Reeves v. Midland Casualty Co.

174 N.W. 475, 170 Wis. 370, 1920 Wisc. LEXIS 5
CourtWisconsin Supreme Court
DecidedJanuary 13, 1920
StatusPublished
Cited by38 cases

This text of 174 N.W. 475 (Reeves v. Midland Casualty Co.) is published on Counsel Stack Legal Research, covering Wisconsin Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Reeves v. Midland Casualty Co., 174 N.W. 475, 170 Wis. 370, 1920 Wisc. LEXIS 5 (Wis. 1920).

Opinions

The following opinion was filed November 4, 1919:

Owen, '].

Appellant contends that the court erred in rendering judgment for full indemnity for the entire period of six months, because it .appears from the verdict that the plaintiff, was not confined within the house and therein regularly and personally visited by a legally qualified physician during the six-months period. While the jury found that he was necessarily and continuously confined within his house for a period of twenty-six weeks and three days, it also found that he visited his physician at the latter’s office at Polar, Wisconsin, for twenty-three weeks and three days, and that plaintiff’s physician visited him in his house for a period of only three weeks. There is, therefore, a direct finding that the period during which the plaintiff was treated by a physician in the house existed for only three weeks, and it is contended that from the further finding that plaintiff visited his physician’s ■ office at Polar, Wisconsin, for a period of twenty-three weeks and three days it necessarily follows that during such time he was not necessarily and [373]*373continuously confined within the house during such period. The trial court gave this provision of the policy a liberal construction, his view as to its proper meaning being revealed in his instruction to the jury, wherein he said:

“I instruct you that the phrase ‘necessarily and continuously confined within the house’ means such time as plaintiff was confined within the house, and for such time as plaintiff was disabled by reason of his sickness from departing from his house for the purpose of attending to the ordinary -affairs of life and to resume the ordinary pleasures thereof, including the times he may be assisted to the porch of his house to enjoy the benefits of fresh air and sunshine as directed by his physician.”

It is a familiar rule that in case of doubt or ambiguity the language of an insurance policy should be construed most strongly against the insurer (Patterson v. Natural Premium M. L. Ins. Co. 100 Wis. 118, 75 N. W. 980), but it is also well settled that construction cannot be resorted to unless ambiguity exists. Under the terms of the policy the insured was entitled to full indemnity only for the period during which he was necessarily and continuously confined zvithin the house and therein regularly and personally 'visited by a legally qualified physician. It would seem that the company ex industria employed language which could leave no doubt as to the period during which the insured should be entitled to full indemnity. He must not only be confined zvithin the house but .he must be therein regularly and personally treated by a physician. Treatment at the physician’s office was excluded as plainly and as definitely as it well could be. We speculate in vain for language that would more surely limit the period during which the insured was entitled to full indemnity to that period during which he was confined within the four walls of his house and regularly and personally treated by a physician therein. To our minds the language employed is not capable of a double meaning. It cannot be reasonably construed to include time around the house, about the house, or when he [374]*374was making trips to Polar and receiving treatment in the physician’s office.

The purpose of the company to thus limit its liability for full indemnity is made more plain when we consider the immediately following provision in the policy for partial indemnity. Under that provision the insured is entitled to partial indemnity “for the period not exceeding two consecutive months immediately following said confinement, during which the insured shall be regularly and personally attended by such physician, and wholly and continuously disabled and prevented from performing any and every duty pertaining to any business or-occupation.” Now the question arises, If. the period during which the insured was necessarily and continuously confined within his house and therein regularly treated by a physician does not mark the limit of time during which he was entitled to full indemnity, then, under the terms of the policy, when did the term, during which he was entitled to full indemnity, end, and when did the partial indemnity period begin? It will be noticed that in order to entitle him to either full or partial indemnity he must have been wholly and continuously disabled and prevented from performing any and every duty pertaining to any business or occupation solely by reason of such illness. That condition must be present to entitle him either to full or partial indemnity. It was also necessary, in order for him to recover either full or partial indemnity, that he be regularly and personally attended by a physician. What, then, is the feature which distinguishes the full from the partial indemnity period? Manifestly it is the continuous and necessary confinement within the house and treatment therein by a physician.

The indemnity provisions of the policy recognize two degrees of illness: one, when the insured is so ill that he is confined within his house and is therein treated by his physician; the other, when he has so far recovered that he is [375]*375able to be outside the house and to receive treatment from his physician at places other than the house. The purpose of these provisions is not difficult to understand. He who is disposed to malinger will grow weary of his simulations more quickly if, in order to enjoy their fruits, he must confine himself within the four walls of his house. The period of convalescence can be more cheerfully prolonged if one be permitted to enjoy the fresh air and sunshine, walk about his yard, take an occasional walk to the neighbors, and make calls at his physician’s office. It was for the purpose of discouraging the protraction of illness for the purpose of securing the fruits of the insurance contract that the company limited full indemnity to the period of actual confinement within the house. This may not be a desirable contract, but the company had the right to prescribe the period during which it should be liable for indemnity, as well as the amount thereof. If the contract did not appeal to plaintiff, he was under no obligations to purchase it. The premium rate was no doubt fixed by the character of the liability assumed and, the company having made use of plain and unambiguous words -prescribing the period of full liability, the éourt should not substitute another and different contract for the parties. The court was in error in ordering judgment upon the theory that the plaintiff was entitled to the full indemnity during the six-months period. Judgment should have been ordered for full indemnity for the period of three weeks and partial indemnity for the remainder of the six-months period.

The policy also contains this provision: “Written notice of injury or of sickness on which claim may be based must be given to the company within twenty days after the date of the accident causing such injury or within ten days after the commencement of disability from such sickness.” It is claimed by the company that written notice of sickness was not given. The plaintiff testified that about the 25th [376]*376of July he instructed Dr. Westphal to notify the Midland Casualty Company that he was ill. Dr. Westphal testified: “I gave written notice to the Midland Casualty Company of plaintiff’s illness on July 25, 1917. Reeves gave me his papers and asked me to complete them for him.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

American Family Mutual Insurance v. Golke
2009 WI 81 (Wisconsin Supreme Court, 2009)
State Ex Rel. Flores v. State
516 N.W.2d 362 (Wisconsin Supreme Court, 1994)
Mullen v. Braatz
508 N.W.2d 446 (Court of Appeals of Wisconsin, 1993)
Pennsylvania Life Insurance v. Bumbrey
665 F. Supp. 1190 (E.D. Virginia, 1987)
Vidmar v. American Family Mutual Insurance
312 N.W.2d 129 (Wisconsin Supreme Court, 1981)
Luedtke v. Shedivy
186 N.W.2d 220 (Wisconsin Supreme Court, 1971)
Olson v. Hardware Dealers Mutual Fire Insurance
173 N.W.2d 599 (Wisconsin Supreme Court, 1970)
Olson v. Sentry Insurance Co.
156 N.W.2d 429 (Wisconsin Supreme Court, 1968)
Suits v. Old Equity Life Insurance Company
106 S.E.2d 579 (Supreme Court of North Carolina, 1959)
Massachusetts Bonding & Insurance Co. v. Springston
1955 OK 142 (Supreme Court of Oklahoma, 1955)
Occidental Life Ins. Co. v. Bocock
266 P.2d 1082 (Arizona Supreme Court, 1954)
Franklin Life Ins. Co. v. Strength
58 So. 2d 126 (Alabama Court of Appeals, 1951)
MacFARLANE v. PACIFIC MUT. LIFE INS. CO.
192 F.2d 193 (Seventh Circuit, 1951)
Mutual Benefit Health & Accident Ass'n v. Milder
41 N.W.2d 780 (Nebraska Supreme Court, 1950)
Straw v. Integrity Mutual Insurance Co.
20 N.W.2d 707 (Wisconsin Supreme Court, 1945)
Mutual Ben. Health & Accident Ass'n v. Ramage
169 S.W.2d 624 (Court of Appeals of Kentucky (pre-1976), 1943)
Clesi v. National Life Accident Ins. Co.
197 So. 413 (Supreme Court of Louisiana, 1940)
Federal Life Ins. Co. v. O'connell's Committee
124 S.W.2d 1043 (Court of Appeals of Kentucky (pre-1976), 1939)
Moss v. Mutual Ben. Health & Accident Ass'n
56 P.2d 1351 (Utah Supreme Court, 1936)

Cite This Page — Counsel Stack

Bluebook (online)
174 N.W. 475, 170 Wis. 370, 1920 Wisc. LEXIS 5, Counsel Stack Legal Research, https://law.counselstack.com/opinion/reeves-v-midland-casualty-co-wis-1920.