Equitable Life Assurance Society of the United States v. Hall

69 S.W.2d 977, 253 Ky. 450, 1934 Ky. LEXIS 683
CourtCourt of Appeals of Kentucky (pre-1976)
DecidedMarch 20, 1934
StatusPublished
Cited by21 cases

This text of 69 S.W.2d 977 (Equitable Life Assurance Society of the United States v. Hall) is published on Counsel Stack Legal Research, covering Court of Appeals of Kentucky (pre-1976) primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Equitable Life Assurance Society of the United States v. Hall, 69 S.W.2d 977, 253 Ky. 450, 1934 Ky. LEXIS 683 (Ky. 1934).

Opinion

Opinion op the Court by

Judge Ratlipp

Reversing-

On June 1, 1932, the Equitable Life Assurance Society of the United States, hereinafter called the Equitable, issued a group insurance policy to the Consolidation Coal Company, herein'af ter called the Coal Company, by the terms of which policy it insured all the employees of the employer, Coal Company, who shall have elected, as certified by the employer to the Insurance Company, to participate in the group life insurance offered to all the employees of the classes specified in the insurance plan. The first clause of the policy provided $2,000 to be paid to the beneficiary of the employee in case of death. The second clause provided for the payment of $36.24 per month for a period of 60 months in the event *451 of total and permanent disability of an employee under age 60. Another clause provided for the payment of $12 a week for a period of not more than 13 weeks for temporary disability.

Appellee, Jerry Hall, plaintiff below, one of the insured employees .of the Coal Company, instituted _ this suit in the Johnson circuit court alleging in his petition that, while the insurance policy was in effect, on the 30th day of March, 1932, he became totally and permanently disabled by disease of the heart usually termed heart trouble, and general disease of the body, and was totally and permanently prevented from engaging in any work of financial value, and asked that he recover under the total and permanent disability clause of the policy in the sum of $2,174.40. He further alleged that he was over the age of 60 years at the time the Equitable issued to him the policy, but further alleged that his age was known to his employer, the Consolidation Coal Company, and, with this knowledge, the defendants issued the policy and accepted the premiums therefor, and therefore they are estopped to complain of his age. The Equitable denied knowledge of appellee’s age, and defended on the ground that he was over the age 60 at the time the policy was issued, and therefore not entitled to recover under the total and permanent disability clause. The trial resulted in verdict and judgment for appellee in the sum of $36.24 per month as stated in that clause of the policy, until the total sum of $2,174.40 shall have been paid, reserving, however, the right of the Equitable-to have the case redocketed for the purpose of determining whether or not appellee has recovered from his disability, in which event the payments would be suspended. The Equitable appeals.

It is insisted for appellee that the Consolidation Company, the employer, was the agent of .the Equitable, and knowledge of the agent would be imputed to the principal. The court instructed the jury that it could not find for plaintiff unless they believed from the evidence that the defendant through its agents knew the plaintiff was over 60 years of age at the time the policy was issued and with that knowledge issued the policy and received the premium thereon. Obviously the court gave this instruction on the theory that the employer, Consolidation Coal Company, was the agent of the Equitable. We cannot concur in that theory.

*452 Kentucky Statutes, sec. 633, defining who shall be deemed agents, does not apply to employers who obtain group insurance for the benefit of their employees. The state of Arkansas has a statute similar to the Kentucky, statute, supra. In construing the Arkansas statute, the Supreme Court of that state held that the statute did not make the employer the insurance company’s agent. Connecticut General Life Ins. Co. v. Speer, 185 Ark. 615, 48 S. W. (2d) 553, 554. The court said:

“It is sufficient to say that similar contracts of insurance under the group plan have been construed not to constitute the insured [employer] as agent of' the insurer to solicit applications for insurance, from its employees,”

and citing Duval v. Metropolitan Life Ins. Co., 82 N. H. 543, 136 A. 400, 50 A. L. R. 1276; Leach v. Metropolitan Life Ins. Co., 124 Kan. 584, 261 P. 603. See, also, Joiner v. Metropolitan Life Ins. Co., 40 Ga. App. 740, 151 S. E. 540.

In Duval v. Metropolitan Life Ins. Co., 82 N. H. 545, 136 A. 400, 404, 50 A. L. R. 1276, the court, in consider-1 ing the argument that the employer was the agent of the insurer, said:

“The employer holds the master policy, not for, but rather against, the insurer. * * * There is nothing-sinister in such a situation. Their interests are not adverse, but common. * * * The insurance was. something the employer and employees were to obtain by their joint efforts. It was not something-the employer was engaged in getting as a representative of the insurer. * * * There is nothing in the situation or conduct of the parties from which an implied general agency on the part of the employer to make representations or waive rights for the insurer could be found.”

In the ease of Peyton v. Metropolitan Life Ins. Co., 148 So. 721, the Court of Appeals of Louisiana held that the1 employer’s action in carrying thé employee on-the pay -roll from September, 1926, until April, 1931, after he became 60 years of age, did not waive the age-60 provisions of .the group policy, and did not work an estoppel .against the insurer on the theory of agency.

; If the relation of principal and agent exists between any two of the three parties involved, the insurer, the- *453 employer, and employee, it could be more logically said tbat such agency is between tbe employer and employee. Tbe employer obtained tlie insurance for tbe benefit of its employees. The employer is not interested financially or otherwise in the insurance company, but it is interested in 'securing the benefits of insurance for its employees. Thus it will be seen that the relation of principal and agent existed between employer and employee and not between employer and insurer.

' Moreover, it must be remembered that the contract in issue is one between two parties (Consolidation Coal Company, employer, and the Equitable, insurer) for the benefit of third parties, of which class the plaintiff is one. The plaintiff has the right to sue on such contract, but the rule in such cases is:

“One who sues on a contract made for his benefit must accept the contract as it was made.”

Kingsland v. Missouri State Life Ins. Co. (Mo. App.) 66 S. W. (2d) 959, 961; 13 C. J. 712, par. 1819.

The appellee, Hall, was not a party to the contract which was made between his employer and the Equitable for his benefit, and, having accepted the contract, he is bound by the terms thereof as entered into between the contracting parties. He had no contractual relation directly with the Equitable except the individual certificate issued to him based upon the group policy, both of which plainly limited compensation for total and permanent disability to employees under age 60.

It is next insisted that appellant is estopped to defend on the ground of appellee’s age because of a pamphlet or book of rules which was distributed by the employer, Coal Company, among its • employees, including appellee, wherein it was stated, among other things:

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69 S.W.2d 977, 253 Ky. 450, 1934 Ky. LEXIS 683, Counsel Stack Legal Research, https://law.counselstack.com/opinion/equitable-life-assurance-society-of-the-united-states-v-hall-kyctapphigh-1934.