Mutual Ben. Health & Accident Ass'n v. Dixon

180 S.W.2d 426, 27 Tenn. App. 312, 1944 Tenn. App. LEXIS 83
CourtCourt of Appeals of Tennessee
DecidedMarch 18, 1944
StatusPublished
Cited by2 cases

This text of 180 S.W.2d 426 (Mutual Ben. Health & Accident Ass'n v. Dixon) 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
Mutual Ben. Health & Accident Ass'n v. Dixon, 180 S.W.2d 426, 27 Tenn. App. 312, 1944 Tenn. App. LEXIS 83 (Tenn. Ct. App. 1944).

Opinion

HICKERSON, J.

Only one question is presented by this appeal, and that is a question of law: The proper construction of the insurance policy which is the basis of this suit.

There is no controversy about the facts. Appellant, who was defendant below, issued a policy of insurance to Ottis G-. Dixon, appellee, who was complainant below. The purpose of the insurance policy was expressed in these words which appear on the back of the policy and at the beginning of the policy on its face: “This policy provides benefits for loss of life, limb, sight or time, by accidental means, or loss of time by sickness as herein limited and provided.” (Italics in this opinion are added.)

The insured had an accident, within the terms of the policy, that resulted in a hernia; and from this injury the insured was totally disabled. • The injury did not cause *314 him to be continuously within doors, hut did require regular medical attention.

Under these conditions the insured contended that he was entitled to the disability benefits provided in Part “D” of the policy.

To the contrary, the insurance company contended that the insured was entitled to the disability benefits provided under Part “L” of the contract.

An insurance contract must be construed as a whole, and effect must be given to every part of it if that can be done. Stoops v. First American Fire Insurance Company, 160 Tenn., 239, 22 S. W. (2d), 1038; Laurenzi v. Atlas Insurance Company, 131 Tenn., 644, 176 S. W., 1022; Karney v. Reliance Insurance Company, 9 Tenn. App., 456; Order of United Commercial Travelers of America v. Edwards, 10 Cir., 51 F. (2d), 187. A full statement of the rule is found in 29 Am. Jur., 176, section 160, which we quote:

“Consideration of Entire Context of Policy. — In determining the intention of the parties to an insurance policy, the policy should be considered and construed as a whole, and if it can reasonably be done, that construction will be adopted which will give effect to the whole instrument and to each of its various parts and provisions. Seeming contradictions should be harmonized if reasonably possible. A construction of an insurance policy which entirely neutralizes one provision should not be adopted if the contract is susceptible of another construction which gives effect to all of its provisions and is consistent with the general intent. Accordingly, in determining the meaning of a provision of a liability policy with respect to liability for -interest on a judgment recovered against the insured, the court is not limited to consideration" of the provision alone, but must con *315 strue the policy in its entirety, endeavoring, if possible, to ascertain the mutual intention of the parties as it existed at the time of the execution of the'instrument.”

If a contract of insurance is ambiguous in its terms it must be construed most favorably to insured; but plain provisions of the policy, taken as a whole, must be enforced as stated. Great Eastern Casualty Company v. Solinsky, 150 Tenn., 206, 263 S. W., 71, 35 A. L. R., 1007; Inman v. Life & Accident Insurance Company, 164 Tenn., 12, 45 S. W. (2d), 1073; Berry v. Prudential Life Insurance Company of America, 23 Tenn. App., 485, 134. S. W. (2d), 886; Travelers Insurance Company v. Ansley, 22 Tenn. App., 456, 124 S. W. (2d), 37.

“Ambiguous” is defined in 3 C. J. S., 1037, as follows:

“The word has been defined as capable of being finder-stood in more senses than one; obscure in meaning through indefiniteness of expression; having a double meaning; doubtful and uncertain; meaning 'unaseertainable within the four corners of the instrument; open to construction; reasonably susceptible of different constructions; uncertain because susceptible of more than one meaning. Its synonyms have been said to be ‘ doubtful,’ ‘equivocal,’ ‘indefinite,’ ‘indeterminate,’ ‘indistinct,’ ‘uncertain,’ and ‘unsettled.’ ”

We shall now consider the policy contract, bearing in mind these rules of construction. This policy is divided into five main parts-or divisions, as follows:

The Insuring Clause: “Mutual Benefit Health and Accident Association hereby insures Ottis G. Dixon (Herein called the Insured) of City of Monoville, State of Tennessee, against loss of life, limb, sight or time, sustained or commencing" while this policy is in force, resulting directly and independently of all other causes, from bodily injuries sustained during any term of this policy, *316 through purely Accidental Means (Suicide, sane or insane, is not covered), and against loss of time beginning while this policy is in force and caused by disease contracted during any term of this policy, respectively, subject, however, to all the provisions and limitations hereinafter contained. ’ ’

Accident Indemnities: ‘‘Part D. Total Accident Disability Benefits for Life. If such injuries, as described in the Insuring Clause, do not result in any of the above mentioned specific losses but shall wholly and continuously disable the Insured for one day or more, the Association will pay a monthly indemnity, as hereinafter provided, at the rate of Fifty ($50.00) Dollars per month for the first fifteen days and at the rate of One Hundred ($100.00) Dollars per month thereafter, so long as'the, Insured lives and suffers said total loss of time.”

Illness Indemnities: “Part K. Confining Illness Disability Benefits for Life. If disability resulting from disease, the cause of which originates more than thirty days after the date of this policy, confines the Insured continuously within doors and requires regular visits therein by a legally qualified physician, the Association will pay a monthly indemnity, as hereinafter provided, at the rate of Fifty ($50:00) Dollars per month for the first fifteen days and at the rate of One Hundred ($100.00) Dollars per month thereafter, for one day or more, so long as such confinement remains continuous; provided said disease causes total disability and necessitates total loss of time.

“Part L. Non-Confining Illness Disability Fifty Dollars Per Month. If disability resulting from disease, the cause of which originates more than thirty days after the date of this policy, does not confine the Insured continuously within doors, but requires regular medical *317 attention, the Association will pay a monthly indemnity at the rate of Fifty ($50.00) Dollars per month, but not exceeding three months; provided said disease necessitates continuous total disability and total loss of time.”

Standard ‘■Provisions: Under this heading áre included seventeen different paragraphs, none of which are in controversy here.

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Bluebook (online)
180 S.W.2d 426, 27 Tenn. App. 312, 1944 Tenn. App. LEXIS 83, Counsel Stack Legal Research, https://law.counselstack.com/opinion/mutual-ben-health-accident-assn-v-dixon-tennctapp-1944.