or profession, the Supreme Medical Director shall approve the same and order the benefit paid. If, however, in the opinion of the Supreme Medical Director there is a fair and reasonable doubt concerning his total or permanent disability, he shall reserve his opinion thereon for any period he may determine upon, not exceeding six months, and shall then order a new examination to be made by the same or other physicians. If the result of this second examination also be uncertain, the Supreme Medical Director may, in like manner, provide for a third examination, which shall be made within three months thereafter, and upon this being done, or upon the expiration of the said three months, he shall either recommend or refuse to recommend the benefit paid, and, for his service rendered in disability claims, receive such an amount as the Supreme Lodge or the Supreme Executive Committee shall determine. Any claimant or his representative feeling aggrieved at the decision of the Supreme Medical Director may take such case by appeal to the Supreme Executive Committee, thence to the Supreme Lodge, by serving notice thereof upon the Supreme Recorder, within thirty days after receipt of notice of the Supreme Medical Director's decision or of the decision of the Supreme Executive Committee; and at the next regular or special session of the Supreme Lodge or Supreme Executive Committee it shall accord the applicant a fair and full hearing, and then dispose of the matter by a majority vote of the Supreme Executive Committee, or if in the Supreme Lodge, by a majority vote of all present entitled to vote thereon, as justice and equity may demand: Provided, that the Supreme Medical Director or any member of the Supreme Executive Committee shall not vote thereon."

The defendant in error, a member of the Order, claiming to have incurred a disability entitling him to the payment of his benefit certificate, prosecuted his claim before the Supreme Medical Director in accordance with the foregoing provisions. That officer rejected the claim; whereupon the defendant in error brought suit for its recovery. Upon the trial, judgment was rendered in his favor, from which the Supreme Lodge of the Order prosecuted error to this court.

The gist of the decision in Order of Select Friends v. Raymond, supra, was, that the right of resort to the courts for the determination of disputed questions of contract liability can only be relinquished, if at all, by the use of the clearest and most explicit terms; that such relinquishment is not to be presumed or inferred from language which stops short of an express renunciation. This is conceded by plaintiff in error, so far as the right to finally appeal to the courts is concerned, but the claim is put forward that one may contract to hold his right of resort to the courts in abeyance until such private and special remedial agencies as may be agreed upon have been applied to and have decided adversely; that, for instance, a member of a benefit society may contract to withhold his appeal to the courts until all the tribunals provided by the order have reviewed his case and determined it against him; and it is said that, considering the benevolent and fraternal character of the Order in question, a fair construction of the terms of its general laws, to which defendant in error subscribed, shows that such a contract was made.

In addition to the sections of the society's general laws before quoted, it is elsewhere provided that "no claim for a benefit from the relief fund shall be paid until all the laws or rules of the Order have been fully complied with and the requisite proof of the justness of the claim has been made in accordance with the general laws of the Order"; and elsewhere it is declared that "the supreme lodge, when convened agreeably to the provisions of the constitution and laws of the Order, shall have original jurisdiction over all subjects pertaining to the welfare of the Order, and absolute control of all appeals from the grand or subordinate lodges and members; and its decisions upon all questions and appeals, when properly presented and heard, are the supreme law of the Order." It will be conceded that the settlement of disputes concerning the payment of death or disability claims, within the membership of the Order and by its own tribunals specially provided therefor, without...