Pledger v. Business Men's Accident Ass'n of Texas

228 S.W. 110, 1921 Tex. App. LEXIS 662
CourtTexas Commission of Appeals
DecidedFebruary 23, 1921
DocketNo. 162-3158
StatusPublished
Cited by57 cases

This text of 228 S.W. 110 (Pledger v. Business Men's Accident Ass'n of Texas) is published on Counsel Stack Legal Research, covering Texas Commission of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Pledger v. Business Men's Accident Ass'n of Texas, 228 S.W. 110, 1921 Tex. App. LEXIS 662 (Tex. Super. Ct. 1921).

Opinion

TAYLOE, J.

This was a suit by Minnie Pledger against the Business Men’s Accident Association of Texas on a contract of accident insurance. The contract was declared upon by plaintiff as consisting of tbe following instruments, to wit:

(a) The application of Beaureguard Pledger for membership in the association, and for accident insurance upon himself in favor of his wife, Minnie Pledger; (b) the certificate or policy issued pursuant to the application; (c) the by-laws of the association; and (d) its charter. The association was a mutual assessment accident association incorporated under the provisions of chapter 5, title 71, of the Eevised Statutes 1911. The application for membership and for insurance gave the following as one of the indemnities; “$5,000 in the case of accidental death.” The certificate, or policy, provided that—

“In consideration of the application for membership * * * the said Business Men’s Accident Association of Texas does hereby receive the said Beaureguard Pledger * * * as a member of said association * * * and upon the further consideration • * * of the payment of the annual dues to be paid as provided in the by-iaws of said association * * * there shall be payable to said member in tbe case of an accidental injury not resulting in death * * * the siim of $25 per week for Wtal disability * * * and in the case of the accidental death of said member there shall be payable to Minnie Pledger (wife) * * * within ninety days after the receipt by said association of satisfactory proof of the happening of said accidental death, the sum of $5,000; provided, however, that in case of liability incurred hereunder, on account of accidental death or accidental loss of both hands * * * said association reserves the right to pay such claim in annual installments of $1,000 each until the entire claim is paid. Such annual payments shall bear interest at the rate of 6 per cent, per annum from date of the first payment, and any and all such payments or liability to pay shall be, and is, in accordance with, and subject to, each and all of the provisions, limitations, and exceptions of the by-laws of said association * * * which said by-laws are hereby referred to and made a part hereof as fully as if they were recited at length over the signatures hereto affixed.”

The by-laws provide for payment of $5,000 for the death of the member caused “solely and exclusively by external, violent, and accidental means.”

Mrs. Pledger sought recovery on two theories, to wit: (1) On account of the accidental death of Pledger; and (2) on account of his death caused solely and exclusively by accidental m^ans.

The association defended principally on the ground that the contingency insured, 'against was death resulting from accidental ■means solely and exclusively; that Pledger’s •death did not result from accidental means, and certainly not from such means solely and exclusiv ely.

Pledger was a cotton buyer. On the day of his death, about noon, he attempted to lift a cotton bale and let it fall. He called one of the men in the cotton yard to •him, stating that he (Pledger) had, lifted •several bales, and that “it got next to his wind.” He then expressed a desire to go home and lie down. He went to his office, and .in a few minutes was seized by an attach ■in the region of his heart, from which he died about 5 o’clock in the afternoon.

There was testimony tending to show that Pledger' suffered a rupture of the heart or heart vessels at the time of lifting the cotton bales; that he was suffering from sclerosis of the arteries, the effect of which was to make them more susceptible to rupture.

The jury found in response to special issues that Pledger lifted the cotton bales, and that his death would not have resulted when it did had he not done so; that the lifting of the cotton bales caused him to suffer a rupture of the heart or heart vessels; that his death was caused by such rupture; that he had a diseased- condition of the heart or heart vessels before lifting the cotton; that such diseased condition assisted in causing his death; that his death was the reasonably expected result of his physical effort in 'lifting the cotton. On the foregoing findings judgment was rendered in favor of the association.

[112]*112On original hearing the court of Civil Appeals held that deceased’s death was accidental, and that the policy insured him against such contingency; that section 27 of the bylaws was in conflict with the policy and ambiguous, and did not have the effect of limiting the policy coverage to death by accidental means. The cause was ordered reversed and remanded. 197 S. W. 889. On rehearing the Court; of Civil Appeals affirmed the judgment of the trial court. In so doing it adhered to its former holding that the policy covered accidental death, and that the deceased died an accidental death, but held further that the entire contract of insurance, including, the by-laws, did not' insure against accidental death, but against death caused solely and exclusively by external, violent, and accidental means. 198 S. W. 311.

The vital question in the case is: Was the accidental death of Beaureguard Pledger a contingency insured against by plaintiff in error? In deceased’s application for insurance accidental death is the contingency named as insured against in the sum of $5,000. There is no reference to death resulting from accidental means in the application, nor is any mention made in the policy of such coverage, or of any limitation upon liability for accidental death. The first reference to death as a result of accidental means is found in the by-laws. The sections of the by-laws throwing light on the policy coverage are sections 27, 28, and 29 of article 5, under the heading “policies.” The' material provisions of the sections referred to are as follows:

“Sec. 27. Subject to the provisions, exceptions, and limitations, prescribed by, and contained in, the policy issued to the members of the association, a member shall be entitled to benefits for injuries and his beneficiary to benefits for the death of the member, caused during his membership, solely and exclusively by external, violent, and accidental means, as follows: Death, $5,000.
“Sec. 28. Subject to the provisions, exceptions and limitations prescribed by, and contained in, the policy issued and to be issued to the members of the association, a member who necessarily sustains loss of time resulting from bodily injuries other than those specified in section 27 of this article, which are the direct result of, and are caused solely and exclusively by external, violent, and accidental means * * * shall be entitled to receive * * * $25 per week. * * *
“Sec. 29. All weekly indemnities paid to a member for disablement resulting in loss of life, the sight of eye or eyes * * * shall be deducted from the sum payable for the loss of life. * * * This association shall not he liable to any person for any indemnity or benefit for injuries or death, loss of hand or foot, * * * from an accident which happens to a member while said member is violating any laws or is in any degree under the influence of intoxicating liquors or narcotics * * * nor for injuries or death in any case in which there is no visible mark or injury on the body of the member; nor for the death of a member occurring through the taking or inhaling of gas; * * * nor in the case such injuries

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Bluebook (online)
228 S.W. 110, 1921 Tex. App. LEXIS 662, Counsel Stack Legal Research, https://law.counselstack.com/opinion/pledger-v-business-mens-accident-assn-of-texas-texcommnapp-1921.