Aleksich v. Mutual Benefit Health & Accident Ass'n

164 P.2d 372, 118 Mont. 223, 162 A.L.R. 263, 1945 Mont. LEXIS 15
CourtMontana Supreme Court
DecidedDecember 18, 1945
Docket8599
StatusPublished
Cited by12 cases

This text of 164 P.2d 372 (Aleksich v. Mutual Benefit Health & Accident Ass'n) is published on Counsel Stack Legal Research, covering Montana Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Aleksich v. Mutual Benefit Health & Accident Ass'n, 164 P.2d 372, 118 Mont. 223, 162 A.L.R. 263, 1945 Mont. LEXIS 15 (Mo. 1945).

Opinions

MR. JUSTICE CHEADLE

delivered the opinion of the court.

Action by Alva Aleksich to recover under an insurance policy issued by defendant to her uncle, Jakor Aleksich, in which she is named as beneficiary. The complaint alleges the issuance of the policy, with a copy thereof attached as an exhibit, together with a copy of the application therefor, wherein plaintiff is named as beneficiary. It further alleges the accidental injury of the insured, while the policy was in effect, and his death within one hour after such injury, and that because of such injury and death, “the said insured, Jakor Aleksich, was.wholly and continuously disabled and caused thereby permanent and total loss of time.” The prayer of the complaint asks damages based on indemnity of $40 for the first month and $80 for each of the succeeding 23 months, “for the time lost by Jakor Aleksich on account of his being injured and killed * *

The order of the trial court sustaining defendant’s general demurrer to the complaint contains the following: ‘ ‘ The court being of the opinion that said complaint cannot be amended so as to state a cause of action in favor of said plaintiff and against said defendant, It Is Ordered that said complaint be, and the same is dismissed at plaintiff’s costs.” Judgment of dismissal followed.

The policy sued on is headed, on the first page:

“Perfect Income Policy. This Policy Provides benefits for *225 Loss of Limb, Sight or Time, by Accidental Means, or Loss of Time by Sickness as Herein Provided.”

The insuring clause provides:

“Mutual Benefit Health and Accident Association, Omaha (herein called the Association) hereby insures Jakor Aleksich (herein called the insured), of the city of Butte, State of Montana, against loss of limb, sight or time, sustained or commencing while this policy is in force, resulting directly and independently of all other causes, from bodily injuries sustained during any term of this policy, through purely accidental means, and against loss of time beginning while this policy is in force and caused by disease contracted during any term of this policy, respectively, subject, however, to all the provisions and limitations hereinafter contained.”

Indemnities for specific losses are set out in Part A, which reads as follows:

“Part A.
“If the insured shall sustain bodily injuries, as described in the Insuring Clause, which injuries shall, independently and exclusively of disease and all other causes, continuously and wholly disable the Insured from the date of the accident and result in any of the following specific losses within thirteen weeks, the Association will pay: (Here follows a schedule of cash indemnity payments for specific loss of limb, etc.)
“Loss in every ease 'referred to in the above schedule for dismemberment of hand or hands, or foot or feet, shall mean severance at or above the wrist or about the ankle joint, respectively. The loss of eye or eyes shall mean the total and irrecoverable loss of entire sight thereof. Loss of arm or leg shall mean severance at or above the elbow or the knee joint, respectively. Loss of thumb, finger or toe shall mean severance of at least one entire phalanx. Only one of the amounts named will be paid for injuries resulting from one accident, and shall be in lieu of all other indemnity.”
Part B provides:
“If such injuries, as described in the Insuring Clause, do not *226 result in any of the above mentioned specific losses but shall wholly and continuously disable the Insured for one day or more, the Association will pay a monthly indemnity at the rate of Forty ($40.00) Dollars for the first month, and at the rate of Eighty ($80.00) Dollars per month thereafter, but not to exceed twenty-four months.”

Other parts of the policy, not here important, provide for partial disability benefits, medical attention, financial aid, and illness and hospital benefits.

The policy contains fifteen provisions designated “Standard Provisions.” Those of interest here are as follows:.

“4. Written notice of injury or of sickness on which claim may be based must be given to the Association within twenty days after the date of the accident causing such injury or within ten days after the commencement of disability from such sickness. In event of accidental death immediate notice thereof must be given to the Association.
“5. Such notice given by or in behalf of the Insured or beneficiary, as the case may be, to the Association * *
“8. The Association shall have the right and opportunity to examine the person of the Insured when and so often as it may reasonably require during the pendency of claim hereunder, and also the right and opportunity to make an autopsy in case of death where it is not forbidden by law.
“11. Indemnity for loss of life of the Insured is payable to the beneficiary if surviving the insured, and otherwise to the estate of the insured. All other indemnities of this policy are payable to the Insured.”

Under the heading of “Additional Provisions,” is found the following:

“(a) This policy does not cover death, disability, or other loss sustained in any part of the world except the United States and Canada, or while the Insured is engaged in military or naval service in time of war, * *

On the back of the policy is the following endorsement:

“This policy provides benefit for loss of limb, sight, or time *227 by accidental means, or loss of time by sickness, as herein provided. ”

No death benefit is mentioned in or provided by the policy. Plaintiff sues for loss of time resulting from the death of the insured, under Part B of the policy, which provides indemnity for loss of time not exceeding 24 months, resulting from injuries which cause none of the specific losses mentioned in Part A. Thus, the complaint alleges “that because of his said injuries and death, and said insured, Jakor Aleksich, was wholly and continually disabled and caused permanent and total loss of time,” and “plaintiff has been damaged by defendant in the sum of One Thousand, Bight Hundred and Eighty ($1,880) Dollars, being monthly indemnity at the rate of Forty ($40) Dollars for loss of time for the first month, and at the rate of Eighty ($80) Dollars per month for loss of time for twenty-three (23) months thereafter.” Plaintiff’s theory, which she must sustain in order to state a cause of action, is that death is an injury or disability insured against under Part B of the policy.

It is apparent .that the insuring clause does not insure against death, nor does the insurer thereby agree to pay any indemnity or benefit by reason of the death of the insured. Therein the contingencies insured against are limited to loss of limb, sight or time resulting from accident or sickness. Neither does any other provision of the contract constitute an agreement to pay indemnity for death of the insured.

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Cite This Page — Counsel Stack

Bluebook (online)
164 P.2d 372, 118 Mont. 223, 162 A.L.R. 263, 1945 Mont. LEXIS 15, Counsel Stack Legal Research, https://law.counselstack.com/opinion/aleksich-v-mutual-benefit-health-accident-assn-mont-1945.