Lloyd v. Wilson Employees' Mutual Benefit Fund
Lloyd v. Wilson Employees' Mutual Benefit Fund
Opinion of the Court
The opinion of the court was delivered by
Plaintiff brought this action to recover benefits claimed to be due him by reason of his membership in the defendant association which will be referred to as the Fund. The cause was tried by the court and from a judgment in plaintiff’s favor the Fund appeals, the questions presented being whether plaintiff had complied with the constitution and bylaws of the Fund, and whether the trial court erred in not sustaining the Fund’s demurrer to plaintiff’s evidence, and in the findings of fact and conclusions of law it made.
There is no dispute that the defendant is a voluntary association, limited in its membership to employees of Wilson & Co., Inc., hereafter referred to as the company, and at the times here mentioned operated under a constitution and bylaws, admitted in evidence by agreement. The entire document had twenty-three numbered sections and, as far as need be noticed, provided that the purpose of the. Fund was to accumulate funds to provide sick and disability benefits to the members who were limited to employees of the company, it being provided that all employees of the company making application on or before June 15,1920, should be admitted to membership, irrespective of age and without physical examination. Each member paid into the Fund the sum of twenty cents per . week, which was deducted from his weekly pay check from the company. Section 8 provided for medical service and expressly stipulated nó medical allowance would be paid on account of injuries arising out of and in the course of regular employment “as such medical attention is provided by the company under the compensation laws.” Under this head, it is provided the secretary of the Fund may require a claimant and his attending physician to furnish a specially prepared form in support of his claim, and failure to comply shall be sufficient cause for not honoring the claim. Section 9 provides that any member, who, prior to attaining the age of 65 years, suffers permanent and total disability as the result of illness or accidental injury not
“No person shall be entitled to any benefit in respect of illness or disability which was not reported before the termination of his employment.”
Sections 15 to 19, inclusive, provide for a board of 21 trustees, ten of whom are elected from specified districts, ten of whom are selected by the company, the other trustee being the president of the company, and specify the duties of the board and its officers. The secretary is directed to appoint assistant secretaries in each of the designated districts. Section 22 provides a form of application which provides in part:
“I further agree, that in case of sickness or injury, I will immediately notify the assistant secretary of my district, or cause him to be so notified, and all claims for benefit shall be reckoned from the date of such notification. I will obtain from the physician designated by the Fund, a certificate of disability and present the same to the secretary when making claims for benefits, and the statements of the physician designated by the Fund shall be final; and it is fully understood and agreed upon by me that a failure to conform to any of the above requirements will act as a forfeiture and waiver of all my rights to receive benefits for such time.”
As part of his proof, it was incumbent on plaintiff to prove that he had complied with the constitution and bylaws of the Fund, and whether he did or not determines whether the trial court erred in not sustaining the Fund’s demurrer to plaintiff’s evidence. After the demurrer had been overruled, defendant did not stand on the ruling, but presented its own proof. We therefore review plaintiff’s evidence, and such parts, if any, of defendant’s evidence as may supply any omissions there may have been in plaintiff’s proof.
The plaintiff’s proof showed that he was about 52 years old in June of 1932; that over eighteen years before he had been employed
The plaintiff also testified that two or three years before he was discharged he had received benefits of $7.50 per week from the Fund.
On cross-examination he identified his signed application for membership in the Fund. It contains the statement quoted in the bylaws mentioned above.
Doctor Sanders testified that Lloyd was afflicted with spastic paralysis which had been growing gradually worse, and on June 22, 1932, it had progressed to a point where he could hardly walk, and that the paralysis had resulted in an internal complaint and had affected his ability to control his bowels. He stated spasticity is
The trial court took the matter under consideration and later rendered judgment for plaintiff as prayed for. Within three days defendant filed a request the trial court make findings of fact and conclusions of law, and its motion for a new trial. On a later day the trial court denied the motion for a new trial and made and filed its findings of fact and conclusions of law, viz.:
“Findings of Fact
“1. The defendant, Wilson’s Employees’ Mutual Benefit Fund, is a voluntary association of individuals, one of the purposes of which is to create, accumulate and maintain a fund with which to provide for its members in case of their illness or disability.
“2. From June 15, 1920, until June 18, 1932, the plaintiff in this case, Arthur Lloyd, was a member in good standing of said Wilson’s Employees’ Mutual Benefit Fund.
“3. That on June 18, 1932, plaintiff was fifty-two years of age.
“4. That prior to June 18, 1932, plaintiff had been an employee of Wilson & Company, and its predecessor, for more than seventeen years; and on June 18, 1932, he was permanently discharged from the service of Wilson & Company because of permanent disability as the result of illness not arising out of and in the course of his regular employment.
“5. That on or about June 20, 1932, an assistant secretary of Wilson’s Em*446 ployees’ Mutual Benefit Fund, C. C. Keller, was notified and knew that the plaintiff had been discharged from the service of Wilson & Company, and that said plaintiff was discharged because he was at that time permanently disabled by illness as above stated.
“6. That the constitution of said Wilson’s Employees’ Mutual Benefit Fund provides in part as follows:
“ 'Any member who, prior to attaining the age of sixty-five (65) years, suffers a permanent and total disability as a result of illness, or accidental injury not arising out of and in the course of his regular employment, shall receive in lieu of death and funeral benefits a sum equivalent to the amount to which such member would, at the time, be entitled as a death benefit, which sum shall be payable in weekly installments of $7.50.’
“7. That the amount of death benefit payable after a membership of five years was $1,000.”
“Conclusions op Law
“The plaintiff in this case is entitled to a judgment against the defendant, Wilson’s Employees’ Mutual Benefit Fund, in the total sum of $1,000, payable in weekly installments of $7.50, with interest at six percent per annum on each installment from the date it becomes due until paid; that the first of said weekly installments of $7.50 became due on June 25, 1932.”
Appellant contends that, under the constitution and bylaws, plaintiff’s membership in the Fund ceased when he was discharged on June 18, 1932, and that not having reported his disability as required by bylaw 14 quoted above, he cannot recover. It is also contended that he was disabled prior to his discharge, but made no report thereof. It will be observed from what has been stated heretofore that the Fund is made up of employees of Wilson & Co., Inc., and that while the employees are represented on its board of trustees, the control is retained by the company’s designation of a majority of the board.- The purpose of the Fund is to provide medical attention and financial benefits to the members arising from sickness or injury not compensable under the workmen’s compensation act. Regardless of what the physical condition of the claimant actually was, or what he himself thought of it, it is undisputed that on June 18, 1932, he was permanently discharged. While it was disputed, there was evidence that he was discharged because he was permanently disabled. That happened on Saturday, and on the following Monday plaintiff went to Keller, the assistant secretary of the Fund, and the proper person to whom application should be made, and asked for his benefits. At that time his demand was refused, Keller’s statement, according to the witness Boles, being:
“Arthur was discharged and there was not any possible chance for him to get anything through the insurance.”
We are of opinion that it is not necessary for us to say that bylaw 14 is unreasonable, but only that under the circumstances of this case it cannot be enforced according to its literal terms, that where the company and the Fund are as closely allied as they are here, the company may not, without notice, discharge an employee on the ground he is physically disabled when up to that time he has been constantly employed, and then have the Fund deny liability because he did not, prior to his discharge, report that he was permanently physically disabled, and especially must this be true where, as here, he immediately thereafter made demand on the Fund for the benefits due him.
It is also contended by appellant that the plaintiff knew he was totally disabled for some time before he was discharged and he was therefore bound to give notice. Of course he knew he was not physically perfect; so did the company; so did the Fund. But the
The argument that plaintiff did not furnish a certificate of the Fund’s physician and he is therefore not entitled to recover is not persuasive. It is true that section 22 of the bylaws specifies a form of application in which the applicant agrees to furnish the certificate of the physician designated by the Fund, and that plaintiff signed such an application. In the bylaws elsewhere, the only provision for such a certificate is in section 8 where, in connection with medical services, it is provided that such certificate will be furnished when required. The two provisions are not consistent in all their parts. But even if it be assumed the bylaws required plaintiff to furnish such certificate, there are four reasons why plaintiff’s failure to do so may not be relied on by the Fund: First, when demand for benefits was refused by the secretary of the Fund, it was on another and different ground. Second, the physician of the Fund was called, and his statement of plaintiff’s condition was in accord with that of plaintiff’s personal physician and not contradictory thereof. Apparently, had plaintiff been told by the secretary he needed the certificate of any particular physician it could have been procured. Third, the company discharged plaintiff because he was permanently physically disabled; the Fund ought not now be permitted to claim otherwise. Fourth, there is no showing that the Fund’s rights have in any manner been prejudiced because the claimed certificate was not furnished. From what has been said, it follows that plaintiff proved that he substantially complied with the constitution and bylaws of the Fund, and that the trial court did not err in overruling the Fund’s demurrer to plaintiff’s evidence.
Appellant’s argument that the trial court erred in its findings of fact and conclusions of law thereon, is directed principally at finding No. 5. Insofar as the contention is made that the facts as found are incorrect, we can only say that there was testimony to
The judgment of the trial court is affirmed.
Case-law data current through December 31, 2025. Source: CourtListener bulk data.