Lee v. Occidental Life Insurance

291 S.W.2d 273, 40 Tenn. App. 265, 1956 Tenn. App. LEXIS 137
CourtCourt of Appeals of Tennessee
DecidedFebruary 24, 1956
StatusPublished
Cited by3 cases

This text of 291 S.W.2d 273 (Lee v. Occidental Life Insurance) is published on Counsel Stack Legal Research, covering Court of Appeals of Tennessee primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Lee v. Occidental Life Insurance, 291 S.W.2d 273, 40 Tenn. App. 265, 1956 Tenn. App. LEXIS 137 (Tenn. Ct. App. 1956).

Opinion

SHRIVEL,, J.

The parties will be referred to as plaintiff and defendant as they appeared in the Court below.

I

The plaintiff brought his suit in the Court of G-eneral Sessions for Davidson County, Tennessee, seeking to collect $800 under an insurance policy for the loss of use of his right hand and arm.

Judgment was rendered in the Court of General Sessions in favor of the plaintiff, whereupon, said cause was appealed to the Circuit Court and there heard before his Honor, Judge Byrd Douglas, without the intervention of a jury.

The Circuit Judge- dismissed plaintiff’s suit and an appeal was perfected to this Court in due course and errors assigned.

[267]*267II

The essential facts are as follows:

In 1943 the defendant insurance company issued to the International Brotherhood of Boilermakers, Iron Shipbuilders and Helpers of America (hereinafter referred to as the Union) a Master Group Policy of insurance providing certain benefits for the members of said union. Plaintiff was issued certificate No. 524266, exhibit “A” to the testimony of Daniel W. Lee, and attached to the transcript. Among other things said certificate provides benefits for partial disability payable to the insured member, and under section 3(b) thereof it is provided: “In the event of the entire irrecoverable loss of the use of one entire hand or arm as the result of accident or disease . . . $800.00.”

It is to be noted that the certificate contains the following provision:

“This Certificate is issued pursuant to Article XII of the Constitution and By-Laws of the International Brotherhood of Boilermakers, Iron Shipbuilders and Helpers of America and the amendments thereto as now in force or as they may hereafter be amended. ”

Said certificate also shows on its face that the insurance coverage is under the terms and conditions of group policy No. 756100, the benefits of which are merely summarized in the certificate issued to plaintiff.

Plaintiff joined the said Union while at work in "Wau-kegan, Illinois, in 1943, and it is not disputed that he continued to pay his dues and the premiums on the aforesaid policy so that it was in force at the time he received [268]*268th.e injuries complained of, although, he had not continued in the occupation of a Boilermaker or Iron Shipbuilder or Helper.

The record shows that, on May 10, 1949, the constitution and by-laws of the Union were duly amended at a convention held in Montreal, Canada, which amendment restricted the coverage for the loss of use of an arm, to á loss sustained while “working at our trade.” On this same day, that is May 10, 1949, an endorsement was added to the Master Group Policy restricting coverage in the manner provided by the aforesaid amendment to the By-laws.

In Aiogust, 1953, plaintiff fell from a ladder while pruning trees at the Tennessee School for the Blind at Donel-son, Tennessee, at which institution he was employed by the State. The fall resulted in a broken foot, for which he was paid certain disability benefits by the State. Following the fall from the ladder, plaintiff began to lose the use of his right arm.

Dr. Laurence Grossman, who treated him, stated in part: “On February 23, 1954, he had developed a marked athetoid tremor of the right hand. In other words his hand would wander in space. That type of tremor is always due to involvement of a certain area of the brain, that condition is thought to be traumatic in its origin.”

The doctor was asked if it was his opinion that the fracture of the foot had some connection with the condition of the patient’s hand and he answered, “I think so-. He never had this condition prior to this. Oftentimes a long period of immobility will result in people having small clots, which may have been the basis of this.”

[269]*269No contention is made by plaintiff that lie was working at the trade of Boilermaker, Iron Shipbuilder or Helper, at the time of the injuries complained of, or that he was on duty for the District, State or Subordinate Lodge.

III

There are two assignments of error as follows:

“1. The Circuit Judge erred in holding that the defendant had power or authority to decrease the benefit provided for in the Group Policy and the certificate and in particular modify that provision of the policy which provided for the payment of $800.00, in the event the insured member sustained by accident, or as a result of disease the entire and irrecoverable loss of use of one hand or one arm. Said power or authority to decrease said benefit being claimed by the defendant under and by virtue of a meeting of the officers of the Brotherhood at a convention held in Montreal, Canada, on or about May 10, 1949.
“2. The Court erred in holding that the Brotherhood was vested with authority to change the contract under which the plaintiff was insured against the loss of use of a hand or arm to the extent of $800.00, so as to deprive the plaintiff of any benefit whatever for the loss of use of his arm and hand.”

IV

It is seen from the foregoing and the record (Tr. pp. 32-33), that the change in the by-laws of the Union resulted in a change in the policy in question from one which covered irrecoverable loss of use of a hand or arm [270]*270caused, by either accident or disease and occuring either •while at,work or otherwise, to a provision to the effect that the policy covered only members who suffered:

(1) "An accident occurring while working at our trade or while on duty for the District Lodge, the State Lodge, (or) the Subordinate Lodge.”
(2) "An occupational disease resulting from working at our trade, or while on duty for the District Lodge, the State Lodge, the Subordinate Lodge, or the International Brotherhood. ’ ’

It is insisted that the defendant accepted premiums from plaintiff from 1943 until time of the accident with knowledge that he was not working at the trade of .boilermaker, or for the lodge or brotherhood. And it is argued that, since there was no reduction in the premium for the decrease in benefits, nor any notice to plaintiff of the restrictions, or reduction of his coverage, the Union had no right or authority to pass resolutions which would enable the defendant to alter, vary or change its written contract with the plaintiff so as to wholly deprive him of his right to disability benefits under the said policy.

Learned counsel for the plaintiff quotes 38 Am. Jur. p. 459 to the effect that, despite an express reservation of the right to amend the by-laws of a mutual benefit society, there are certain limitations upon the right to bind a member by such an amendment. It is said,

"In addition to those limitations upon the general power to amend, such amendments must be reasonable and must not impair vested rights. ■ Furthermore, a society cannot avail itself of its reserved power of amendment as a means of repudiating its just obligations, or thereby so alter the terms of its [271]*271contracts of membership as practically to destroy their value.” 38 Am. Jur. 459.

38 Am. Jur. pp. 460-461, sec.

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Bluebook (online)
291 S.W.2d 273, 40 Tenn. App. 265, 1956 Tenn. App. LEXIS 137, Counsel Stack Legal Research, https://law.counselstack.com/opinion/lee-v-occidental-life-insurance-tennctapp-1956.