International Security Life Insurance Co. v. Maas

458 S.W.2d 484, 1970 Tex. App. LEXIS 2731
CourtCourt of Appeals of Texas
DecidedJuly 31, 1970
Docket15656
StatusPublished
Cited by19 cases

This text of 458 S.W.2d 484 (International Security Life Insurance Co. v. Maas) is published on Counsel Stack Legal Research, covering Court of Appeals of Texas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
International Security Life Insurance Co. v. Maas, 458 S.W.2d 484, 1970 Tex. App. LEXIS 2731 (Tex. Ct. App. 1970).

Opinion

COLEMAN, Justice.

This is a suit to recover medical and hospitalization expense alleged to be due under a sickness and accident insurance policy issued by appellant, a Stipulated Premium Insurance Company. Judgment for the plaintiffs was entered after a trial to the court without a jury.

Appellant contends that appellees failed to prove that the loss sustained did not come within certain exclusions from liability found in the insurance policy and that the court erred in awarding a penalty and attorney’s fees. The court properly entered judgment for the loss sustained, but erred in awarding the penalty and attorney’s fees.

In paragraph VII of its answer appellant alleged:

“Said defendant would show that it has no liability for the claim or claims as herein asserted by the plaintiff, in that the insurance policy issued by said defendant to plaintiff, and said defendant’s liability thereunder, is subject to all of the provisions and limitations in said policy, that specifically said defendant is not liable for each and all of the following reasons, to-wit:
“1. The provisions, limitations and exclusions contained in the insuring clause of said policy.
“2. The provisions, limitations and exclusions contained in Part I. of said policy.
“3. The provisions, limitations and exclusions contained in Part III. of said policy.
“4. The provisions, limitations and exclusions contained in Part V. of said policy.
“5. The provisions, limitations and exclusions contained in Part VI. of said policy.
“6. The provisions, limitations and exclusions contained in Part IX. of said policy.
“7. The provisions, limitations and exclusions contained in Part X. of said policy.
“8. The provisions, limitations and exclusions contained in Part XI. of said policy.
“Said defendant herein does hereby specifically plead in defense to Plaintiff’s action, the foregoing provisions, exclusions and limitations contained in said policy.”

Appellant states in its brief that the policy exclusions were pleaded exactly as the policy exclusion defense was pleaded in Sherman v. Provident American Insurance *486 Company, 421 S.W.2d 652 (Tex.1967). The statements made in the opinion with reference to the pleadings in that case are, therefore, applicable to this case.

By points of error appellant urges that appellees failed to prove: that the Methodist Hospital (a world famous hospital located in the Texas Medical Center of Houston, Texas) was a legally constituted hospital as defined by the policy; that the hospitalization was not provided at the expense of any philanthropic, fraternal, eleemosynary or governmental institution or agency, or otherwise provided without cost to the person insured (although they knew that the proceeds of the policy had been assigned to secure payment of the doctor) ; that the hospital bills were authorized by a legally qualified doctor of medicine or osteopathy (although the claim submitted contained a statement of the doctor reflecting that he was a doctor of medicine and that he had performed surgery); that the loss resulted “wholly or partly in or from hospitalization for which the principal purpose is for physical examination or diagnosis (the evidence shows that Mrs. Maas suffered a stroke six days before the hospitalization and that diagnostic studies were made at the Kelsey-Seybold Clinic prior to the hospitalization). Not made the subject of points of error are the numerous other exclusions contained in the policy which were mentioned in the pleadings. While the pleading referred to is not in the transcript, appellees state in their brief that appellant filed a cross-action based on fraud on the day prior to trial, but presented no evidence supporting the pleading.

In Sherman, supra, the court said:

“At the time this Court granted this application for writ of error, it was thought we would be able to pass upon the sufficiency of the defendant’s pleading of the exclusions and limitations contained in the policy.
it * * *
“Many of the policy exceptions pleaded by respondent and included in its motion as grounds for an instructed verdict were obviously sham defenses. To seek in this manner to frustrate the intended purpose of Rule 94 violates both its spirit and its letter; but we know of no authority, either of rule of procedure or of decided case, which authorizes this Court to reverse the judgment of the trial court because it failed in the absence of motion or exception, to strike or disregard the sham defenses, particularly since petitioners have made no complaint thereof on appeal.
t( * * *
“Rule 90, Vernon’s Texas Rules Ann., in plain and unambiguous language provides in part, ‘[ejvery defect, omission or fault in a pleading either in form or of substance, which is not specifically pointed out by motion or exception in writing and brought to the attention of the Judge in the trial court before the instruction or charge to the jury or, in a non-jury case, before the rendition of judgment, shall be deemed to have been waived by the party seeking reversal on such account.’ (Emphasis added.)
“Insufficiency of pleadings cannot be raised for the first time in the appellate courts. Bednarz v. State, 142 Tex. 138, 176 S.W.2d 562 (1944); Texas Osage Co-Op. Royalty Pool v. Kemper, 170 S.W.2d 849 (Tex.Civ.App., 1943), writ refused. This last case has been cited in many cases down through Olivares v. Service Trust Company (Tex.Civ.App., 1964), 385 S.W.2d 687, 688, no writ history, and its holding has never been questioned. Therefore, we do not have before us and cannot decide the question regarding the sufficiency of defendant’s allegations in the case at bar.”

Obviously here many of the policy exceptions pleaded by appellant were sham defenses. Appellant has violated both the spirit and the letter of Rule 94, Texas Rules of Civil Procedure. Here Rule 90, T.R.C.P., is not applicable because appel-lees are not seeking to reverse the trial court. This is a case tried to the court *487 without a jury. No findings of fact or conclusions of law were requested or filed. We must affirm the judgment rendered if it can be supported by the record under any applicable theory of law.

Rule 94, T.R.C.P., reads:

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Bailey v. City of Austin
972 S.W.2d 180 (Court of Appeals of Texas, 1998)
Trahan v. Trahan
894 S.W.2d 113 (Court of Appeals of Texas, 1995)
Emma J. Trahan v. Jack F. Trahan
Court of Appeals of Texas, 1995
Austin Transportation Study Policy Advisory Committee v. Sierra Club
843 S.W.2d 683 (Court of Appeals of Texas, 1993)
Durish v. Texas State Board of Insurance
817 S.W.2d 764 (Court of Appeals of Texas, 1991)
Durish v. TEXAS STATE BOARD OF INS.
817 S.W.2d 764 (Court of Appeals of Texas, 1991)
Texas Dept. of Public Safety v. Sefcik
751 S.W.2d 239 (Court of Appeals of Texas, 1988)
Las Vegas Pecan & Cattle Co. v. Zavala County
669 S.W.2d 808 (Court of Appeals of Texas, 1984)
Robinson v. State
661 S.W.2d 279 (Court of Appeals of Texas, 1983)
Group Life & Health Insurance Co. v. Turner
620 S.W.2d 670 (Court of Appeals of Texas, 1981)
French v. Insurance Co. of North America
591 S.W.2d 620 (Court of Appeals of Texas, 1979)
Johns-Manville Sales Corp. v. RJ Reagan Co., Inc.
577 S.W.2d 341 (Court of Appeals of Texas, 1979)
First State Bank, Hearne v. Citizens Bank of Bryan
569 S.W.2d 604 (Court of Appeals of Texas, 1978)
Gumpp v. Philadelphia Life Insurance Co.
562 S.W.2d 885 (Court of Appeals of Texas, 1978)
Dairyland County Mutual Insurance Co. of Texas v. Roman
498 S.W.2d 154 (Texas Supreme Court, 1973)
Dairyland County Mutual Insurance Co. of Texas v. Roman
486 S.W.2d 847 (Court of Appeals of Texas, 1972)

Cite This Page — Counsel Stack

Bluebook (online)
458 S.W.2d 484, 1970 Tex. App. LEXIS 2731, Counsel Stack Legal Research, https://law.counselstack.com/opinion/international-security-life-insurance-co-v-maas-texapp-1970.