King v. Equitable Life Assurance Society of the United States

466 N.E.2d 353, 125 Ill. App. 3d 542, 80 Ill. Dec. 901, 1984 Ill. App. LEXIS 2019
CourtAppellate Court of Illinois
DecidedJuly 6, 1984
DocketNo. 3—83—0401
StatusPublished
Cited by2 cases

This text of 466 N.E.2d 353 (King v. Equitable Life Assurance Society of the United States) is published on Counsel Stack Legal Research, covering Appellate Court of Illinois primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
King v. Equitable Life Assurance Society of the United States, 466 N.E.2d 353, 125 Ill. App. 3d 542, 80 Ill. Dec. 901, 1984 Ill. App. LEXIS 2019 (Ill. Ct. App. 1984).

Opinion

JUSTICE BARRY

delivered the opinion of the court:

This is an appeal from a directed verdict in favor of plaintiff Lorraine M. King entered in the circuit court of Peoria County in a cause to recover life insurance benefits under a group policy issued by defendant Equitable Life Assurance Society to cover employees of the city of Peoria.

Plaintiff’s husband, Gerald King, was a Peoria police captain in charge of the traffic division who was injured in a fall occurring while he was on duty on January 4, 1979. King’s injuries, which included a broken neck, required that he be hospitalized in traction for a time and further greatly hampered his mobility after he was discharged from the hospital. He was placed on “Injured On Duty” status (IOD) and continued to receive his full salary for 90 working days following the accident. On May 15, 1979, he was placed on disability pension status, where he remained until his death on January 5, 1980, from causes unrelated to the accident.

Effective April 1, 1979, Equitable’s group insurance policy insuring members of the police department was amended to increase life insurance benefits from $1,000 to $6,000 for all employees. At the time that amendment took effect, King was on IOD status, which means that his name still appeared on the active duty roster, he was still subject to all the rules and regulations of the department, and on April 6, 1979, he received his annual $200 allowance for the expense of carrying weapons.

The insurance policy provided that while an employee was disabled, the insurance protection would be the amount for which he was last insured under the group life insurance plan prior to the discontinuance of active work. The insurance booklet given to each employee, which was a part of the policy, indicated that the increased benefits were effective as to all employees on April 1, 1979, and also stated:

“If you are absent from work on the day on which your insurance would normally begin, you will become insured on the day you return to active work.”

Another pertinent provision of the policy provides that an employee’s insurance will cease automatically when his employment terminates. The policy also states:

“Cessation of active work by an employee shall be deemed to constitute the termination of his employment except that ***
(b) in the case of Life and Accidental Death and Dismemberment Insurance, an employee, absent from active work because of injury or sickness may be regarded as still in the employment of the Policyholder for the full period of such absence until the effective date entered on the insurance records maintained in connection with this policy ***.”

Although King never returned to full-time active duty, Equitable obviously considered that he was an employee on the date of his death, since his widow was tendered benefits of $1,000 plus interest which she refused. Plaintiff filed this suit to recover $6,000, and in the course of the trial before the jury, plaintiff produced several witnesses who related the number of conferences, phone calls, police reports, and other police business which King transacted from his home both before and after April 1,1979.

At the conclusion of all the evidence the trial court granted plaintiff’s motion for directed verdict, ruling that the insurance policy was ambiguous and must be construed against the insurer. The court allowed plaintiff 6% interest on the proceeds of the policy from the date of death and denied plaintiff’s motion for taxation of costs as a penalty for defendant’s allegedly unreasonable and vexatious refusal to pay the amount owed.

On appeal, defendant asserts three errors: (1) that the trial court erred as a matter of law in construing the contract; (2) that the question whether King returned to work after April 1, 1979, was a question of fact for the jury; and (3) that defendant should have been ordered to pay no more than 5% interest.

Defendant first argues that the contract was not ambiguous since the provisions relating to the date the increased benefits took effect should be construed together to mean that the increase in benefits are payable to all persons employed by the city of Peoria on April 1, 1979, providing they are at work on that date, and any employee absent from work on April 1 will become insured in the increased amount on the day he returns to active work. We agree that the provisions should be read together, but when we do so, we find that there is still an ambiguity. The policy does not define “active work” and therein lies the ambiguity.

The rule of law in Illinois in such cases is that the issue of whether an ambiguity exists is a question of law, and further that the construction of an insurance contract presents an issue of law only, not submissible to a jury. (E.g., Voss v. Associated Life Insurance Co. (1976), 36 Ill. App. 3d 105, 343 N.E.2d 174.) Thus the determination of whether an ambiguity exists here was properly made by the trial court as a question of law.

Once that determination was made, a special rule of construction applies in the case of insurance policies. In Dora Township v. Indiana Insurance Co. (1980), 78 Ill. 2d 376, 379, 400 N.E.2d 921, 923, the Illinois Supreme Court stated:

“[Wjhere language in an insurance policy is subject to different interpretations such ambiguity is to be construed in favor of the insured, and not the insurance company, which drafted the contract of insurance.”

Here the trial court stated that the provisions of the policy were to be construed against defendant, who wrote the policy, and that the provisions relating to effective date are difficult to apply “because of the lack of any clear language or definitions.” We agree.

Many cases have been cited to us where insureds were found to qualify for life insurance benefits even though they were disabled to such an extent that they were at home or even in the hospital, and we have been cited to other cases denying benefits. (See Annot., 59 A.L.R.3d 993 (1974).) None of those cases involved a police officer.

When we look at the evidence presented in this case, we see that after April 1, 1979, King continued to perform some work in connection with his supervisory duties as police captain in charge of the traffic division. He resolved personnel problems, received oral reports of investigations, gave advice to subordinate police officers, called other officers in the department about police matters, made recommendations for training assignments, and was on call for large fires or other emergencies. In addition, King was involved in a dispute with some people who allegedly harassed him and his wife and threatened harm to his home. In the course of the incident, King had taken possession of a bicycle and attempted to make an arrest. Although the police superintendent testified that he considered King to be a witness and not on active duty with regard to that incident, he nonetheless at the time directed King to prepare an official report on police department forms.

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466 N.E.2d 353, 125 Ill. App. 3d 542, 80 Ill. Dec. 901, 1984 Ill. App. LEXIS 2019, Counsel Stack Legal Research, https://law.counselstack.com/opinion/king-v-equitable-life-assurance-society-of-the-united-states-illappct-1984.