Walker v. Commercial Cas. Ins. Co.

• Decision Date: 03 August 1939
• Docket Number: 14932.
• Parties: WALKER v. COMMERCIAL CASUALTY INS. CO.
• Court: South Carolina Supreme Court

4 S.E.2d 248

191 S.C. 187

WALKER v. COMMERCIAL CASUALTY INS. CO.

No. 14932.

Supreme Court of South Carolina

August 3, 1939

J Wesley Crum, of Denmark, and H. L. O'Bannon, of Barnwell for appellant.

Cooper & Maher, of Columbia, for respondent.

G DEWEY OXNER, Acting Associate Justice.

Appellant seeks in this action to recover certain benefits under an insurance policy issued by respondent on October 7, 1936, on the life of Ella Walker. Appellant is named as beneficiary under the policy. The insured, Ella Walker, was confined to her bed on May 8, 1937, with an illness which resulted in her death on May 16, 1937. Her death did not result from bodily injury sustained through accidental means, but solely from the illness above mentioned. The only issue is the amount appellant is entitled to recover under the policy. Appellant contends that respondent is liable for $300 for the death of the insured from natural causes, $50 under clause "H" of the policy to cover all reasonable expenses put upon the insured during such illness, and a month's illness indemnity of $15. Respondent contends that the limit of its liability for the death of the insured from natural causes is $65, represented by the last two items above mentioned, which amount it offered to appellant who declined to accept it. The only issue in controversy is whether under the terms of the policy there is an indemnity in the sum of $300 for death from natural causes. The case was submitted to his Honor, Judge Rice, on an agreed statement of facts, who held that the indemnity of $300 did not apply to death from natural causes. Appellant appeals from this order.

The policy is not set out in full in the transcript of record. According to the agreement of counsel, only the following portion of the policy has any bearing upon the issue in controversy.

The policy, in large, bold, black type, has the following statement on the back and at the top of the page immediately preceding the contract, to-wit: "This policy provides indemnity for loss of life, limb, limbs, sight or time caused by accidental means, or for natural death, or for disability by illness to the extent herein provided."

The relevant portions of the contract are as follows:

"Commercial Casualty Insurance Company, Newark, New Jersey, does hereby insure Ella Walker (Hereinafter called the Insured) subject to all of the conditions and agreements herein contained and endorsed ***, against death, and disability resulting directly and exclusively of all other causes, from bodily injury sustained solely through external, violent and accidental means (excluding suicide, sane or insane), hereinafter called 'Such Injury', and against disability caused from any bodily disease or illness which is contracted and begins during the life of this policy and after same has been in force for not less than thirty (30) days from date of issue, hereinafter called 'Such Illness', as follows:

"(AA) Principal Sum $300.00 Dollars.

"Monthly Accident Indemnity $15.00 Dollars.

"Monthly Illness Indemnity $15.00 Dollars.

"Accident Insurance

"(A) If any one of the following specific losses shall result solely from such injury within ninety days from date of accident the Company will pay, in lieu of all other indemnity, for loss of:

"Life from accident--The Principal Sum; Both Eyes--The Principal Sum; One Eye and One Hand--The Principal Sum; One Hand--One-Half the Principal Sum; Both Hands--The Principal Sum; One Hand and One Foot--The Principal Sum; One Foot--One-Half the Principal Sum; Both Feet--The Principal Sum; One Eye and One Foot--The Principal Sum; One Eye--One-third the Principal Sum."

"The occurrence of any loss for which benefit is payable under the terms of Paragraph A, of this Policy, shall at once terminate the Insurance effected by this Policy and not more than one of the benefits provided in this paragraph 'A' will be paid under any circumstances." (Clauses B to G, inclusive, are irrelevant and omitted.)

"Death from Illness

"(H) If illness for which indemnity is payable under this policy is of such a serious character that it results fatally after the expiration of a period of forty-five days (45) from date of policy, the Company will pay an additional indemnity on account of such illness, sufficient in amount, to cover all reasonable expenses put upon the Insured during such illness and by reason thereof, not exceeding fifty dollars ($50.00) in amount."

Counsel agree that the omitted parts do not provide any indemnity for death from natural causes and have no bearing upon the construction of the above quoted parts of the contract of insurance.

In construing this policy, certain established principles, applicable in the construction of insurance contracts, must be kept in mind. Among them, the following may be stated:

"The parties have the right to make their own contracts and when such contracts are capable of clear interpretation the Court's duty is confined to the enforcement thereof; it cannot exercise its discretion as to the wisdom of such contract or substitute its own for that which was agreed upon." Brown v. Mutual Life Insurance Co. of New York, 186 S.C. 245, 195 S.E. 552, 555.

"Where the language of such a contract may be understood in more senses than one, or where it is doubtful whether given words were used in an enlarged or a restricted sense, other things being equal, that construction should be adopted which is most beneficial to the insured." Prosser v. Carolina Mutual Benefit Corp., 179 S.C. 138, 183 S.E. 710, 712.

"Printed insurance contracts prepared by experts in any respect ambiguous or capable of two meanings must be construed in favor of the assured." Jennings v. Clover Leaf Life & Casualty Co., 146 S.C. 41, 143 S.E. 668, 670.

"In the construction of insurance contracts, *** in cases of doubt, uncertainty, manifest ambiguity, or susceptibility of two equally reasonable interpretations, since the language used is the selection and arrangement of the insurer, such contracts must be liberally construed in favor of the insured." Parker v. Jefferson Standard Life Ins. Co., 158 S.C. 394, 155 S.E. 617, 618.

In support of its contention that the policy indemnifies against death from natural causes, appellant calls attention to the use of a comma after the word "death" in the first paragraph of the policy. Appellant contends that if the insurer intended to restrict the coverage to death from bodily injury sustained through accidental means, the above mentioned comma would not have been inserted, but a comma would have been used after the word "disability". Res...