Gust v. Provident Life & Accident Insurance

12 P.2d 831, 136 Kan. 88, 1932 Kan. LEXIS 22
CourtSupreme Court of Kansas
DecidedJuly 9, 1932
DocketNo. 30,675
StatusPublished
Cited by5 cases

This text of 12 P.2d 831 (Gust v. Provident Life & Accident Insurance) is published on Counsel Stack Legal Research, covering Supreme Court of Kansas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Gust v. Provident Life & Accident Insurance, 12 P.2d 831, 136 Kan. 88, 1932 Kan. LEXIS 22 (kan 1932).

Opinions

The opinion of the court was delivered by

Smith, J.:

This was an action on an insurance policy. Judgment was for plaintiff. Defendant appeals.

Appellee is a coal miner. In 1929 he was employed by the Cowan Coal Company. While so employed he received an injury which resulted in the loss of the sight of one eye. He brought an action before the commissioner of workmen’s compensation for the state and was awarded compensation. This award was appealed to the district court and sustained. Two days after the award was sustained Hal C. Cowan, as a sole trader and doing business as the Cowan Coal Company, was adjudged a bankrupt. There were not sufficient assets to satisfy the award. This action was then brought. The petition alleged the facts that have already been detailed and in [89]*89addition that on May 1, 1928, appellant had made and delivered to Hal C. Cowan an insurance policy by which appellant insured the Cowan Coal Company against liabilities arising against him by reason of the operation of the mine. A copy of the insurance policy was attached to the petition. The petition further alleged that one John Simion was the agent of appellant and had full power and authority, among other things, to make arrangements and provide for medical and physical examination of injured and disabled persons upon whom appellant issued policies of insurance, or who were entitled to make claim against appellant, or its policyholders for such disabilities, and that this agent had full power and authority on behalf of appellant to settle claims. The petition then alleged that appellee had accompanied John Simion at his verbal request to a specialist in order that the extent of the injury to the eye might be ascertained for the benefit of appellant. Judgment was asked for the amount of the award. A demurrer to the petition was filed on the ground that it did not state a cause of action. This demurrer was overruled. From that judgment this appeal is taken.

There are two grounds urged in the appeal. One is that the policy of insurance in question was for the benefit of the assured and not for the benefit of the employee and the employee has no right of action on this policy, and the policy or contract of insurance in question is not a policy of insurance under the workmen’s compensation law.

In order to decide these questions it will be necessary to notice more particularly some provisions of the insurance policy that were attached to the petition.

The following provisions are deemed pertinent:

“In consideration of the statements and agreements contained in schedule indorsed hereon, and attached hereto, and made a part hereof, and the further consideration of the payment of premiums as proportionately set forth in said schedule, does hereby indemnify and agree to pay.the Cowan Coal Company, Arcadia, Kan., hereinafter called the assured, the indemnities as set forth in such schedule for each class, or group of employees, such schedule signed by the assured or hi's authorized agent, subject to the provisions, conditions and limitations herein contained and indorsed hereon . . . against bodily injuries suffered by said employee through external, violent and accidental means while in the course of employment and actually engaged in the performance of duties for the assured at the places named in the schedule when such injuries are sustained within the period herein stated, hereinafter called such injury.
“If such injury to the employee shall, within 366 days from the date of [90]*90accident and exclusive of all other causes, result in any of the following specific losses, the company will pay the assured in lieu of all other indemnity, the sum specified in this part for such loss; provided, however, that not more than one indemnity for specific losses shall be payable though more than one of the specific losses enumerated shall result from an accident.
“Loss of one eye . . . seven hundred fifty dollars ($750.00). In every case referred to in his policy, the loss of any member or members above specified shall mean a loss by severance at or above the wrist joints or ankle joints and loss of eye or eyes shall mean the irrecoverable loss of the entire sight thereof.
“If such injuries, independent of all other causes, shall from date of accident continuously and wholly disable and prevent such employee from engaging in any work or occupation for wages or profit, the company will pay the assured an amount equal to 60 per cent of the employee’s wages at the rate shown to have been earned by such employee by the records of the assured for the thirty days (or total number of days if less than thirty) immediately preceding date of injuiy, but not exceeding eighteen dollars ($18) per week for the period of such total disability, commencing on the eighth day of disability, not exceeding fifty-two weeks in respect to any one accident.
“The assured shall give immediate written notice to the company’s home office, or to the agent who has countersigned this policy, of any accident or injury for which a claim is to be made, with full particulars thereof, and full name and address of the assured and of the injured person. Affirmative proof of death or loss of limb or of sight, or of duration of disability must also be furnished to said company within sixty days from the time of death, or of loss of limb or of sight, or of the termination of disability.
“The premium of this policy, if calculated at a per cent of the earnings of the employees, shall be based on the entire compensation of all employees, during the policy period, except employees specifically excluded herein, and the assured shall remit to the company monthly the amount of premium so calculated. If based on a fixed amount for each employee, the assured shall remit, to the company such amount as is fixed in schedule each month, except employees specifically excluded herein.”
“B. Any medical examiner of the company shall be allowed to examine the person or body of the injured employee in respect to any alleged injury, as often as may be required.”

After enumerating certain exceptions which the policy would not cover it contained the following language:

“Provided, however, if the assured is held legally liable for an injury so excepted above, by a court, or under a workmen’s compensation act, these exceptions shall not be effective, but in no case shall the company be liable in excess of the indemnity provided herein.”

[91]*91It will be seen that the insuring clause of the policy is a contract between appellant and the Cowan Coal Company with no reference to a right of action in the employees, and that the company is referred to throughout the policy as the insured.

Appellee argues that this contract in the policy of insurance is for the benefit of the employees and that under well-established rules where a contract is made between two parties for the benefit of a third the third party can maintain an action on the contract even though he is not a party to it. Appellant acknowledges this rule as laid down in Burton v. Larkin, 36 Kan. 246, 13 Pac. 398, but argues that this case comes within the rule'further laid down in that case, where this court said:

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Bluebook (online)
12 P.2d 831, 136 Kan. 88, 1932 Kan. LEXIS 22, Counsel Stack Legal Research, https://law.counselstack.com/opinion/gust-v-provident-life-accident-insurance-kan-1932.