Smith v. Mutual Benefit Health & Accident Ass'n

258 P.2d 993, 175 Kan. 68, 45 A.L.R. 2d 456, 1953 Kan. LEXIS 370
CourtSupreme Court of Kansas
DecidedJuly 6, 1953
Docket39,006
StatusPublished
Cited by19 cases

This text of 258 P.2d 993 (Smith v. Mutual Benefit Health & Accident Ass'n) is published on Counsel Stack Legal Research, covering Supreme Court of Kansas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Smith v. Mutual Benefit Health & Accident Ass'n, 258 P.2d 993, 175 Kan. 68, 45 A.L.R. 2d 456, 1953 Kan. LEXIS 370 (kan 1953).

Opinion

The opinion of the court was delivered by

Parker, J.:

This was an action to recover accident benefits under the terms of a health and accident insurance policy. The appeal is from an order and judgment sustaining a demurrer to plaintiff’s third amended petition and rendering judgment against him for costs.

Plaintiff who was carrying health and accident insurance with the defendant sustained accidental injuries at a time when the policy of insurance was in full force and effect. Thereafter he commenced this action by the filing of a petition in the district court of Shawnee county wherein he sought to recover benefits under its terms. De *69 fendant attacked this pleading by a motion to strike certain of its allegations and to make others more definite and certain. This motion was sustained. Thereupon defendant filed an amended petition to which a demurrer was also sustained. Thereafter he filed a second amended petition and, when a motion to make it more definite and certain was sustained, he filed the instant or third amended petition, hereafter for purposes of brevity referred to as the petition, to which defendant demurred on the ground it failed to state facts sufficient to constitute a cause of action. When this demurrer was sustained plaintiff perfected the appeal to which reference is made in the opening paragraph of this opinion.

Omitting formal averments, allegations relating to the extent of appellant’s injuries and the prayer portions of the petition, which it may be added included by reference the policy of insurance in question, required for disposition of questions raised on appeal read:

“That on the 28th day of May, 1950, near the city of Alexandria, in the State of Virginia, plaintiff suffered accidental injuries resulting in compressed and fractured first lumbar vertebrae and contusion of both heels. That plaintiff made a jump in a parachute and suffered such injuries when he came in contact with the ground.
“Plaintiff was a civilian at the time of such injuries. That the airplane was not piloted by plaintiff and plaintiff had no control of its operation. That the airplane was operated by the Civil Air Patrol, and was making a short local flight. The airplane in which plaintiff had gone up was an Aeronca numbered NC84490 owned by Cecil E. Brown. The pilot of tire plane was Paul'Dove and his license number was 899000, which is a commercial pilot’s rating. Both the owner and said airplane and the pilot reside in Alexandria, Virginia.
“Plaintiff was trained and experienced during the War as a paratrooper, and was making a practice parachute jump for an Airshow. Plaintiff was not a fare-paying passenger in a licensed passenger plane provided by a common carrier of passengers upon a regular passenger route.
“That the plaintiff was not injured on or as a result of any fault or defect in the airplane or parachute. That as plaintiff descended in the parachute and neared the ground, he saw that he would collide with one of several air-craft parked on the ground, and plaintiff swung his body and attempted to maneuver and land betwen the parked air-craft. That without intention on the part of the plaintiff, the speed of plaintiff’s descent suddenly increased and plaintiff was thrown to the ground between the said parked airplanes, landing upon his buttocks and back with such force that plaintiff suffered the injuries herein-before described.”

The rights of the parties depend upon a construction of certain provisions of the policy. One of these is the insuring clause. So far as pertinent its provisions read:

*70 “Hereby insures the person whose name is shown in the Schedule on the last page hereof (herein called the Insured), subject to the provisions and limitations of this policy, against loss of life, limb, or sight occurring, or loss of time sustained and commencing, while this policy is in force and resulting directly, and independently of all other causes, from such injuries, . . .
“(a) the term, such injuries, as used in this policy, shall mean accidental bodily injuries occurring while this policy is in force, but shall not include . . ., or (3) injuries received as a result of or while participating in aeronautics or air travel except as provided in Part H; . . .”

Part H, referred to in the insuring clause, provides:

“Commercial Air Travel Passenger Coverage. This policy covers such injuries, caused by any of the hazards of aviation or aeronautics, only if received while the Insured is riding as a fare-paying passenger in a licensed passenger airplane provided by an incorporated common carrier of passengers and while operated by a licensed transport pilot upon a regular passenger route between definitely established airports.”

In passing we pause to note it is well to keep in mind that subsection (a) (3), above quoted, is a part of the exclusionary clause of the policy and Part H merely provides an exception to that clause under certain conditions.

There can be no question in this jurisdiction with respect to the general rules governing construction of insurance contracts when directly applied to policies dealing with aviation and aeronautical activities. They are well stated in Knouse v. Equitable Life Ins. Co., 163 Kan. 213, 181 P. 2d 310, where we held:

“If the terms of a policy of insurance are ambiguous or obscure or susceptible of more than one construction, the construction most favorable to the insured must prevail.
“As an insurer prepares its own contracts and it is its duty to make the meaning clear if it fails to do so, tire insurer and not the insured must suffer.
“Courts should not be astute to evade the meaning of words manifestly intended by the parties, but where an insurance contract is unambiguous it must be enforced according to its terms.
“Where an insurance contract is not ambiguous, the court may not make another contract for the parties; its function is to enforce the contract as made.” (Syl. ¶¶ 1, 2, 3 and 4.)

To the foregoing rules of contractual construction another can well be added. It is that the fact terms of a policy of insurance may be construed as ambiguous when applied to one set of facts does not make them ambiguous as to others which come directly within the purview of such terms.

Neither can there be any question regarding the sole issue presented for decision in the instant appeal nor what is required of *71 this court in its disposition. In his brief appellant states the question for decision is whether, under facts such as are set forth in the petition, he is defeated by the limitation or exclusion clause appearing in subsection (a) (3) of the insurance clause of the policy while appellee, both in its brief and on oral argument, states the question is whether parachute jumping, as described in that pleading, constitutes participating in aeronautics or air travel within the meaning of those terms as used in such subsection of the policy.

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Cite This Page — Counsel Stack

Bluebook (online)
258 P.2d 993, 175 Kan. 68, 45 A.L.R. 2d 456, 1953 Kan. LEXIS 370, Counsel Stack Legal Research, https://law.counselstack.com/opinion/smith-v-mutual-benefit-health-accident-assn-kan-1953.