DocketNumber: 32391.
Judges: Felton, Parker, Sutton
Filed Date: 4/22/1949
Status: Precedential
Modified Date: 11/8/2024
1. 2. In an action predicated upon a receipt from an insurance agent, which by reference to an application for insurance showed that the two instruments were complementary and together constituted the agreement between the parties, the court did not err in requiring the plaintiff to attach a copy of the application to the four counts of the petition, under the facts of this case.
3. The court did not err in sustaining the general demurrer and in dismissing the action as against the following contentions of the plaintiff: (1) a. that the application was approved by the company; b. that the application and receipt constituted a temporary policy; (2) that the agent's authority was not limited by the provisions of the application; (3) that the receipt and application were ambiguous; (4) that the advance receipt of a premium constituted a binding contract of insurance; (5) that the agent's statement to the effect that the insured was protected from the date of the receipt was binding on the company; (6) that an alleged custom of the company could contradict the plain and unambiguous contract.
4 (a), (b), Additional discussion of some questions raised.
In count two, the plaintiff by reference adopted substantially the allegations of count one, and in addition alleged: that, at the time of payment of the $11.20 premium, the defendant's agent and representative told the plaintiff's husband that, if the premium was paid in advance, the insurance would begin from that date; that the deceased, acting upon said statement, made the payment; and that, when given the receipt and binder, the plaintiff's husband was assured by the agent and representative of the defendant that he was insured from that date. *Page 166
Count three is the same as count two with the additional allegations: that it is provided in the application that when the applicant is not over 40 years of age and the life policy is for not more than $5,000, no medical examination is required but only the personal approval of the defendant's agent: that the plaintiff's husband at that time was 25 years of age; that the defendant's agent and representative personally examined the deceased and approved said application, he having well known the plaintiff's husband for some six months; that it was the trade custom of the defendant company that, where the premium is paid in advance, protection begins as stated by the defendant's agent to the plaintiff's husband; and that, if the applicant died before the issuance of the policy, it was the trade custom of the defendant to pay the amount of insurance as set out in the application.
Count four is the same as count two with the additional averments; that, under the terms of said application, an applicant who is under 40 years of age and applying for a life policy not greater than $5,000 is not required to submit to a medical examination, and all that is necessary is a personal examination of the applicant by the defendant's agent supported by personal knowledge and investigation of said agent; that the defendant's agent, W. A. May, having known the plaintiff's husband for six months, examined the deceased and approved said application, and on May 21, 1947, H. B. Hatcher, home office inspector for the defendant, approved and recommended the issuance of the policy.
The defendant filed its demurrers, both general and special. The court sustained ground three of the special demurrer to paragraph four of all counts, and issued the following order: "1. The plaintiff is required to amend said counts by attaching a copy of the application referred to in said ground of demurrer, and referred to in the petition as No. 591846. The amendment hereby required shall be allowed and filed on or before 22nd day of December, 1948. It will be observed that the plaintiff attaches the receipt issued by the defendant, as exhibit A to count one, and by reference makes the same a part of the other counts, but does not attach the application to which the receipt *Page 167
refers. It is evident from the allegations contained in the several counts of the petition that the plaintiff relies, for a cause of action, on both the receipt and the application. In order that the court may properly determine whether or not the plaintiff has a cause of action, it is necessary that the application be attached, that the same may be considered in connection with the provisions of the receipt. Code, § 81-105;Social Benevolent Society v. Holmes,
"As was said in Himes v. Metropolitan Life Ins. Co.,
"2. It is further ordered that the defendant file in the registry of the Court, by filing with the Clerk of Wilkinson Superior Court, on or before the 14th day of December, 1948, the original application referred to in the several counts of the petition, and numbered 591846, in order that the plaintiff, and her counsel, may have an opportunity to examine the same for the purpose of preparing the amendments required by this order.Gonackey v. General Accident Fire Life Assurance Corp.,
"3. While the terms of this order require that each count of *Page 168 the petition be amended by attaching thereto a copy of the application, the court has no objection, if agreeable between counsel, that the application be attached to only one count, and made a part of the others by reference, as has been done in the present petition with respect to the receipt.
"4. In view of the terms of this order, no ruling is made at this time on the grounds of demurrer to the several counts, other than herein stated."
To this ruling, the plaintiff filed exceptions pendente lite, but subsequently amended her petition complying with the order of the court by attaching a copy of the application. The application referred to in the receipt set out, among other things, the same conditions as in the receipt, and in addition thereto stated: "(3) With the exception of officers of the company, notice to or knowledge of the agent, medical examiner or any other person is not notice to or knowledge of the company unless stated in either Part A or B of this application, and none of such persons are authorized to accept risks or pass upon insurability nor shall any of such persons have the power on behalf of the company to make or modify any contract on behalf of the company or to waive any of the company's rights or requirements."
The defendant then renewed its original demurrers to the petition as amended. The court sustained the general demurrer and dismissed the action. To this judgment and the order requiring the plaintiff to amend by attaching the application, she excepts.
1. The plaintiff in error contends that the court was without authority to require her to attach a copy of the application to the petition. Her contention is that the requirement was not made under penalty of having the action dismissed, but was an exercise of judicial power for disobedience to which she would have been subjected to a citation for contempt of court. Assuming for the sake of argument that this contention is correct, the judgment of the court was not harmful to the plaintiff for the reason that the court properly required the attaching of the application insofar as such action was necessary in order for the *Page 169
court to determine whether the plaintiff had a cause of action, and the question of contempt was eliminated by the submission to the order. The trial judge's order covers fully the reasons for his action and cites the authority for it, and it is needless for us to repeat the reasons or authority which are set forth in full in the statement of the case. If the judgment requiring the amendment was simply rendered under the implied penalty of a dismissal of the action, the ruling became the law of the case when the plaintiff acquiesced in the ruling, and it is immaterial that the judgment did not include an express provision for the dismissal of the action if the amendment was not filed. The case of Luke v. Ellis,
2. Counsel for the plaintiff in error insists that the action is upon the so-called "binder receipt" alone. The ruling of the trial judge shown above completely answers this contention. It is only necessary to call attention again to the facts that in the receipt the plaintiff is not named as beneficiary, nor is any amount of insurance provided for. If there was a cause of action on the receipt, it was not in the plaintiff. It is plain that the plaintiff had no cause of action without consideration of the application, and that examination of the application was necessary to determine whether she had one or not.
3. The trial court rendered a most thorough and exhaustive opinion, which we shall take the liberty of adopting and setting forth in full, and merely make a few comments in addition thereto.
"The instant suit is based on an application made by Jack F. Maddox to Life Casualty Insurance Company of Tennessee, dated May 20, 1947, for a policy of life insurance in the sum of *Page 170 $5,000, in which Mary C. Maddox, applicant's wife, is designated as beneficiary, and upon a conditional receipt issued to the applicant by an agent of the company, dated May 19, 1947. It further appears that the applicant died on May 22, 1947. The defendant demurred generally to the petition, as amended, and the issues made by the several counts of the petition may be generally stated as: (1) Was the applications approved by the company, or was further approval necessary? (2) The effect of the limitation on the agents' authority contained in the application. (3) Are the provisions of the application and the conditional receipt ambiguous? (4) Whether the payment of an advance premium made the insurance applied for immediately effective? (5) Whether statements by the company's agent that the insurance was immediately effective were binding on the company, notwithstanding the limitation of authority placed on the agent in the application? And (6) whether custom might serve to modify or change the terms of the application and conditional receipt?
"1. Approval of application by Company. ``Insurance is a matter of contract.' North British Mercantile Ins. Co. v. Tye,
"In Hill v. Life Casualty Ins. Co.,
"Nor do the application and conditional receipt constitute a temporary policy. The distinction is pointed out in Fort ValleyCoca-Cola Bottling Co. v. Lumbermen's Mutual Casualty Company,
"In Mutual Life Ins. Co. of New York v. Young,
"As in Smith v. Metropolitan Life Ins. Co.,
"2. Right of Company to limit agent's authority by provisions in application. ``It was within the power of the insurance company, as between itself and its agent, to define and limit the powers of the latter. Limitations upon the power of an agent affect all third persons dealing with him, who have knowledge or notice thereof; and any notice of limitations upon the agent's power, which a prudent man is bound to regard, is the equivalent of knowledge to the insured.' Reliance Life Ins. Co. v.Hightower,
"3. Ambiguity. ``A contract may be so clear as not to require interpretation, but a mere lack of clarity on casual reading is not the criterion for determining whether a contract is afflicted with ambiguity within the rule as to the admission of parol evidence to explain its meaning. Nor is a contract ambiguous within that sense merely because it may be even difficult to construe. The construction of a contract, if needed, being a question of law for the court, as well as a duty that rests upon the court, there can be no ambiguity within the rule to which we have referred, unless and until an application of the pertinent rules of interpretation leaves it really uncertain which of two or more possible meanings represents the true intention *Page 174
of the parties. Code §§ 20-701, 20-702.' McCann v. GlynnLumber Co.,
"Rule of construction and duty of court to construe. ``Courts are not called upon, because of the rule that contracts of insurance are to be strictly construed against the insurer and because the contract itself is one of insurance, to call forth doubt, through construction of plain and unambiguous provisions of such a contract. They should not make hypercritical construction of such contracts. "The language of the contract should be construed in its entirety, and should receive a reasonable construction and not be extended beyond what is fairly within its terms."' New York Life Ins. Co. v. Thompson,
"A reasonable construction of the application and conditional receipt is that the company, by an officer of the company, as distinguished from an agent or employee, must determine the insurability of the applicant, and whether or not he was a risk acceptable to the company under its rules. As was held inVardeman v. Penn. Mut. Life Ins. Co.,
"The report of the home office inspector (Application, Part F) does not purport to be an acceptance of the application for insurance. There is no contention in the several counts of the petition that the home office inspector is an officer of the company.
The district office report (Application, Part E), signed by a clerk, after the death of the applicant, could, in no event, be construed as an acceptance by the company.
"4. Acceptance of premium in advance. ``Where pending *Page 176
mere negotiations for a policy of insurance, the person on whose life it might or might not have been written dies, the company is not liable on the proposed policy simply because it accepted premiums in advance on the supposition that the policy would be issued.' McGlothin v. United States National Life CasualtyCo.,
"5. Statement by agent contrary to provisions of application and receipt. ``While we recognize the rule that a policy of insurance must be construed most strongly against the insurer, still the words of the policy must be given the meaning which they ordinarily bear; and where it is manifest that it was the intention of the insurer that liability should attach only in given circumstances, the law will uphold the contract according to its true intent and import. . . The writing being unambiguous, parol evidence as to what was said by the parties at the time it was executed will not be admitted to vary or alter the terms of the writing. The petition set forth no cause of action, and was properly dismissed on demurrer.' Wheeler v. Fidelity Casualty Co. of New York,
"6. Custom in insurance cases. ``When parties make an express contract which is plain, evidence of usage and custom is inadmissible to control, vary or contradict it.' Custom or usage can not be ``repugnant to, or inconsistent with, the contract.'Park Iverson v. Piedmont c. Ins. Co.,
"7. Accordingly, applying the principles above stated, it is ordered that the defendant's general demurrer, renewed to the petition as amended, be, and the same is sustained, and the petition is dismissed, at plaintiff's costs."
4(a). It might be well for us to state one or two more reasons why the trial court's judgment was correct. The plaintiff in error insists that rules of the insurance company not shown in the application and receipt are not binding on the insured. The rules referred to in Code § 56-904 are rules which form a part of the contract of insurance. This principle of law does not apply to the rules by which the insurance company determines the insurability of an applicant and the desirability of the risk.
(b) The plaintiff in error contends that "completion of Part B" of the application means completion by the soliciting agent and home office inspector. Aside from the general practice that such agents do not and cannot issue contracts of insurance, the application shows that the soliciting agent makes a report to someone of his opinion as to whether a policy should be issued. The same is true of the home office inspector. Question 12 in the application signed by the soliciting agent is: "If question 10 shows any policies lapsed, would you, in view of the applicant's lapse record, advise the insurance of this policy?" Question 7, signed by the home office inspector is: "Do you recommend issuance of policy?" Answer: "Yes." These questions alone show that the application must go higher up for approval and the application so specifically states. The fact that no medical examination was required does not mean that the soliciting agent or the home office inspector could bind the company by a final contract of insurance. The officials still have the right to investigate the condition of the applicant's health, his character, and his desirability as an insurance risk. The completion of section or part B of the application means the final decision on the part of the officers of the company to issue a policy, after it has made whatever investigation it sees fit to make. The application and receipt provide that insurance is to become *Page 178 effective after such a completion of part B of the application — not from the date of the application. If the plaintiff in error's contention is correct, the company might as well turn their non-medical examination policies over to the soliciting agents and home office inspectors and permit them to issue policies directly.
The court did not err in sustaining the general demurrer to each count and in dismissing the action.
Judgment affirmed. Sutton, C. J., and Parker, J., concur.
Himes v. Metropolitan Life Ins. Co. ( 1945 )
Park & Iverson v. Piedmont & Arlington Life Insurance ( 1873 )
Haupt v. Phœnix Mutual Life Insurance Co. ( 1900 )
Davis v. Metropolitan Life Insurance ( 1926 )
Insurance Co. v. Young's Administrator ( 1875 )
Mitchiner v. Union Central Life Insurance ( 1937 )
Hutson v. Prudential Insurance ( 1905 )
Wheeler v. Fidelity & Casualty Co. ( 1907 )
Fort Valley Coca-Cola Bottling Co. v. Lumbermen's Mutual ... ( 1943 )
Keller v. Provident Life & Accident Ins. ( 1948 )
Cato v. Ætna Life Insurance ( 1927 )
Mobile Fire Department Insurance v. Coleman & Collat ( 1877 )
Emery v. Atlanta Real Estate Exchange ( 1891 )
Merchants National Bank v. Demere ( 1894 )
Fowler v. Preferred Accident Insurance ( 1897 )
Simpson v. Prudential Insurance Co. of America ( 1962 )
Paulk v. STATE MUTUAL LIFE INSURANCE CO. ( 1952 )
American Aviation & General Insurance Company v. Georgia ... ( 1955 )
Burks v. Colonial Life & Accident Ins. Co. ( 1951 )
Turner v. Worth Insurance Company ( 1970 )
Cotton States Mutual Insurance v. Hutto ( 1967 )
George Washington Life Insurance v. Smith ( 1954 )
Ransom v. Penn Mutual Life Insurance ( 1954 )
Saddler v. Cotton States Life & Health Insurance ( 1960 )
Guest v. Kennesaw Life & Accident Insurance ( 1958 )
New York Life Insurance v. Whitfield ( 1966 )
Loveless v. LIFE & CASUALTY INSURANCE COMPANY OF TENNESSEE ( 1966 )
Cherokee Credit Life Insurance v. Baker ( 1969 )
Manzi v. Cotton States Mutual Insurance ( 2000 )