Union Fraternal League Of Boston v. Johnston

• Citation: 124 Ga. 902,53 S.E. 241
• Parties: UNION FRATERNAL LEAGUE OF BOSTON, MASS. v. JOHNSTON.
• Decision Date: 20 November 1905
• Court: Georgia Supreme Court

53 S.E. 241

(124 Ga. 902)

UNION FRATERNAL LEAGUE OF BOSTON, MASS.

v.JOHNSTON.

Supreme Court of Georgia.

Nov. 20, 1905.

1. Insurance — Rights of Members — Suit Against Association—Resort to Tribunals of Order.

Where the constitution of a benefit society declared that "no suit shall be brought against this order without first referring the matter to the grievance committee, " with right of appeal to the "cabinet" and from them to the "annual congress, " a suit by a member on a claim for a "sick benefit" could not be maintained without first exhausting the remedies so prescribed, especially in the absence of a valid reason for not so doing.

[Ed. Note.—For cases in point, see vol. 28, Cent. Dig. Insurance, § 1987.]

2. Same — Constitution and By-Laws — Amendment.

Where a member of such a society expressly agreed to comply not only with the constitution, laws, and rules thereof in force at the time of the issue of his certificate, but also with such as might thereafter be adopted, it was error for the court, on the trial of an action against the society brought by such member on a claim for a "sick benefit, " in which the defense was set up that the plaintiff had not followed the procedure prescribed by the constitution and bylaws of the society, to charge that the plaintiff was bound only by the constitution and bylaws in force when his certificate was issued.

[Ed. Note.—For cases in point, see vol. 28, Cent. Dig. Insurance, § 1855.]

3. Appeal — Questions Reviewable — Contentions Not Made Below.

A ground for the dismissal of an appeal in the superior court, which was not there raised and insisted upon, cannot be successfully urged in the Supreme Court as a reason for the affirmance of the judgment rendered in the superior court in the case on appeal.

(Syllabus by the Court.)

Error from Superior Court, Richmond County; H. C. Hammond, Judge.

Action by J. H. Johnston against the Union Fraternal League of Boston, Mass. There

was judgment for plaintiff, and defendant brings error. Reversed.

Johnston sued the Union Fraternal League of Boston, Mass., in a justice's court, for $100, on a "sick or benefit claim, " under a benefit certificate issued to him by the defendant. From a judgment against the defendant, in the justice's court, it appealed to the superior court, where a verdict was rendered against the defendant, and its motion for a new trial having been overruled, it excepted. The defendant resisted the plaintiff's action on the ground that he was not entitled to sue, for the reason that he had not exhausted his remedies under the constitution and by-laws of the order, by which it was contended he was bound under his certificate. On the trial in the superior court, the following facts appeared: The certificate was issued to the plaintiff July 12, 1898, and expressly stipulated that it was issued on condition "that said member * * * complies with the constitution, laws, and rules now governing or that may hereafter be enacted for the government of the order"; and that "All benefits during life [were] payable to the member, * * * in accordance with and under the provisions of the laws governing said fund of the order upon satisfactory evidence to the officers of the order, of the accruing of any benefit hereunder." Article 11, § 3, of the constitution of the order, as amended by its "annual congress" of 1900, declares that no sick or disability benefits will be allowed for certain diseases, among them eczema, if contracted prior to the issue of the certificate. Section 8 of the same article is as follows: "In case of contention as to any claim by virtue of sickness or accident, in any class granting benefits for the same, the matter shall be referred to the committee on arbitration for adjustment. No suits will be allowed on sick or disability claims. Likewise, in case of contention upon any point of membership involving any financial benefit, the committee on arbitration shall adjust the differences." By section 2 of article 12 it is declared: "No suit shall be begun against this order without first referring the matter to the grievance committee; and if its action be objected to by either party, an appeal can be taken to the cabinet, and from thence to the annual congress. Until this action is resorted to, no member, or beneficiary of a member, shall be entitled to proceed at common law against the order, and it shall be deemed a sufficient answer on the part of this order that the member or beneficiary has failed to comply with these laws to dismiss his action and compel him or her to proceed as herein provided. Provided however, that in no case shall the tribunals of this character except in the matter of sick or accident benefits, preclude bringing suits after such an appeal be taken, if decided adverse to the claimant." The plaintiff testified: "I continued my payments in it [the league] for some time after my illness, for which they decline to pay me. * * * I sent on proper notice of this claim, filled out proper papers and blanks, and forwarded them. So did my physician. I had eczema and was disabled for 10 weeks, was entitled to $10 a week. They did not pay me, but wrote me that under their by-laws they were not liable, referring me to a certain section of their bylaws. They refused to pay me, saying they were not liable for eczema. (Witness here identified a letter to him, dated July 18, 1904, from James F. Reynolds, cabinet secretary of the league) * * * I did not appeal to the grievance committee. I think when I first wrote the league, they notified me they had not received any certificate from the doctor. I then had doctor fill out one and he sent it off. Still there was delay. I wrote them again and then got this letter [referring to letter already identified] declining to pay. They had paid me before for the same disease; and I thought they would pay me this time." B. D. Lester testified, that he was treasurer of the local chapter, in Augusta. Ga., of the defendant league, and that no change was made in the sick benefits under the constitution of the league of 1904, "only an increase in the assessments." The letter which the plaintiff testified he had received from the "cabinet secretary" of the defendant league was dated July 18, 1904, addressed to the plaintiff, and was in the following language: "In response to your letter of inquiry of the 12th inst, regarding your claim. I wish to call your attention to the fact that that we have not received the affidavit of your attending physician. Hence why no action has been taken on your claim. We sent him a blank the same day that your own blank was sent out, and this paper has never been returned to us. I also wish to call your attention to the fact that the nature of your disease is eczema and under the provisions of article 11, section 3, of the constitution and laws, we are prohibited from paying benefits for eczema."

C. P. Pressley, for plaintiff in error.

Austin Branch and C. Henry Cohen, for defendant in error.

FISH, C. J. (after stating the facts). 1. A member of a benefit society must, in applying for benefits under its by-laws, follow the procedure therein prescribed. It is a well-settled...