Continental Casualty Company v. Summerfield

482 P.2d 308, 87 Nev. 127, 1971 Nev. LEXIS 367
CourtNevada Supreme Court
DecidedMarch 9, 1971
Docket6200
StatusPublished
Cited by9 cases

This text of 482 P.2d 308 (Continental Casualty Company v. Summerfield) is published on Counsel Stack Legal Research, covering Nevada Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Continental Casualty Company v. Summerfield, 482 P.2d 308, 87 Nev. 127, 1971 Nev. LEXIS 367 (Neb. 1971).

Opinion

*129 OPINION

By the Court,

Compton, D. J.:

Defendant Continental Casualty Company, hereafter for convenience referred to as Insurer, appeals from an adverse trial court judgment. The respondent is the special administratrix of the Estate of Lester D. Summerfield, deceased. The decedent will be hereafter referred to as Insured.

The cause was submitted to the trial judge on a stipulation covering facts agreed upon and the contentions in issue.

Effective July 1,1962, Insurer issued two policies to Insured. One, denominated a $10,000 Reserve Policy, numbered 27D 0000105, contained a Visiting Nurse Expense clause which read as follows: “The reasonable expense actually incurred by the Insured for the visit of a visiting nurse at the residence of the Insured up to a dollar limit of $6.50 per visit and up to one such visit per day, for which a charge is made by the Public Health Nursing Agency with whom the visiting nurse is accredited.” The policy defines “visiting nurse” as follows: “ ‘Visiting Nurse’ means a nurse accredited by the Public Health Nursing Agency located in the community where the Insured resides or is being treated.” The policy also contained a $500 annual deductible clause, and covered 75 percent of the excess.

A second, denominated a $5,000 Medical Policy numbered 27E0000105, contained no visiting nurse expense benefits; however, effective April 1, 1965, a Visiting Nurse Expense Rider was added to No. 27E0000105. It defines “Visiting Nurse” in these words: “ ‘Visiting Nurse’ means a nurse accredited by the Public Health Nursing Agency located in the community where the Insured resides or is being treated, or a nurse employed by a hospital.” (Emphasis added.) This policy and rider were subject to a $100 annual deductible amount, and covered 75 percent of the excess.

Both policies were in full force and effect through November 7, 1966, the date of the death of Insured.

*130 Expenses for nursing services in Insured’s home were incurred during the years 1965 and 1966. During this period nurses were employed through the local Washoe County Medical Society of Visiting Nurses, and the Nurses Registry. Two of the nurses were employed through the Visiting Nurses Service and the remainder through the Nurses Registry. The employment through the Visiting Nurses Service was billed through that service. The remainder was billed by the nurse.

The Visiting Nurses Society hires licensed practical nurses and registered nurses on a full time basis, and they render services as such solely between the hours of 8:00 a.m. and 5:00 p.m. daily; however, there is no prohibition against its employees rendering similar services while off duty. The nurses have the same qualifications as licensed practical nurses and registered nurses engaged through the Nurses Registry or private duty nurses. Licensed practical nurses and registered nurses may be employed through the Nurses Registry. It is conceded by Insurer that the terms “visiting nurse,” “visiting nurses association” and “nurses registry” are generally unknown in the community to nonmedical persons.

The trial court rendered judgment for the plaintiff, special administratrix, in the sum of $4,037.49, under both policies, together with attorneys fees and costs.

The appellant assigns the following as error:

1. Respondent failed to carry her burden of proving that all the expenses incurred by the insured were such as come within the coverage of each policy.

2. The court erred as a matter of law in the interpretation of each of the insurance contracts.

3. The award of the judgment is not supported by the Findings of Fact and Conclusions of Law.

Assignment No. 3 is wholly without merit since it is conceded that as to each policy an expense was actually incurred for nursing services by the Insured, and we believe that determination of No. 2 will effectively dispose of the question raised in Assignment No. 1.

Insurer lists eight so-called “issues” on appeal. Some are settled by stipulation of facts; the others we believe will be resolved by our consideration of Assignment of error No. 2.

Insurer, in effect, admits that had all nurses been employed through the Visiting Nurses Service and their services billed for by that agency, the plaintiff’s claim would be proper. Here, however, as below, Insurer contends that only the nurses hired through the Washoe County Medical Society of Visiting Nurses *131 comply with the policy requirements. Liability is denied for the visits of any others.

Insurer has stipulated that the terms “visiting nurse,” “visiting nurses association” and “nurses registry,” are generally unknown in the local community to nonmedical persons, and the trial court so found, but it asserts that this fact is irrelevant and immaterial.

The trial court found the following facts and adopted it as a conclusion of law, i.e.:

“13. That there is no distinction in fact or in law differentiating between ‘visiting nurse,’ ‘visiting nursing association’ and ‘nurses registry’ in this case, and in this community, and that fairness deems, and the facts require, a finding that the Plaintiff should be paid in the amount guaranteed by the contract.”

The determinative issue in the case evolves from this finding and conclusion. We agree with this finding and conclusion and affirm the judgment of the trial court.

Without question, a policy of insurance is a contract, which must be enforced according to its terms, and the burden of proof is upon the claimant. Healey v. Imperial Fire Ins. Co., 5 Nev. 268 (1869). However, as Insurer aptly points out, the object of the interpretation of an insurance policy is to determine the intent of the parties so that the contract may be given effect consistent with the parties’ real intent and purpose (citing Home Indemnity Co. v. Desert Palace, Inc., 86 Nev. 234, 468 P.2d 19, 21 (1970)), but this court further said there: “[T]he intention of the parties should control and the terms of the clause should be taken and understood in their plain, ordinary and popular sense. ... In determining the intent of the parties a court should consider all the salient facts. . . . If . . . there is room for construction or doubt, the benefit of the doubt must be given to the assured.” (Citing Richfield Oil Corp. v. Harbor Ins. Co., 85 Nev. 185, 452 P.2d 462 (1969), and Gerhauser v. North British and Merc. Ins. Co., 7 Nev. 174, 185 (1871).)

Insurer contends that there is no room for doubt; that the trial court created the doubt if there be any, and that such terms as “accredited,” “visiting nurse” or “nurse employed by a hospital” should be given their literal meaning as set forth in the insurance contracts. With this we cannot agree. When the contracts are considered in the light of stipulated facts, it is obvious that there is a need for construction.

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Cite This Page — Counsel Stack

Bluebook (online)
482 P.2d 308, 87 Nev. 127, 1971 Nev. LEXIS 367, Counsel Stack Legal Research, https://law.counselstack.com/opinion/continental-casualty-company-v-summerfield-nev-1971.