Kellogg v. United Benefit Life Insurance

516 S.W.2d 45, 1974 Mo. App. LEXIS 1394
CourtMissouri Court of Appeals
DecidedNovember 12, 1974
DocketNo. 35695
StatusPublished

This text of 516 S.W.2d 45 (Kellogg v. United Benefit Life Insurance) is published on Counsel Stack Legal Research, covering Missouri Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Kellogg v. United Benefit Life Insurance, 516 S.W.2d 45, 1974 Mo. App. LEXIS 1394 (Mo. Ct. App. 1974).

Opinion

KELLY, Judge.

Appellant (hereinafter the “plaintiff”) brought suit against the respondent (hereinafter the “defendant”) for certain hospital, surgical, doctor and other medical expenses he incurred as the result of injuries he sustained while a passenger in an elevator which fell from the eighth floor to the basement of the office building in which he was employed as he was departing from his place of employment at the end of his work day. Defendant filed its timely answer to the amended petition of the plaintiff and thereafter filed a motion for summary judgment accompanied by an affidavit in support thereof. Plaintiff filed a counter-affidavit and request that the court overrule defendant’s motion and followed this two days later with his own motion for summary judgment. The cause was submitted to the trial court on the pleadings, the motions for summary judgment and defendant’s affidavit in support of its motion and plaintiff’s counter-affidavit. The trial court, after considering the aforementioned, rendered judgment overruling plaintiff’s motion for summary judgment and sustaining defendant’s motion and entering judgment thereon in behalf of the defendant and against the plaintiff. We reverse and remand for reasons hereinafter stated.

The facts of this case as gleaned from the pleadings, exhibits attached thereto, the motions for summary judgment of the parties, and affidavits, both in support and counter, are as follows: the plaintiff was employed by the Southwestern Freight Bureau in its offices in an office building situated in the downtown St. Louis area on the 12th day of August, 1966. At approximately 5:00 p. m., at the end of his work day, the plaintiff boarded a freight elevator furnished to him for the purpose of descending to the lobby of the office building, when the elevator malfunctioned and plunged from the 8th floor to the basement of the office building. He was injured as a result of this elevator malfunction and as a direct and proximate result thereof was forced to incur reasonable and necessary expenses for hospitalization, x-rays, doctors’ treatment and consultation, physical therapy and medication in the approximate sum of $4,000.00. The defendant, an insurance company licensed to do business in the State of Missouri, issued to the Association of Western Railways, Chicago, Illinois, Group Insurance Policy GLUG-3920, which was in full force and effect on the date of plaintiff’s injury, and which furnished insured certain medical benefits for active employees and dependents against enumerated hospital, surgical and medical expenses less a $100.00 deductible to the extent of 80% of said charges or expenses. The group policy contained certain exclusionary provisions, among which were included “Occupational injuries or sickness covered by a workmen’s compensation law or similar legislation.” Defendant, in its Answer and in its Affidavit in Support of its Motion for Summary Judgment, contends that it is not liable to the plaintiff under the terms of the group insurance policy because the injuries sustained by the plaintiff arose out of and in the course of his employment and are covered by the Workmen’s Compensation Act of the State of Missouri. In its Affidavit in Support of its Motion for Summary Judgment the defendant, through its attorney, states under oath that on the date of the occurrence the lease executed by the employer of the plaintiff and the owner of the building required the owner to furnish elevator service for the use of the employees of plaintiff’s employer and the employer paid for the cost of the transportation of the plaintiff and its other employees as a part of its rental payments. That on the fateful day one of the regular passenger elevators was out of service and the building owner provided the freight elevator for the use of the employees of tenants in the building and plaintiff was notified of this by his employer for his use if the passenger elevator service was inadequate. With this [47]*47knowledge plaintiff boarded the freight elevator in leaving his place of employment. While being operated by an employee of the owner of the building the elevator malfunctioned and plummeted to the basement. The affidavit further states that plaintiff was subject to the Missouri Workmen’s Compensation Law at the time of the incident and that neither he nor his employer had filed a rejection of the law. That by reason of the aforesaid exclusion of accidental bodily injuries arising out of or in the course of the employment of the insured or his dependents or sickness covered by Workmen’s Compensation or similar legislation, defendant is not liable to the plaintiff. Plaintiff filed his affidavit in opposition to defendant’s motion for summary judgment through his attorney wherein he contended that since defendant did not file a copy of the lease of the premises with his affidavit it was not properly before the court, denied the allegations in the affidavit with respect to the “facts leading up to the Plaintiff using an elevator after his normal working hours,” that there was any evidence by way of deposition or interrogatories to the effect that one of the passenger elevators was out of service and the building owner provided the freight elevator for the use of the various tenants and their employees in the building on the day of the occurrence and that the plaintiff was so advised by his employer. He further states defendant’s statement that the plaintiff is covered by the Workmen’s Compensation Law is a conclusion, unsupported by certification of said status from the Division of Workmen’s Compensation of the State of Missouri and further denies that the facts would support proof of said status for, as a matter of fact, the plaintiff is covered by the Federal Employers’ Liability Act inasmuch as his employer was created and organized by the Association of Western Railways, and is merely an extension. of the services offered ana provided through Interstate Commerce by the Railroads themselves rather than by each Railroad. He further states that the Group Insurance Policy on its face shows that it was issued to the Association of Western Railways of Chicago, Illinois. He complains that the defendant, in Paragraph 4 of its motion, pleads portions of a written contract but fails to attach a written copy of the contract as an exhibit and that the words set out in said allegations varies with the language of the Certificate of Insurance provided to the plaintiff.

On appeal the plaintiff presents what purports to be five Points Relied On. However, only the first meets the standards of Rule 84.04(d), V.A.M.R., as a brief and concise statement of what actions or rulings of the court are sought to be reviewed and why they are claimed to be erroneous. The other four really constitute statements in support of the first which, reduced to its essentials, is that the trial court erred in granting the defendant’s motion for summary judgment since there were real and actual fact controversies for the court to consider and determine. The following Points in support of the former are: Point II, that the exclusion clause in the Group Insurance Policy is ambiguous and should be strictly construed against the defendant and most favorably for the plaintiff-assured; Point III, the exclusionary provision of the policy would be a deprivation of his property rights under the provisions of the policy without due process of law because the provision of the policy in contrary to the public policy of the State of Missouri, Art. I, Sec.

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Cite This Page — Counsel Stack

Bluebook (online)
516 S.W.2d 45, 1974 Mo. App. LEXIS 1394, Counsel Stack Legal Research, https://law.counselstack.com/opinion/kellogg-v-united-benefit-life-insurance-moctapp-1974.